Study On The Observation Of Autophagy By The Brain Tissue Surrounding Hematoma After Intracerebral Hemorrhage, As Well As Sthenia And Protration ZHENGs In Intracerebral Hemorrhage Patients

Objectives:This study is to observe the number of autophagic vacuoles in the peri-hematomal brain region of intracerebral hemorrhage (ICH) patients by using transmission electron microscopy, so as to investigate into the relationship between autophagy and Sthenia ZHENG, Protration ZHENG, volume of hematoma, scores of NIHSS and GCS. To discuss the effect of autophagy and the possible mechanisms in secondary injury after intracerebral hemorrhage. To provide the molecular biology standard for the microcosmic syndrome differentiation with traditional Chinese medicine (TCM).Materials and methods:24 patients with ICH are collected and are divided into three groups:YIN Sthenia ZHENG group,YANG Sthenia ZHENG group and Protration ZHENG group. All of 24 patients(16 cases of male,8 cases of female,the average age is 58 years,aged 45-76 years old) are selected and undergone surgical intervention according to the hypertensive intracerebral hemorrhage diagnostic criteria,and they must be able to be diagnosed as one of the syndromes based on the differentiation standards of TCM.YANG Sthenia patients are 12,among which 8 patients are male and 4 patients are female. The average age is 53 years (aged 45-66 years old). YIN Sthenia patients are 8, among which 6 patients are male and 2 patients are female. The average age is 64 years (aged 57-76 years old). Protration ZHENG patients are 4,among which 2 patients are male and 2 patients are female. The average age is 62 years (aged 50-76 years old).6 normal barin tissue are taken as normal control group. All of the specimens in ICH group are collected by surgical intervention. The DUO TIAN formula was used to calculate the volume of hematoma, the NIHSS and GCS was used to score. The specimens are made strictly by the related methods. We observe autophagy in the peri-hematomal brain region by using transmission electron microscopy.Results:1.The number of autophagic vacuoles is significantly increased in the peri-hematomal brain region of ICH Patients compared with that in the normal control group(P<0.05). 2.The number of autophagic vacuoles is significantly different among YANG Sthenia ZHENG,YIN Sthenia ZHENG and Protration ZHENG group(P<0.01). The number of autophagic vacuoles:the first one is Protration ZHENG group, the second one is YIN Sthenia ZHENG and the last one is YANG Sthenia ZHENG3.The number of autophagic vacuoles expresses positive correlation to the volume of hematoma in the peri-hematomal brain region of ICH Patients(P<0.01).4.The number of autophagic vacuoles expresses positive correlation to scores of NIHSS,but the number of autophagic vacuoles expresses negative correlation to scores of GCS(P<0.01).5.The volume of hematoma and scores of NIHSS and GCS are clearly different among YANG Sthenia ZHENG,YIN Sthenia ZHENG and Protration ZHENG group(P<0.01).The volume of hematoma and scores of NIHSS:the first one is Protration ZHENG group, the second one is YIN Sthenia ZHENG and the last one is YANG Sthenia ZHENG, the scores of GCS is adverse.Conclusion:1.There is few of autophagosome and lysosome in the normal control group by using transmission electron microscopy.Lysosomal autophagy pathway can be activated in the peri-hematomal brain region of ICH Patients,there is more autophagosome and lysosome in the nerve cells.2. Autophagy is induced in the peri-hematomal brain region of ICH Patients, the number of autophagic vacuoles expresses positive correlation to the volume of hematoma and scores of NIHSS, the number of autophagic vacuoles expresses negative correlation to scores of GCS.So we speculate that autophagy may be involved in the secondary brain injury after ICH in human.3.The expression of autophagy in the peri-hematomal brain region of ICH Patients can provide some help for the microcosmic syndrome differentiation with TCM. Combining with the volume of hematoma,scores of NIHSS and GCS maybe provide evidence on diagnosing Sthenia ZHENG and Protration ZHENG with TCM.