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The automatic recognition technology of muscle fatigue has widespread application in the field of kinesiology and rehabilitation medicine. In this paper, we used surface electromyography (sEMG) to study the recognition of leg muscle fatigue during circuit resistance training. The purpose of this study was to solve the problem that the sEMG signals have a lot of noise interference and the recognition accuracy of the existing muscle fatigue recognition model is not high enough. First, we proposed an improved wavelet threshold function denoising algorithm to denoise the sEMG signal. Then, we build a muscle fatigue state recognition model based on long short-term memory (LSTM), and used the Holdout method to evaluate the performance of the model. Finally, the denoising effect of the improved wavelet threshold function denoising method proposed in this paper was compared with the denoising effect of the traditional wavelet threshold denoising method. We compared the performance of the proposed muscle fatigue recognition model with that of particle swarm optimization support vector machine (PSO-SVM) and convolutional neural network (CNN). The results showed that the new wavelet threshold function had better denoising performance than hard and soft threshold functions. The accuracy of LSTM network model in identifying muscle fatigue was 4.89% and 2.47% higher than that of PSO-SVM and CNN, respectively. The sEMG signal denoising method and muscle fatigue recognition model proposed in this paper have important implications for monitoring muscle fatigue during rehabilitation training and exercise.
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Électromyographie , Mémoire à court terme , Fatigue musculaire , 29935 , 35416RÉSUMÉ
Indirect energy metabolism measurement is the gold standard for providing nutritional support for critical illness. The accuracy of the measurement data directly affects the outcome of the disease. In order to study the influence of sampling delay on the accuracy of energy metabolism measurement under mechanical ventilation, the Matlab/Simulink platform and respiratory electrical model were used for simulation and quantitative analysis. The results show that the error of indirect energy metabolism measurement increases with the increase of sampling delay, the error of sampling delay in mechanical ventilation mode is larger than that of spontaneous breathing, and the error of sampling delay in PCV mode of mechanical ventilation is larger than that in VCV mode. Therefore, there should be different sampling delay compensation strategies under severe mechanical ventilation and its different control modes.
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Humains , Simulation numérique , Maladie grave , Métabolisme énergétique , Ventilation artificielleRÉSUMÉ
A lung diffusion function detection system is designed. Firstly, the controllable collection of air, test gas source and calibration gas source was based on single-breath method measurement principle. Secondly, pulmonary diffusing capacity for carbon monoxide (DlCO) was calculated by gas concentration measured by the non-dispersive infrared sensor to measure, the gas flow measured by the differential pressure sensor, and the temperature, humidity and atmospheric pressure sensors to test and evaluate the quantitative detection and evaluation of lung diffusion function. Moreover, a preliminary verification of the lung diffusion function detection system was implemented, and the results showed that the error of the lung carbon monoxide diffusion and the alveolar volume did not exceed 5%. Therefore, the system has high accuracy and is of great value for early screening and accurate assessment of COPD.
