Estrogen receptor α36(ERα36),a splice variant of ERα66,is crucial in the pathogenesis,progression,and therapeutic resistance of female estrogen-related tumors(e.g.,breast,cervical,and endometrial cancers)as it uniquely activates non-genomic signaling pathways.This review provides a comprehensive summary of the structural features of ERα36 and its molecular mechanisms in regulating tumor prolif-eration,migration,and drug resistance via membrane-mediated pathways,including phosphatidylinositol 3-kinase/protein kinase B(PI3K/AKT)and mitogen-activated protein kinase/extracellular signal-regulated kinase(MAPK/ERK).The interaction between ERα36 and epi-dermal growth factor receptor/human epidermal growth factor receptor2(EGFR/HER2)forms a positive feedback loop that exacerbates ma-lignant transformation.High ERα36 expression is associated with decreased sensitivity to chemotherapy and resistance to tamoxifen.Recent studies have demonstrated that natural compounds and synthetic inhibitors targeting ERα36 can reverse drug resistance and suppress can-cer stem cell activity by blocking non-genomic signaling.This review provides novel insights into overcoming drug resistance and optimizing targeted therapies for female estrogen-related malignancies.

Lung cancer is one of the leading causes of cancer-related death worldwide.In China,the incidence and mortality rates of lung cancer are constantly rising.Effective screening and diagnostic methods are crucial for improving patient survival rates.Currently,the early screening methods for lung cancer are insufficient.Serum tumor markers as conventional screening indicators,have relatively low sensitivity and are mainly used for monitoring treatment efficacy and prognosis.Tumor-associated autoantibodies(TAAbs)as emerging biomarkers,include seven types:p53,PGP9.5,SOX2,GAGE7,GBU4-5,MAGE A1 and CAGE.Due to their detectability in the early stage of lung cancer,long half-life,high sensitivity and specificity,they have attracted extensive attention from researchers.This article reviews the generation mechanisms,characteristics and the applications of these seven TAAbs in the diagnosis of lung cancer.Based on domestic and international research,this paper reviews the sensitivity and specificity of these autoantibodies in the diagnosis of lung cancer,and focuses the development of multi-factor combined detection strategies,the combination of traditional tumor markers and imaging techniques(such as low-dose CT)to further enhance the diagnostic efficiency of lung cancer,aiming to achieve early and accurate diagnosis.

Lung cancer is one of the leading causes of cancer-related death worldwide.In China,the incidence and mortality rates of lung cancer are constantly rising.Effective screening and diagnostic methods are crucial for improving patient survival rates.Currently,the early screening methods for lung cancer are insufficient.Serum tumor markers as conventional screening indicators,have relatively low sensitivity and are mainly used for monitoring treatment efficacy and prognosis.Tumor-associated autoantibodies(TAAbs)as emerging biomarkers,include seven types:p53,PGP9.5,SOX2,GAGE7,GBU4-5,MAGE A1 and CAGE.Due to their detectability in the early stage of lung cancer,long half-life,high sensitivity and specificity,they have attracted extensive attention from researchers.This article reviews the generation mechanisms,characteristics and the applications of these seven TAAbs in the diagnosis of lung cancer.Based on domestic and international research,this paper reviews the sensitivity and specificity of these autoantibodies in the diagnosis of lung cancer,and focuses the development of multi-factor combined detection strategies,the combination of traditional tumor markers and imaging techniques(such as low-dose CT)to further enhance the diagnostic efficiency of lung cancer,aiming to achieve early and accurate diagnosis.

Objective To use multiple model integration to predict the potential distribution of suitable areas for Hedysari Radix in China and the main environmental factors affecting its distribution.Methods Based on 119 geographical distribution points obtained from species distribution databases,and incorporating 19 bioclimatic and topographic factors,a species distribution model was constructed using the Biomod2 software package 3.5-1 version ensemble modeling platform,integrating six algorithms including generalized linear model,gradient boosting machine,random forest,and others.Geographic information system spatial analysis methods were used to quantitatively assess the distribution characteristics of suitable habitats of Hedysari Radix under current climate conditions and under future climate scenarios,while identifying the primary environmental drivers of its distribution.Results The ensemble model showed significantly superior predictive performance.TSS value and AUC value were 0.924 and 0.992,respectively.Key environmental factors significantly influencing the distribution of Hedysari Radix included slope,aspect,daily average temperature difference,isothermity,seasonal variation coefficient of temperature,lowest temperature in the coldest month,annual precipitation,driest month precipitation,and seasonal variation coefficient of precipitation.Under current climate conditions,suitable habitats for Hedysari Radix were primarily concentrated in the regions of Longnan and Dingxi in Gansu Province,covering an area of approximately 26.17×104 km2.Under future climate scenarios,suitable habitats will gradually shift toward the northwest into lower temperature zones,with a significant reduction in area.Conclusion The habitat suitability model developed in this study provides a basis for the conservation and sustainable utilization of Hedysari Radix genetic resources,while also offering a methodological reference for ecological adaptability studies of medicinal plants.

