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Ensuring high slope stability has become a critical technical challenge that threatens construction safety, restricts project progress, and affects safe operation. This research utilizes 3DEC software to establish the slope model, analyze the stability of high slopes with down-layer and anti-dip slab-cracked rock bodies using the discrete element method and strength reduction method, and investigate the influence of each feature of the slab-cracked rock body on the stability of the slab-cracked structure slope. Then, a slope was designed with the reinforcement scheme of “anchor anti-slip pile + prestressed anchor cable + drainage + slope protection” as an example to analyze the effectiveness of slope reinforcement under different anti-slip pile positions and sizes and to verify the effectiveness of the slope reinforcement scheme through the displacement changes of the slope. The results show that the slope safety coefficient is positively correlated with the rock mass, thickness, and strength of the cracked body. The most obvious effect is the rock mass, and the safety coefficients of the two kinds of cracked slopes when the rock mass is the highest are 4.464 and 6.714, respectively. The displacements in the X direction and the Z direction are reduced by 78.04% and 60.34%, respectively, and the reinforced design has played the role of limiting the decline of slopes. To some extent, it can ensure the effectiveness of the slope-reinforced scheme. The design of reinforcement plays an effective role in limiting slope decline, which can provide the stability of the slope to a certain extent.

ObjectiveTo analyze the morbidity and mortality characteristics and prevalence trends of asopharyngeal carcinoma among registered residents in Yuyao City of Zhejiang Province from 2012 to 2021， and to provide suggestions for the prevention and treatment of the cancer.MethodsThe incidence and mortality data of asopharyngeal carcinoma in Yuyao City from 2012 to 2021 were collected. The incidence， mortality， standardized rate， cut-off rate， cumulative rate and annual percentage of trend change were calculated. A linear logarithmic model was used to analyze the variation trend.ResultsFrom 2012 to 2021， the crude incidence rate was 6.46/105 in Yuyao， while the Chinese standard rate was 4.78/105 and the world standard rate was 3.68/105， which all increased over the years. The indicators in males were higher than these in females （χ2=85.377， P

Objective: To analyze detection rate and changing trend of clinical multi-drug resistant bacteria(MDRB) in recent 5 years, and explore drug resistance characteristics of carbapenem resistant gram-negative bacteria, so as to provide reference for nosocomial infection prevention and control and empirical treatment of antibiotics in clinical practice. Methods: Seven kinds of MDRB isolated from clinical specimens of hospitalized patients during January 2017 to December 2021 were retrospectively analyzed, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus (VRE), extended spectrum β-lactamases producing Escherichia coli (ESBL-eco), extended spectrum β-lactamases producing Klebsiella pneumoniae (ESBL-kpn), carbapenem resistant Enterobacteriaceae (CRE), carbapenem resistant Acinetobacter baumannii (CR-AB) and carbapenem resistant Pseudomonas aeruginosa (CR-PA). The rate of carbapenem resistant gram-negative bacilli to common antibiotics and the carbapenemase production of CRE strain were analyzed with SPSS 20.0. Results: VRE was not detected in this study. Except ESBL-eco, the isolated rates of the other five MDRB increased in the past five years. The detection rates of MRSA, ESBL-kpn, CRE, CR-AB and CR-PA fluctuated between 37.0%-53.6%, 19.3%-34.3%, 2.5%-10.6%, 34.1%-63.4% and 11.3%-22.8%, respectively. It revealed that 65.4% CRE, 72.0% CR-AB, and 59.3% CR-PA isolates were isolated from ICU. The resistant rates of CRE and CR-AB to quinolones, cephalosporins and β-Lactamase inhibitor complex were 90.0%. Among 272 CRE strains, 221 strains were Klebsiella pneumoniae, accounting for 81.3%. The carbapenemase was detected in 90 strains of CRE, in which three kinds of carbapenemases (KPC, NDM and IMP) were detected and the constituent ratio of KPC enzyme was 90.0%. Conclusions: The isolated rates of six MDRB in this study are much lower than the average level in Shanghai and national tertiary hospitals in the same period, but the isolated rates of MRSA, ESBL-kpn, CRE, CR-AB and CR-PA show an upward trend, which should be paid attention to, especially the carbapenem resistant gram-negative bacteria in ICU. In this study, 90 strains of CRE tested produced three kinds of carbapenem enzymes, in which KPC enzymes showed a high proportion.

Cardiac contractility modulation (CCM) is a novel device‐based therapy used to treat patients with heart failure with reduced ejection fraction (HFrEF). In both randomized clinical trials and real‐life studies, CCM has been shown to improve exercise tolerance and quality of life, reverse left ventricular remodeling, and reduce hospitalization in patients with HFrEF. In this case report, we describe for the first time the use of CCM combined with left bundle branch pacing (LBBP) cardiac resynchronization therapy pacemaker (CRT‐P) implantation therapy in a female with a 22‐year history of non‐ischemic dilated cardiomyopathy. With the optimal medical therapy and cardiac resynchronization therapy (CRT) strategies, the patient's quality of life initially recovered to some extent, but began to deteriorate in the past year. Additionally, heart transplantation was not considered due to economic reasons and late stage systolic heart failure. This is the first case of CCM implantation in Fujian Province and the first report of a combined CCM and left bundle branch pacing CRT‐P implantation strategy in a patient with non‐ischemic etiology dilated cardiomyopathy in China. [ABSTRACT FROM AUTHOR]

A palladium catalytic method has been developed for the coupling of amides and cyclopropanols to γ-diketones, through simultaneous C–N and C–C activation. Heteroatom ligand exchange and heteroatom-to-carbon ligation mode switching enable the achievement of molecular cross-coupling in an amide N-atom structural context-dependent manner, avoiding any stoichiometric organometallic reagent or base. [ABSTRACT FROM AUTHOR]