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Monoxyde de carbone , Poumon , Capacité de diffusion pulmonaire/méthodesRÉSUMÉ
Objective:To investigate the incidence and risk factors of human cytomegalovirus (HCMV) reactivation in immunocompetent severe pneumonia patients with mechanical ventilation and their effects on clinical outcomes.Methods:A prospective observational study was conducted. Forty-eight immunocompetent patients requiring invasive mechanical ventilation due to severe pneumonia in the department of critical care medicine of the First Affiliated Hospital of Guangzhou Medical University from June 30th, 2017 to July 1st, 2018 were enrolled. Meanwhile, all cases were followed up until 90 days after inclusion and were required to quantitatively detect HCMV DNA in serum at regular weekly intervals until 28 days after transferring to intensive care unit (ICU). Patients were divided into HCMV reactivation group (≥5×10 5 copies/L) and non-reactivation group (<5×10 5 copies/L) based on HCMV DNA at any time point within 28 days. Demographic data, basic indicators, respiratory indicators, disease severity scores, laboratory indicators, complication and clinical outcomes of the two groups were collected and analyzed. Multivariate Logistic regression analysis was performed to screen independent risk factors for HCMV reactivation. Results:All 48 subjects were tested positive for HCMV immunoglobulin G (IgG), so HCMV seropositive rate was 100%. HCMV reactivation occurred in 10 patients within 28 days after admission to ICU, and the reactivation incidence of HCMV was 20.83%. There was no significant difference in gender, age, body mass index (BMI), underling disease reasons for ICU transfer (except sepsis), basic vital signs, disease severity scores, or laboratory findings including infection, immune, blood routine, liver, kidney and circulatory indicators except neutrophils count (NEU), hypersensitivity C-reactive protein(hs-CRP), hemoglobin (Hb), blood urea nitrogen (BUN), N-terminal pro-brain natriuretic peptide (NT-proBNP) between the two groups. The height (cm: 160±6 vs. 166±8), body weight (kg: 49.4±11.2 vs. 57.6±10.5), Hb (g/L: 87±18 vs. 104±24) in HCMV reactivation group were significantly lower than non-reactivation group, as well as NEU [×10 9/L:12.7 (9.9, 22.5) vs. 8.9 (6.2, 13.8)], hs-CRP [mg/L: 115.5 (85.2, 136.6) vs. 39.9 (17.5, 130.2)], BUN [mmol/L:13.7 (8.9, 21.5) vs. 7.1 (4.9, 10.5)] and NT-proBNP [ng/L: 6 751 (2 222, 25 449) vs. 1 469 (419, 4 571)] within 24 hours of admission to ICU. The prevalence of sepsis [60.0% (6/10) vs. 15.8% (6/38)], blood transfusion [100.0% (10/10) vs. 60.5% (23/38)], hospitalization expense [ten thousand yuan: 35.7 (25.3, 67.1) vs. 15.2 (10.4, 22.0)], 90-day all-cause mortality [70.0% (7/10) vs. 21.1% (8/38)], length of ICU stay [days: 26 (16, 66) vs. 14 (9, 19)], the duration of mechanical ventilation [days: 26 (19, 66) vs. 13 (8, 18)] in HCMV reactivation group were significantly higher than non-reactivation group, and there were significant statistical differences between the two groups (all P < 0.05). Logistic regression analysis showed that sepsis was an independent risk factor for HCMV reactivation in immunocompetent mechanical ventilation severe pneumonia patients with mechanical ventilation [odds ratio ( OR) = 9.35, 95% confidence interval (95% CI) was 1.72-50.86, P = 0.010]. Conclusions:HCMV infection is very common in immunocompetent severe pneumonia patients on mechanical ventilation and incidence of HCMV reactivation is high. Moreover, HCMV reactivation could adversely affect clinical prognoses, and sepsis may be a risk factor for HCMV reactivation.
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Objective To investigate the effect of intra-articular tumor necrosis factor (TNF) inhibitor injection in patients with moderate to severe rheumatoid arthritis (RA) and values of power Doppler ultrasonography in evaluating effect of intra-articular injection.Methods RA patients with arthritis in knee and/or elbow and/or ankle referred to the Department of Rheumatology in the First Affiliated Hospital of Xi'an Jiaotong University were enrolled to receive intra-articular injection with 50 mg or 25 mg of recombinant human tumor necrosis factor-α receptor Ⅱ:IgG Fc fusion protein (TNFR:Fc) for injection after synovial fluid aspiration.Evaluation of visual analogue scale for pain of the involved joints,erythrocyte sedimentation rate (ESR),C reactive protein (CRP) and 28-joint disease activity score (DAS28) were performed before and after intra-articular TNFR:Fc injection.Synovial hypertrophy,power Doppler signal and joint effusion were analyzed and graded by ultrasound before and after intra-articular TNFR:Fc injection.Comparisons of continuous data between groups was made by t test.The data that were not normally distributed was analyzed by Mann-Whitney U rank sum test.Results Fifty-four patients with RA [6 men and 48 women,mean age (52±11) years,mean duration of disease (7±3) years] were included in this study.A significant decrease in visual analogue scale for pain of the involved joints (t=2.630,P=0.018;t=2.160,P=0.043),ESR (t=2.094,P=0.030;Z=-2.242,P=0.030),CRP (Z=-2.199,P=0.030;Z=-3.337,P=0.001) and DAS28 (t=3.579,P=0.002;t=5.538,P=0.000) were observed after one month of injection of 50 mg or 25 mg of TNFR:Fc.Synovial hypertrophy (t=2.175,P=0.036;t=2.280,P=0.030) power Doppler signal (t=2.500,P=0.020;Z=-2.504,P=0.013) and joint effusion (Z=-1.790,P=0.042;t=2.230,P=0.027) were reduced significantly after one month of intra-articular TNFR:Fc injection in knee.Synovial hypertrophy (t=2.180,P=0.034;t=2.480,P=0.030) and power Doppler signal (t=2.681,P=0.020;t=5.482,P=0.000) were also reduced significantly after one month of intra-articular TNFR:Fc injection in elbow and ankle.Conclusion Intra-articular TNFR:Fc injection is an effective and safe treatment in RA patients with monoarthritis.Ultrasound may be an objective and valid method in evaluating the effect of intraarticular TNF inhibitor injection in RA patients.