Objective To analyze the habitat suitability status of Rhododendron anthopogonoides Maxim.in Gansu and Qinghai Provinces;To predict its potential suitable areas in different climate scenarios;To provide references for the protection and rational utilization of Rhododendron anthopogonoides Maxim.Methods The MaxEnt model,combined with ArcGIS 10.3,was used to simulate and analyze the potential habitat suitability and spatial distribution of Rhododendron anthopogonoides Maxim.under current and future climate conditions,using species distribution data and environmental factors.Additionally,the habitat suitability was classified,and key environmental factors influencing the distribution of Rhododendron anthopogonoides Maxim.under current climate conditions were identified through a comprehensive evaluation of factor contribution rates and validation using the Jackknife method.Results The predicting results showed that under the current climate,the total area of potential suitable habitat for Rhododendron anthopogonoides Maxim.was 21.27×104 km2,primarily distributed in Lanzhou,Linxia Hui Autonomous Prefecture and Gannan Tibetan Autonomous Prefecture in Gansu Province,and in Xining,Haidong,Huangnan Tibetan Autonomous Prefecture and Hainan Tibetan Autonomous Prefecture in Qinghai Province.Under different future climate scenarios,the potential suitable habitat area was projected to increase by 4.51%to 21.91%,and migrating to high altitude areas.Elevation,precipitation in the driest month,annual precipitation and the average temperature in the driest quarter were identified as the main environmental factors influencing the distribution of Rhododendron anthopogonoides Maxim.Conclusion Under different climate scenarios in the future,the habitat area of Rhododendron anthopogonoides Maxim.in Gansu and Qinghai Provinces is showing an increasing trend,which can provide reference for the protection and rational utilization of Rhododendron anthopogonoides Maxim.resources under climate change.

Objective To use multiple model integration to predict the potential distribution of suitable areas for Hedysari Radix in China and the main environmental factors affecting its distribution.Methods Based on 119 geographical distribution points obtained from species distribution databases,and incorporating 19 bioclimatic and topographic factors,a species distribution model was constructed using the Biomod2 software package 3.5-1 version ensemble modeling platform,integrating six algorithms including generalized linear model,gradient boosting machine,random forest,and others.Geographic information system spatial analysis methods were used to quantitatively assess the distribution characteristics of suitable habitats of Hedysari Radix under current climate conditions and under future climate scenarios,while identifying the primary environmental drivers of its distribution.Results The ensemble model showed significantly superior predictive performance.TSS value and AUC value were 0.924 and 0.992,respectively.Key environmental factors significantly influencing the distribution of Hedysari Radix included slope,aspect,daily average temperature difference,isothermity,seasonal variation coefficient of temperature,lowest temperature in the coldest month,annual precipitation,driest month precipitation,and seasonal variation coefficient of precipitation.Under current climate conditions,suitable habitats for Hedysari Radix were primarily concentrated in the regions of Longnan and Dingxi in Gansu Province,covering an area of approximately 26.17×104 km2.Under future climate scenarios,suitable habitats will gradually shift toward the northwest into lower temperature zones,with a significant reduction in area.Conclusion The habitat suitability model developed in this study provides a basis for the conservation and sustainable utilization of Hedysari Radix genetic resources,while also offering a methodological reference for ecological adaptability studies of medicinal plants.

