The Relationship Between the Disorder of Circadian Clock Gene and Early Cognitive Dysfunction After General Anesthesia
试验速览
- 阶段
- 不适用
- 入组人数
- 1,000
- 试验地点
- 1
- 主要终点
- Blood samples and Apolipoprotein E genotyping
研究概览
简要总结
Postoperative cognitive dysfunction (POCD) is a common postoperative complication in patients aged 65 and over, which refers to cognitive function changes such as memory decline and attention deficit after anesthesia and surgery. In severe cases, personality changes and social behavior decline may also occur, resulting in irreversible cognitive impairment.Previous studies have suggested that cognitive dysfunction after general anesthesia is linked to a genetic disorder of the body clock.Exosomes are cellular forms of cellular microvesicles containing complex RNA and proteins.Exosomes can mediate the expression of genes in the late transcriptional period of the clock system, and directly or indirectly participate in the negative regulation of rhythm expression of minute control genes, playing an important role in the intercellular circadian rhythm information output pathway.Rhythm disorders in the core biological clock system of urinary exosomes and the clock control genes related to kidney can early indicate circadian rhythm changes in the core biological clock system.The sorting and detection of urinary exosome clock information materials in patients has the advantages of easy access, continuous monitoring, early diagnosis and less damage, making urinary exosome a biomarker for the diagnosis and monitoring of circadian rhythm of a good kidney biological clock system.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 90 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •patients whose age ≥ 18 years old and <90 years of preoperative sleep disorder;
- •Primary cancer patients who had not received any radiotherapy or chemotherapy before surgery;
- •Surgeries expected to be performed under general anesthesia after ≧3 hours
排除标准
- •a history of schizophrenia, epilepsy, Parkinson's disease, or myasthenia gravis;
- •inability to communicate due to coma, severe dementia, language impairment or serious illness;
- •critically ill (preoperative ASA (American Society of Anesthesiologists)>III), Childe-Pugh C or severe renal insufficiency (preoperative dialysis);
- •Neurosurgery.
研究组 & 干预措施
General anesthesia Group
干预措施: receiving general anesthesia (Other)
Healthy control group
结局指标
主要结局
Blood samples and Apolipoprotein E genotyping
时间窗: at the end of surgery
peripheral blood was collected from each patient for apolipoprotein E genotyping.
Neurocognitive testing
时间窗: 3 years after surgery
Neurocognitive testing was performed preoperatively and 6 weeks postoperatively, followed up 1 and 3 years postoperatively.
Core clock gene and kidney clock control gene detection
时间窗: at the end of surgery
The urine exosomes were extracted by overspeed centrifugation method. The mRNA ( messenger ribonucleic acid) expression results of the core heart clock gene and the renal bell control genes in the urinary exosomes were detected by timing and quantitative PCR(Polymerase Chain Reaction) and the rhythm was analyzed
Neurocognitive testing
时间窗: one day before the surgery
Neurocognitive testing was performed preoperatively and 6 weeks postoperatively, followed up 1 and 3 years postoperatively.
Neurocognitive testing
时间窗: 6 weeks after surgery
Neurocognitive testing was performed preoperatively and 6 weeks postoperatively, followed up 1 and 3 years postoperatively.
Neurocognitive testing
时间窗: 1 year after surgery
Neurocognitive testing was performed preoperatively and 6 weeks postoperatively, followed up 1 and 3 years postoperatively.
次要结局
未报告次要终点
研究者
Yanchao Yang
Principal investigator
Shengjing Hospital