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ABSTRACT:Objective To investigate the clinical features of seronegative rheumatoid arthritis (RA)in western China and its outcomes after one-year treatment with disease modifying anti-rheumatoid drugs (DMARDs) so as to provide evidence for effective therapy.Methods We made a retrospective analysis of 240 RA patients treated in our department from May 2013 to June 2014.We compared the 47 seropositive and 25 seronegative RA patients in clinical features,laboratory parameters and outcomes after one-year DMARDs medication.Results The percentage of seronegative RA was 10.4% (25/240).The number of swollen small joints was significantly smaller in seronegative RA group (P<0 .0 1 ).Compared with those in seropositive RA,the level of hemoglobin was lower,the level of platelets was higher,and the level of alkaline phosphatase was lower in seronegative RA (P<0 .0 5 ).The remission rate was higher in seronegative RA group than in seropositive RA group after one-year DMARDs administration (P<0.05).Conclusion Seronegative RA is not rare in clinic.Even though seronegative RA patients often present fewer swollen small joints, it is difficult to distinguish between seronegative and seropositve RA just based on the clinical features.Besides,hematological damage is more severe in some patients with seronegative RA.Only after one-year treatment with DMARDs,the remission rate is higher in seronegative RA patients than in seropositve RA ones.
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BACKGROUND:Abnormal activation of lymphocytes and nuclear factorκB-dependent non-specific inflammation are two major manifestations of joint damage in rheumatoid arthritis. Co-stimulatory signal CD40/CD40L is the dominant co-stimulatory factor in the recognition and activation of T cel s. IκBαeffectively inhibits nuclear factorκB pathway, prevent the inflammation in the central link, and suppress the damage caused by inflammatory factor in the synovial tissue. OBJECTIVE:To investigate the therapeutic effect of double gene co-expressing adenovirus vector on arthritis based on an arthritis model rat transfected by CD40LIg-IRES2-IκBαco-expressing adenovirus vector. METHODS:The pAdCD40LIg-IRES2-IκBαco-expressing adenovirus vector was established. Arthritic model was established through multi-subcutaneous injections of complete Freund's adjuvant of type col agen II (1 g/L) into Wistar rats. Then 20 arthritic rats were divided into two groups:untreated group and transfection group, receiving an injection of saline and pAdCD40LIg-IRES2-IκBαadenovirus vector to distal joint cavity of limbs, respectively. RESULTS AND CONCLUSION:At 14 days post-transfection, compared with the untreated group, the mean arthritis index score, the CD40L expression of lymphocytes in synovial fluid, the nuclear factor-κB p65 expression in synovial tissue, and levels of interleukin-2, interleukin-6, tumor necrosis factor-α, matrix metal oproteinase-3 and matrix metal oproteinase-9 in synovial fluid of rats in transfection group were significantly lower than those in untreated group. Focal transfection of the CD40LIg-IκBαco-expression adenovirus vector can effectively inhibit arthritic symptoms, and reduce the expressions of inflammatory cytokine in synovial fluid and inflammatory molecule in synovial tissue of arthritic rats, which shows good therapeutic effect.
