Develop Portable Quinary Channels Gastrointestinal Sound Monitoring System And Pilot Clinical Application

Objective:To develop the portable quinary channels gastrointestinal sound monitoring system (PQCGISMS) so as to afford facilitated, objective and noninvasive gastrointestinal function monitoring apparatus for clinical purpose. By monitoring the gastrointestinal sound(GIS) of the healthy people and the elderly diabetic respectively, to analyze the GIS characteristics, relevant factors and changing rules to provide the reference for the study of gastrointestinal motility and nursing practice.Methods:1. To develop the portable digital GIS signal acquisition device with chips of suitable parameters covering the GIS characteristics and use of blueteeth technique.2. To combine spectrum analysis, power spectrum density estimation, smoothing filtering, principal component analysis and pattern recognition methods to develop the GIS automatic identification and analytic software.3.120 healthy subjects were monitored by the PQCGISMS in fasting, after eating solid meal and liquid meal, respectively, in order to analyze the GIS characteristics of the healthy people and construct pilot evaluation criteria for the PQCGISMS, and to explore the effect of age, the meal properties, and the monitor sites on the GIS.4.60 elderly diabetics were monitored by the PQCGISMS in fasting. Then fasting blood-glucose (FBG) and glycosylated hemoglobin (GHb) were measured. Compared to the healthy elderly, we discussed the feature of fasting GIS of the elderly diabetic and the correlation between the fasting GIS and FBG, so was that of GHb.Results:1. The design and selected components of the signal acquisition device met the characteristics of GIS, the experiments showed that the signals were reliably authentic.2. The accuracy rate of automatic identification and analysis ranged from 71% to 74%, and manual correction could improve the recognition accuracy.3. The GIS of healthy people showed a skewed distribution, while the correlation coefficients of the healthy people GIS in five sites of the abdomen were low.4. Compared to the healthy adults, the healthy elderly had the less number of GIS, the shorter time of GIS, the lower power of GIS. There were difference between the healthy adults and the healthy elderly in the number of GIS (P<0.001), the percentage of GIS time (P<0.001), the mean of GIS time (P<0.01), and the mean of GIS power (P<0.01), but no difference in the mean of GIS frequency (P>0.05).5. Compared to condition of fasting, the meal increased the number of GIS, lengthened the time of GIS, increased the power of GIS, and liquid meal made the significant difference. There were differences in the number of GIS (P<0.001), the percentage of GIS time (P<0.001), the mean of GIS time (P<0.001), the mean of GIS power (P<0.001) among fasting, solid meal and liquid meal, while no statistical difference in the mean of GIS frequency (P>0.05), except the mean of GIS frequency in the sigmoid colon (P=0.041) was near to the significant statistical borderline.6. Compared to the healthy elderly in fasting, the elderly diabetic had the less number of GIS and the shorter mean of GIS time. There were difference in the number of GIS (P<0.05), and the mean of GIS time (P<0.05) in stomach, ileocecus and sigmoid colon. There were no statistical difference in the mean of GIS frequency (P>0.05), except in the sigmoid colon (P=0.021).7. There were no statistical correlation between fasting GIS and FBG (P>0.05), neither was that of GHb (P>0.05), except the mean of GIS power in the sigmoid colon(rs=0.26, P=0.044).Conclusions:1. PQCGISMS could record the GIS reliably, and could automatically and accurately identify and analyze GIS. It provided a research foundation for optimizing clinical noninvasive gastrointestinal function monitoring technique.2. There were wide ranges of GIS among healthy individuals, and low relevance of GIS among different sites of gastrointestinal tract.3. Age, eating and meal properties were pertinent factors caused the change of GIS.4. There were slight correlation of integrated GIS among five sites around the abdomen, GIS should be monitored at multiple sites simultaneously.5. Compared with the healthy elderly, the elderly diabetic had weak GIS in stomach, ileocecus and sigmoid colon.6. There was no statistical correlation between fasting GIS and FBG, neither was that of GHb, except the mean of GIS power in the sigmoid colon.