Peripheral Blood Single Cell Sequencing Analysis of Postoperative Delirium (POD) and Chronic Postsurgical Pain (CPSP) in Elderly Patients After Total Knee Arthroplasty
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Postoperative Delirium
- Sponsor
- Xuzhou Central Hospital
- Enrollment
- 10
- Locations
- 1
- Primary Endpoint
- Visual analogue scale（VAS）
- Status
- Recruiting
- Last Updated
- 3 years ago
Overview
Brief Summary
Single-celled sequencing for evaluating differences in gene expression patterns in different cell types of the dynamics of a means of this research as a starting point, to study the postoperative delirium and chronic pain at the cellular level changes the contents of a cell, reveal its occurrence and development of the role of gene regulation, find targets and biomarkers, and to provide new ideas for its pathogenesis, To provide theoretical basis support for its prevention, clinical diagnosis and treatment.
Detailed Description
The aim of this study was to investigate leukocyte heterogeneity in patients undergoing total knee arthroplasty with POD, paired non-POD patients, and cognitively normal healthy subjects by single cell sequencing, and to investigate leukocyte heterogeneity in patients with chronic pain and patients with pain relief after surgery through postoperative pain follow-up. Moreover, multi-omics single cell technology is used to analyze various cellular contents in a single cell simultaneously, which can capture molecular footprints with higher resolution. Comprehensive analysis of multiple omics datasets reveals the relationships between cellular patterns, establishes complex regulatory networks, and provides a holistic view of cellular state. From a single cell level analysis of POD and occurred in patients with chronic pain in patients with the characteristics of the white blood cells, looking for the peripheral immune system in the pathogenesis of the POD and the potential role of chronic pain occurs, may provide POD pathogenesis and chronic pain occurred an important visual Angle, may also help to provide POD biomarkers and therapeutic targets, To provide a possible solution for the prevention and treatment of postoperative delirium and postoperative chronic pain.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age ≥65 years old, regardless of gender.
- •total knee arthroplasty for the first time.
- •The ASA classification is I-Ⅲ.
Exclusion Criteria
- •severe neurological or psychiatric disorders
- •drug and alcohol abuse
- •patients on antidepressants
- •failure and decompensation of vital organs
- •chronic pain from previous surgery or trauma
Outcomes
Primary Outcomes
Visual analogue scale（VAS）
Time Frame: 3 months after the surgery
A moving scale measuring about 10cm in length was used, with 10 scales on one side and "0" and "10" ends, respectively, with 0 indicating no pain and 10 indicating the most severe pain that could not be endured.
Leeds Assessment of Neuropathic Symptoms and Signs（LANSS）
Time Frame: 3 months after the surgery
Make the needle perpendicular to the patient's skin, and apply different pressure on the skin to determine whether the patient has touch-induced pain.
Difference of single cell sequencing before and after surgery
Time Frame: 1 day before surgery，1 day after surgery
Leukocytes were isolated from peripheral blood and then sorted for subsequent single-cell sequencing analysis. Unbiased, high-throughput and high-resolution transcriptome analysis of single cells can reveal the gene structure and gene expression status of single cells, reflect the heterogeneity between cells, classify and analyze them, and carry out personalized research
3-minute Diagnostic Interview for CAM (3D-CAM)
Time Frame: Consecutive 7 days after the surgery
Postoperative delirium was assessed by 3-minute Diagnostic Interview for confusion assessment method (CAM).
Short form McGill pain questionnaire（SF-MPQ）
Time Frame: 3 months after the surgery
SF-MPQ is composed of sensory and emotional descriptors of pain, current pain intensity and visual analogue scale.
Pain catastrophizing scale(PCS)
Time Frame: 3 months after the surgery
PCS is defined as a belief system, a coping strategy and an evaluation process when experiencing and feeling pain.