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Objective To assess the disorders of glucose metabolism and insulin resistance in patients with rheumatoid arthritis (RA) and its relationship with disease activity.Methods One hundred and twenty-three RA patients along with 98 age and sex matched controls were studied.Seventy-five g oral glucose tolerance test was performed.The homeostasis model assessment of insulin resistance (HOMA-IR) and beta cell function (HOMA-β) were evaluated.Disease activity score (DAS28) was used to assess disease activity.According to their DAS28 values,patients were divided into high disease activity group and low to moderate disease activity group.Glucose tolerance and HOMA-IR were compared between the two groups.Parameters that reflects disease activity,such as CRP and ESR,as well as disease activity scores were compared between patients with T2DM or prediabetes and patients with normal glucose tolerance.The data was analyzed by t test,Pearson correlation analysis and chi-square test.Results The prevalence of T2DM [20.3%(25/123) vs 5.1% (5/98),x2=10.774,P<0.01] and prediabetes [39.0% (48/123) vs 7.1% (7/98),x2=29.657,P<0.01] increased in RA patients compared to controls.RA patients had higher HOMA-IR (2.5±1.5 vs 0.8±0.4; t=5.185,P<0.01) and lower HOMA-β (83±69 vs 192±85; t=3.768,P<0.01) compared to controls.ESR [(55±30) mm/1 h vs (37±26) mm/1 h; t=3.159,P<0.01],CRP [(40±23) mg/L vs (19±10) mg/L; t=3.628,P<0.01] and DAS28 score (5.6±1.3 vs 4.8±1.2; t=2.923,P<0.01) were higher in RA patients with T2DM or prediabetes than in RA patients with normal glucose tolerance.In RA patients,the HOMA-IR was significantly positively correlated with DAS28 (r=0.39,P<0.01),ESR (r=0.54,P<0.01)and CRP (r=0.20,P<0.05).The HOMA-IR value and fasting insulin levels were higher in high disease activity patients (DAS28> 5.5) than in low-to-moderate disease activity patients (DAS28 ≤5.5) although fasting plasma glucose level did not differ significantly in these two groups.Conclusion The prevalence of T2DM and prediabetes increases in RA patients comparing to controls.RA patients have insulin resistance that is associated with disease activity and systemic inflammation.
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AIM:To establish a rapid in vitro method for mast cell degranulation tracing by raster image corre-lation spectroscopy (RICS).METHODS:RBL-2H3, a basophilic granulocyte mast cell line transfected with CD 63-GFP plasmid, was used for evaluating the methods , including β-hexosaminidase ( HEX) colorimetric assay, scanning electron microscopy (SEM) and RICS in the detection of mast cell degranulation .The sensibilities of these methods were com-pared.RESULTS:The sensitivities of β-HEX colorimetric assay and SEM were 5 mg/L and 3.9 ×10 -2 mg/L, respec-tively.RICS detection showed obvious decrease in the diffusion coefficient at dose of 3.9 ×10 -2 mg/L.CONCLUSION:Fluorescent molecular diffusion dynamic measurement can be used for rapid tracing of allergic substances in vitro.Accord-ing to the results, RICS can achieve nearly the same extent of sensitivity as the SEM does and is far more sensitive than β-HEX colorimetric assay.Compared with SEM, RICS has several advantages: it is faster, simpler and cheaper; it can be used in living cells;it is more suitable for rapid in vitro allergenic compounds tracing .Therefore, RICS is applicable in clinic allergic antigen screening and may also be used in pharmaceutical quality control .
