Background: and Purpose Therapeutic target selection in noninvasive brain stimulation for poststroke motor recovery typically relies on the interhemispheric inhibition model, which is effective for mildly affected patients but offers limited benefits for severely affected individuals. The mechanisms governing recovery from moderate-to-severe stroke remain poorly understood, which hinders the development of targeted interventions. Methods: We analyzed resting-state functional magnetic resonance imaging data from patients with unilateral subcortical stroke and moderate-to-severe upper limb deficits, both pre- and postintervention, along with data from healthy controls. We developed a novel dynamic lag analysis method for identifying recovery-related homotopic sensorimotor regions with altered interhemispheric interactions. To further uncover the global reorganization pathway, we developed dynamic lateralization approaches to detect large-scale functional connectivity (FC) alterations associated with the identified regions in transient lateralization states. Results: Dynamic time-lag analysis revealed significantly reduced synchronized states in the homotopic dorsal premotor cortex (PMd) post-intervention compared with pre-intervention, which correlated with motor recovery. Further dynamic lateralization analysis revealed a prolonged segregation state in patients, characterized by weakened interhemispheric and strengthened intrahemispheric interactions. In this state, patients showed decreased FC in the ipsilesional PMd and increased FC in the contralesional PMd with bilateral subcortical networks. These recoveryrelated alterations were absent in the traditional static analysis. Conclusions Dynamic analyses targeting interhemispheric interactions are valuable for understanding neural reorganization after stroke. The diminished interactions between the homotopic PMd indicate a compensatory mechanism. Importantly, a state-dependent compensatory pathway was identified, wherein the contralesional PMd assumes the functions of the ipsilesional PMd through enhanced interactions with subcortical structures, potentially guiding more effective interventions.

Results of the IMbrave150 clinical study showed that atezolizumab plus bevaci-zumab have better overall survival and progression-free survival than sorafenib in the treatment of hepatocellular carcinoma patients. However, hepatocellular carcinoma patients with esophageal varices were not included in the IMbrave150 clinical study mainly considering the bleeding risk of patients undergoing treatment of bevacizumab. The authors introduce the atezolizumab plus bevaci-zumab treatment of an advanced hepatocellular carcinoma patient with moderate esophageal varices. By reducing the dose of bevacizumab, the patient achieved an excellent curative effect.

Objective:To investigate the correlation between positive rate of thyroid autoantibodies in healthy people and thy -roid dysfunction.Methods:Fasting blood from 3218 healthy examined people in Cangzhou were collected and the serum was separa -ted.Automatic electrochemiluminescence immunoassay systems and reagents were used to determine the concentration of thyroid stimu -lating hormone(TSH),free triiodothyroninthyroid(FT3),free thyroxine(FT4),peroxidase antibody(TPOAb)and thyroglobulin antibody ( TgAb ) .TPOAb>34 U/ml and TgAb>115 U/ml was positives.Statistical analysis of test results .statistica analysis of test reults.Results:The positive rate of thyroid autoantibodies of tested population was 16.19%.The positive rates of TPOAb and TgAb were 14.57%,12.74%separately.The detection rate of TPOAb and TgAb was 11.12%in tested population.The positive rate of TPO-Ab and TgAb and TPOAb+TgAb were 6.92%,5.68%,5.03%separately in 1532 male subjects and were 21.53%,19.16 ,16.67%separately in 1686 female subjects,which were significantly higher in female group than that in male group (P<0.001).They gradually increased with age and reached a peak above 70 years old in female group and in 50-59 in male group.The positive rate and OR of thy-roid autoantibodies in hyperthyroidism and subclinical hyperthyroidism and in hypothyroidism and subclinical hypothyroidism and in hy -pothyroidism and subclinical hypothyroidism were statistically significant .Conclusion:The positive incidence of thyroid autoantibodies is higher in healthy people of Cangzhou .It is essential to follow-up these people of normal thyroid function with positive autoantibodies in order to facilitate prevention and early diagnosis and treatment of thyroid disease .

Objective To know about the abnormal condition of thyroid function in healthy population of urban residents in Cangzhou City,to reduce the incidence of thyroid disease to provide a reference.Methods Urban residents participated in a health checkup were selected as respondents in Cangzhou from 2013 to 2015,whose thyroid examination and laboratory test data of thyroid function were collected.Statistical analysis of thyroid dysfunction was performed.Results Totally 3 218 healthy controls with 248 cases of thyroid dysfunction were tested.The detectable rate was 7.71％.The detectable rates of hypothyroidism,subclinical hyperthyroidism,hypothyroidism,and subclinical hypothyroidism were 0.81％ (26/3 218),0.68％ (22/3 218),1.83％ (59/3 218),and 4.38％ (141/3 218),respectively.The prevalence of subclinical thyroid disease (5.07％) was higher than that of clinical thyroid disease (2.64％,x2 =32.140,P ＜ 0.01).The detectable rates of thyroid dysfunction from 2013 to 2015 were 2.73％ (24/879),6.54％ (71/1 086),and 12.21％ (153/1 253),respectively.The differences among the three were statistically significant(x2 =69.443,P＜0.01).The detectable rate of male thyroid dysfunction was 3.20％ (49/1 532)and female was 11.80％ (199/1 686).The women's rate was significantly higher than that of men (x2 =12.806,P ＜ 0.01).The majority of patients were in the 40 to under 50 and older than 70 years of age which accounted for 10.25％ (65/634) and 10.40％ (31/298),respectively.Conclusions The detectable rate of thyroid dysfunction in healthy population of urban residents in Cangzhou City is increasing year by year,most cases are subclinical hypothyroidism.In the future,early diagnosis and differential diagnosis of thyroid diseases should be strengthened and appropriate intervention measures should be taken to reduce the incidence of thyroid and related diseases.