Objective To evaluate the pelvic floor function in post-hysterectomy patients. Methods Transperineal pelvic ultrasound was used to observe the pelvic organs in post- hysterectomy patients, and parameters of pelvic floor were measured. Taking the inferior margin of public symphysis as the reference plane,the shape and motion of the proximal urethra and bladder neck were observed at rest and on maximum Valsalva maneuver. Bladder neck-symphyseal distance(BSD) and retrovesical angle were measured. And the bladder neck descent(BND),urethral rotation angle and the rotation angle of the bladder neck were also calculated. Interclass correlation coefficients were calculated to evaluate the consistency of data. Results At rest,the BSD and retrovesical angle were (-2.73±0.37)cm and (119.00±22.40)°, while on maximum Valsalva maneuver was (-0.25±0.67)cm and (114.74±21.50)°,respectively. BND was (2.46±0.59)cm,the urethral rotation angle and the rotation angle of the bladder neck was (70.68±19.91)° and (60.81±17.34) °,respectively. Combined with pelvic ultrasound and clinical manifestations,29 cases of pelvic floor dysfunction after hysterectomy were diagnosed (58.00%, 5 cases of stress urinary incontinence, 8 cases of proctoptoma and 16 cases of bladder prolapse). The consistency was very high in measuring BNS, retrovesical angle at rest and on maximum Valsalva maneuver and BND by different observers. The interclass coefficient was 0.90,0.89,0.91,0.88,0.92,respectively. And the interclass coefficient of urethral rotation angle and the rotation angle of the bladder neck was 0.79, 0.88,respectively. These results showed a good interobserver agreement. Conclusion Transperineal pelvic ultrasound is a simple,reproducible and noninvasive imaging method, which can reveal the position and function of female pelvic organ dynamically and evaluate postoperative pelvic floor function.

Objective To evaluate the effects of modified method of fixation and withdrawal of needles in intravenous infusion.Methods The modified method of two-step fixation and withdrawal of needles was adopted in emergency transfusion room of our hospital from September 2013.In January 2015,during every day's low peak period 12:00-14:00,246 emergency transfusion patients were chosen and divided into the traditional group (122 cases,using three-step fixation and withdrawal of needles) and the modified group (124 cases,using two-step fixation and withdrawal of needles) according to transfusion order.The pain degree caused by withdrawal of needles using Numeric Rating Scale (NRS),time consumption of fixation and withdrawal of needles and rate of adhesive pastes abscission was assessed by nurses and compared between two groups.Results The incidence of pain in the modified group was lower than that of the traditional group [48.39％ (60/124) vs.81.97％ (100/122)],x2=30.49,P＜0.05.The time consumption of fixation and withdrawal of needles in the modified group was shorter than that of the control group [(7.55 ±2.01) seconds vs.(10.88 ±2.72) seconds;(2.44 ±0.84) seconds vs.(11.55 ± 4.62) seconds],Z=8.70,13.55,P＜0.05.Therate of adhesive pastes abscission in the modified group was lower than that of the control group [4.0％(5/124) vs.18.9％ (23/122)],x2 =13.39,P＜0.05.All the difference between two groups was statistically significant.Conclusions The modified method of fixation and withdrawal of needles can relieve the pain caused by withdrawal of needles.Nurses can operate easily,adhesive pastes is fixed sturdily,which is popular among nurses and patients.

Objective:To evaluate the effect of the comprehensive reforms of clinic-pharmacy separation and medical-consumables expenditure linkage in Beijing.Methods:Monitoring data of the comprehensive reforms were collected from 363 public medical institutions in Beijing between January 2016 and December 2019, while descriptive analysis and interrupted times series analysis using segmented regression models were adopted to analyze the influence of the two reforms on medical expense and its structure. We also studied the impact mechanism of service utilization and service price factors on medical expense control.Results:During the period from 2016 to 2019, the medical expenditure of public medical institutions in Beijing increased steadily at an annual growth rate of 4.4%-7.2%. The proportion of drug expense decreased from 44.6% in 2016 to 34.6% in 2019, while the proportion of medical service expense rose from 15.6% in 2016 to 24.3% in 2019, the proportion of examination and laboratory test expenses respectively showed a significant decline in April 2017 and June 2019. These two months witnessed respectively the launch of the two comprehensive reforms. Service utilization played an important role in controlling outpatient and emergency expenses, and service price was the key factor for controlling inpatient expenditure.Conclusions:The implementation of the two reforms in Beijing has effectively curbed the unreasonable growth of medical expenditure, and the expense structure has been constantly optimized and labor value of medical staff gradually improved.