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OBJECTIVE@#To investigate the diagnosis and treatment of mixed connective tissue disease (MCTD) and myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) associated vasculitis, which is a rare clinical entity in medical practice.@*METHODS@#A 35-year-old female of Asian origin was admitted to our hospital due to complaints of Raynaud's phenomenon, myalgia, arthralgia and fatigue. The patient was diagnosed as MCTD in the out-patient department 8 months prior to admission based on Alarcon-Segovia classification criteria of Raynaud's phenomenon, myalgia, arthralgia and a high anti-U1 ribonucleoprotein antibody level. Interstitial lung disease was determined by chest computed tomography. Renal biopsy was performed because of marked proteinuria on 24 h urine collection. Histopathological examination revealed glomerulonephritis with fibrocellular/cellular crescents, in which moderate staining of IgM was shown by direct immunofluorescence. She was tested positive for myeloperoxidase antineutrophil cytoplasmic antibody.@*RESULTS@#High dose of methylprednisolone (500 mg/d for 3 days) was started intravenously when the results of renal biopsy were obtained. Oral prednisone and intravenous cyclophosphamide therapy (0.8 g/month) were continued for 12 months. Daily urinary protein loss decreased dramatically and serum creatinine was maintained at a normal level.@*CONCLUSION@#Corticosteroids and cyclophosphamide are effective in the treatment of MPO-ANCA associated glomerulonephritis in MCTD.
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Adulte , Femelle , Humains , Anticorps anti-cytoplasme des polynucléaires neutrophiles , Cyclophosphamide , Glomérulonéphrite , Méthylprednisolone , Connectivite mixte , Myeloperoxidase , ProtéinurieRÉSUMÉ
Objective To explore the influence of gender and age on hip and plantar pressure changes in the sit-to-stand transition. Methods Kinematic parameters such as changes in hip joint angle,motor velocity and speed,and also plantar pressure changes such as stress,pressure and contact area were observed as subjects of different ages and genders performed sit-to-stand transitions. Results ①Hip kinematics:The speeds of trunk movement and hip joint angle change in men and women were significantly different.Their average speed in rising was also significantly different.The young and middle-aged people rose faster with faster hip joint angle changes than the elderly.Their total rising time was therefore significantly shorter as well.()Plantar pressure kinematics:The men's plantar pressures were significantly higher than those of the women throughout the rising process.The plantar pressure of the young and middle-aged subjects was also significantly higher than that of the elderly.At the last stage of sit-to-stand transfer process the ground contact area of the women's was significantly larger,on average,than that of the men,and the elderly had significantly larger contact areas than young or middle-aged people. Conclusion During sit-to-stand transfers,men and young people move faster than women or the elderly.Women and older people tend to have larger foot-ground contact areas than men and younger persons.Different rehabilitation measures are required for different ages,genders and diseases.
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Objective To measure the activity energy expenditure(AEE) of healthy adults during level walking by using indirect calorimetry,and to analyze the characteristics and underlying influencing factors such as age and gender. Methods A total of 60 healthy adults aged 20-50 years (30 males and 30 femdes) participated in the study.All the subjects were divided into six groups by gender and age (the age span of each group was 10 years). The subjects were arranged to walk at speeds of 3.5,4.5,5.5km/h and run at 5.5,6.5,7.5km/h, respectively, on the treadmill. The resting energy expenditure ( REE ) and AEE were measured during walking and running at different speeds.There was a 5-minute rest among the test sessions. Results No difference in terms of AEE between the female and male at the same age ( P > 0. 05 ). During 3.5km/h walking,AEE of 21-30 year-old females was lower than 31-40 yearold females and males( P <0.05 ) ;During 4.5km/h walking,AEE of 31-40 year-old females was higher than 21-30 yearold females and males and 41-50 year-old females; AEE of 21-30 year-old females was lower than 41-50 year-old males (P < 0.05 ) ;During 5.5km/h walking,AEE of 31-40 year-old females was higher than 21-30 year-old females and males ( P < 0. 05 ). During 6.5 km/h running, AEE of 31-40 year-old females was higher than 41-50 year-old females ( P <0.05), while during 7.5km/h running, AEE of 21-30 year-old males was higher than 41-50 year-old females (P <0.05 ). It was also found that the AEE of all groups except the 41-50 year-old females group was higher when walking at the speed of 5.5km/h than running at the same speed( P < 0.05 ). Conclusions Age has more effect on REE and AEE than the gender. AEE of elder subjects is higher than that of the younger ones during walking, however, AEE of younger people increases faster than the elders during running. AEE of 31-40 year-old females is the highest in all groups both in walking and running. AEE in running is higher than in walking at the same speed.
