Study On Expression Of Cathepsin D By The Brain Tissue Surrounding Hematoma After Intracerebral Hemorrhage,as Well As Sthenia And Protration ZHENGs In Intracerebral Hemorrhage Patients

Objective:This study is to observe the expression of Cathepsin D in the peri-hematomal brain region of Intracerebral Hemorrhage (ICH) patients, study the roal of Cathepsin D in autophagy after ICH;and investigate into the relationship among Sthenia and Protration ZHENG, the expression of Cathepsin D, volume of blood tumor, scores of NIHSS and GCS. To provide the molecular biology standard for the microcosmic syndrome differentiation with traditional Chinese medicine (TCM) to quest for new treatment.Materials and methods:27 patients with ICH were collected and divided into three groups:YIN sthenia group,YANG sthenia group and protration ZHENG group.All were accord with the diagnosing point of ICH and must be able to be diagnosed as one of the syndromes based on the differentiation standards of TCM and undergone surgical operation,among which 14 were male and 13 were female.The age was (55.51 ± 17.35)years old.YANG excess patients were 12,among which 7 were male and 5were female.The age was(58.33±18.96)years old.YIN excess patients were 9,among which 3were male and 6were female.The age was(64.00± 13.79)years old.Prostration Patients were 6,among which 4 were male and 2 were female.The age was (52.33±13.85)years old.6 normal brain tissue were taken as normal control group.We collected the perihematomal brain tissues in the course of evacuation of hematoma in ICH group. The DUO TIAN formula was used to calculate the volume of hematoma, the NIHSS and GCS were used to score. The specimens were made strictly by the related methods. We observed the expression of Cathepsin D in the peri-hematomal brain region by using immunohistochemistry and imaging analysis.Results:1.The expression of Cathepsin D in the per-hematomal brain region of ICH patients significantly increased in comparison with the normal control group(P<0.01)2.The expression of Cathepsin D was significantly different among YANG Sthenia ZHENG,YIN Sthenia ZHENG and Protration ZHENG(P<0.01). The expression of Cathepsin D of Protration ZHENG was the highest, YIN Sthenia ZHENG second, YANG Sthenia ZHENG was the last.3.There were positive correlation among the expression of Cathepsin D and scores of NIHSS (P<0.01).There were negative correlation among the expression of Cathepsin D and scores of GCS(P<0.01).The expression of Cathepsin D showed obvious positive correlation with the hematoma volume(P<0.01).4.The hematoma volume and The scores of NIHSS and GCS were significant different among YIN Sthenia ZHENQYANG Sthenia ZHENG and the Protration ZHENG in ICH(P<0.01).The volume and the scores of NIHSS of Prostration ZHENG was the first,While YIN Sthenia ZHENG second and YANG Sthenia ZHENG was the last.While the scores of GCS was the opposite.Conclusion:1.Autophagy occurred after cerebral hemorrhage and the expression rate of Cathepsin D in the peri-hematomal brain region of ICH patients significantly increased in comparison with the normal control groups.The expression of Cathepsin D was positive correlation with the tumor volume and NIHSS score,was negative correlation with GCS score.Suggest that autophagy participated in the secondary cerebral injury of cerebral hemorrhage.Cathepsin D can be used as evaluation index of autophagic activity.2.The Cathepsin D level maybe provide the molecular biology standard for the microcosmic syndrome differentiation with TCM.Combinging the expression of Cathepsin D in brain tissue with the volume of bleeding,GCS and NIHSS score maybe provide the molecular biology standard for the microcosmic syndrome differentiation with TCM.3.Both the Sthenia of stroke and protration ZHENG in ICH could reflect the degree of brain impairment.The secondary cerebral injury of cerebral hemorrhage in Protration ZHENG is more serious than the Sthenia of stroke.4.The study prompts:we maybe provide some new ideas to treat ICH that can accommodate the expression of autophagy in the peri-hematomal brain region of ICH patients.