The Disorder of Circadian Clock Gene and Early Cognitive Dysfunction After General Anesthesia

Study Overview
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Brief Summary
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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.

Official Title
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The Relationship Between the Disorder of Circadian Clock Gene and Early Cognitive Dysfunction After General Anesthesia

Conditions
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Postoperative Delirium, General Anesthesia, Exosomes, Clock Gene, Circadian Rhythm Disorders

Intervention / Treatment
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* Other: receiving general anesthesia


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 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 Exclusion Criteria: 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.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: General anesthesia Group<br> | Other: receiving general anesthesia<br>* patients receiving surgery under general anesthesia<br>|
| No Intervention: Healthy control group<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neurocognitive testing | Neurocognitive testing was performed preoperatively and 6 weeks postoperatively, followed up 1 and 3 years postoperatively. | one day before the surgery | 
| Neurocognitive testing | Neurocognitive testing was performed preoperatively and 6 weeks postoperatively, followed up 1 and 3 years postoperatively. | 6 weeks after surgery | 
| Neurocognitive testing | Neurocognitive testing was performed preoperatively and 6 weeks postoperatively, followed up 1 and 3 years postoperatively. | 1 year after surgery | 
| Neurocognitive testing | Neurocognitive testing was performed preoperatively and 6 weeks postoperatively, followed up 1 and 3 years postoperatively. | 3 years after surgery | 
| Core clock gene and kidney clock control gene detection | 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 | at the end of surgery | 
| Blood samples and Apolipoprotein E genotyping | peripheral blood was collected from each patient for apolipoprotein E genotyping. | at the end of surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Postoperative Delirium, general anesthesia, Exosomes, clock gene, Circadian Rhythm Disorders