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.

Multiple myeloma (MM) is a malignant disease characterized by clonal plasma cell proliferation, with metabolic reprogramming. Abnormal metabolism of amino acids, glucose, lipids and nucleotides plays a crucial role in various pathological processes in MM, such as proliferation, metastasis, immune escaping and drug resistance. This review summarized the application of metabolomics technology in identifying biomarkers for MM and targeting related metabolic pathways. The objective is to guide further investigations into the metabolic mechanisms underlying MM and encourage innovation in clinical diagnosis and treatment strategies for this disease.

Multiple myeloma (MM) is a malignant disease characterized by clonal plasma cell proliferation, with metabolic reprogramming. Abnormal metabolism of amino acids, glucose, lipids and nucleotides plays a crucial role in various pathological processes in MM, such as proliferation, metastasis, immune escaping and drug resistance. This review summarized the application of metabolomics technology in identifying biomarkers for MM and targeting related metabolic pathways. The objective is to guide further investigations into the metabolic mechanisms underlying MM and encourage innovation in clinical diagnosis and treatment strategies for this disease.

Objective To investigate the systolic synchrony of the left ventricle in patients with left ventricular hypertrophy (LVH) or with heart failure but preserved ejection fraction (HF-PEF),and to evaluate the impact of systolic dyssynchrony on left ventricular function.Methods During June 2011 to May 2014,a total of 352 patients(160 males,192 females,average age:(67.6±7.8)years) with essential hypertension (EH) were enrolled in this retrospective study.Ultrasonic and G-MP1 were performed for assessment of left ventricular remodeling and systolic synchrony and the results were statistically analyzed by oneway analysis of variance and x2 test.Relationship between BNP and synchronic parameters as well as other clinical factors were analyzed by partial correlation analysis.Results The EH patients were divided into hypertension group (rt =182),LVH group (n =74) and HF-PEF group (n =96).In comparison to hypertension group,significant LVH developed in LVH and HF-PEF groups although the LVEF was still preserved.The LVMI of the 3 groups were (94.4±10.1),(121.1±9.8) and (123.2±10.9) g/m2,respectively(F=8.66,P＜0.05).The LVEF was (58.6±7.3)％,(60.8±10.4)％ and (55.1±4.6)％,respectively(F=2.89,P＞0.05).Diastolic dysfunction was identified in LVH and HF-PEF groups with significantly reduced E/A ratio (1.19±0.23,0.80±0.28,0.67±0.17;F=13.46,P＜0.05).Remarkable left ventricular systolic dyssynchrony with phase histogram bandwidth (PHB) of (88.4±8.6) ° and phase standard deviation (PSD) of (23.6±1.9)° and increased BNP of (228.4±69.7) ng/L were revealed in HF-PEF group.The BNP in HF-PEF group was significantly higher than that in LVH group((92.5±13.6) ng/L;q=8.63,P＜0.05).Positive correlation was found between BNP level and PHB,PSD,LVMI,respectively (r=0.277-0.331,all P＜0.05).Conclusion Left ventricular systolic dyssynchrony is concomitant with HF-PEF patients induced by EH,and this dyssynchrony might be one of the factors leading to diastolic dysfunction.