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Objective To investigate the effects of tegaserod on visceral sensitivity and explore the regulating mechanism.Methods Forty-two male Spragre-Dawley rats,which were induced colonic inflammation by intraluminal administration of trinitrobenzenesulfonic acid(TNBS),were randomly divided into eight groups.In the three colorectal distention(CRD) treated groups(n=6),abdominal contractions were recorded after 3,7 and 14 days of intra-gastric administration of tegaserod 2mg/kg d.In the three CRD control groups(n=4),abdominal contractions were recorded after 3,7 and 14 days of intra-gastric injection of saline 2.0mL/d.In immunohistochemistry(IH) treated group(n=6) and IH control group(n=6),samples of colon were removed and processed for SP and CGRP immunohistochemistry after 7 days of intra-gastric administration of tegaserod and saline,respectively.Results Abdominal contractions induced by colonic distention decreased significantly at 1.2mL and 1.6mL distention volume after 3 days of tegaserod administration(P
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Objective The aim of this study was to investigate Fos expression in rat lumbarsacral spinal cord and medulla oblongata induced by chronic colonic inflammation. Methods Twenty six male Sprague Dawley rats were divided into three groups: group 1, colonic inflammation was induced in sixteen rats by intraluminal instillation of trinitrobenzenesulfonic acid (TNBS); group 2, saline was instilled intraluminally in eight rats; group 3, no stimulation was given in 2 rats. After 3, 7, 14 and 28 days of instillation, lumbarsacral spinal cord and medulla oblongata were removed and processed for Fos immunohistochemical staining. Results Fos neurons induced by TNBS instillation were mainly distributed in deep laminae (laminae Ⅲ Ⅳ,Ⅴ Ⅵ) in spinal dorsal horn and in medullary visceral zone in medulla oblongata. The number of Fos cells in the spinal cord and medullary visceral zone was significantly higher in rats after 7 and 14 day of TNBS instillation compared with that of controls. After 28 days of TNBS instillation, the number of Fos neurons in the medullary visceral zone decreased and became comparable to that of control group. However, the number of Fos cells (54.1?16.3) in the spinal cord in some rats was still significantly higher than that of controls (12.2 ?2.6, P
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Objective To investigate the responses of astrocytes and neurons in rat lumbosacral spinal cord and medulla oblongata induced by chronic colonic inflammation,and the relationship between activated astrocytes and neurons.Methods Thirty-three male Sprague-Dawley rats were randomly divided into two groups.In treated group(n=17),colonic inflammation was induced by intraluminal administration of trinitrobenzenesulfonic acid(TNBS) in rats;In non-treated group(n=16),saline was intraluminally administered.The lumbosacral spinal cord and medulla oblongata were removed 3,7,14 and 28 days after intraluminal administration and processed for anti-GFAP,Fos and GFAP/Fos immunohistochemistry. Results Most activated GFAP positive astrocytes were distributed in the superficial laminae(Ⅰ-Ⅱ),intermediolateral nucleus(lamina Ⅴ),posterior commissural nucleus(laminae Ⅹ) and anterolateral nucleus(laminae Ⅸ) in lumbosacral spinal cord.Fos positive neurons were mainly expressed in the deeper laminae of the spinal cord(Ⅲ-Ⅳ,Ⅴ-Ⅵ).In the medulla oblongata,both GFAP-IR astrocytes and Fos-IR neurons were mainly distributed in medullary visceral zone(MVZ),which is composed of the nucleus of solitary tract(NTS),ventrolateral medulla(VLM) and intermediat reticular(IRt).The density of GFAP positive astrocytes in the spinal cord in treated rats 3,7 and 14 days after TNBS administration was significantly higher than that in non-treated rats(P0.05).Conclusions The astrocytes in lumbosacral spinal cord and medulla oblongata can be activated by colonic inflammation.The response of astrocytes decreased with the recovery of the colonic inflammation.Activated astrocytes are closely related to activated neurons in MVZ.