Estrogen receptor α36(ERα36),a splice variant of ERα66,is crucial in the pathogenesis,progression,and therapeutic resistance of female estrogen-related tumors(e.g.,breast,cervical,and endometrial cancers)as it uniquely activates non-genomic signaling pathways.This review provides a comprehensive summary of the structural features of ERα36 and its molecular mechanisms in regulating tumor prolif-eration,migration,and drug resistance via membrane-mediated pathways,including phosphatidylinositol 3-kinase/protein kinase B(PI3K/AKT)and mitogen-activated protein kinase/extracellular signal-regulated kinase(MAPK/ERK).The interaction between ERα36 and epi-dermal growth factor receptor/human epidermal growth factor receptor2(EGFR/HER2)forms a positive feedback loop that exacerbates ma-lignant transformation.High ERα36 expression is associated with decreased sensitivity to chemotherapy and resistance to tamoxifen.Recent studies have demonstrated that natural compounds and synthetic inhibitors targeting ERα36 can reverse drug resistance and suppress can-cer stem cell activity by blocking non-genomic signaling.This review provides novel insights into overcoming drug resistance and optimizing targeted therapies for female estrogen-related malignancies.

Objective To analyze the habitat suitability status of Rhododendron anthopogonoides Maxim.in Gansu and Qinghai Provinces;To predict its potential suitable areas in different climate scenarios;To provide references for the protection and rational utilization of Rhododendron anthopogonoides Maxim.Methods The MaxEnt model,combined with ArcGIS 10.3,was used to simulate and analyze the potential habitat suitability and spatial distribution of Rhododendron anthopogonoides Maxim.under current and future climate conditions,using species distribution data and environmental factors.Additionally,the habitat suitability was classified,and key environmental factors influencing the distribution of Rhododendron anthopogonoides Maxim.under current climate conditions were identified through a comprehensive evaluation of factor contribution rates and validation using the Jackknife method.Results The predicting results showed that under the current climate,the total area of potential suitable habitat for Rhododendron anthopogonoides Maxim.was 21.27×104 km2,primarily distributed in Lanzhou,Linxia Hui Autonomous Prefecture and Gannan Tibetan Autonomous Prefecture in Gansu Province,and in Xining,Haidong,Huangnan Tibetan Autonomous Prefecture and Hainan Tibetan Autonomous Prefecture in Qinghai Province.Under different future climate scenarios,the potential suitable habitat area was projected to increase by 4.51%to 21.91%,and migrating to high altitude areas.Elevation,precipitation in the driest month,annual precipitation and the average temperature in the driest quarter were identified as the main environmental factors influencing the distribution of Rhododendron anthopogonoides Maxim.Conclusion Under different climate scenarios in the future,the habitat area of Rhododendron anthopogonoides Maxim.in Gansu and Qinghai Provinces is showing an increasing trend,which can provide reference for the protection and rational utilization of Rhododendron anthopogonoides Maxim.resources under climate change.

OBJECTIVE To explore the predictive factors of cefoperazone/sulbactam-induced thrombocytopenia in adult inpatients， and to establish and validate the nomogram prediction model. METHODS Data of adult inpatients treated with cefoperazone/sulbactam in Xi’an Central Hospital from Jun. 30th， 2021 to Jun. 30th， 2023 were retrospectively collected. The training set and internal validation set were randomly constructed in a 7∶3 ratio. Singler factor and multifactor Logistic regression analysis were used to screen the independent predictors of cefoperazone/sulbactam-induced thrombocytopenia. The nomogram was drawn by using “RMS” of R 4.0.3 software， and the predictive performance of the model was evaluated by the receiver operating characteristic curve and C-index curve. Hosmer-Lemeshow goodness-of-fit test was used to evaluate the calibration degree of the model. Using the same standard， the clinical data of hospitalized patients receiving cefoperazone/sulbactam in Xi’an First Hospital in the same period were collected for external validation of the nomogram prediction model. RESULTS A total of 1 045 patients in Xi’an Central Hospital were included in this study， among which 67 patients suffered from cefoperazone/sulbactam-induced thrombocytopenia， with an incidence of 6.41%. After the false positive patients were excluded， 473 patients were included finally， including 331 in the training set and 142 in theinternal validation set. Multifactor Logistic regression analysis showed that age [OR＝1.043， 95%CI （1.017， 1.070）]， estimated glomerular filtration rate （eGFR） [OR＝0.988，95%CI（0.977， 0.998）]， baseline platelet （PLT） [OR＝0.989， 95%CI（0.982， 0.996）]， nutritional risk [OR＝3.863， 95%CI（1.884， 7.921）] and cumulative defined daily doses （DDDs） [OR＝1.082， 95%CI（1.020， 1.147）] were independent predictors for cefoperazone/sulbactam-induced thrombocytopenia （P＜0.05）. The C-index values of the training set and the internal validation set were 0.824 [95%CI （0.759， 0.890）] and 0.828 [95%CI （0.749， 0.933）]， respectively. The results of the Hosmer-Lemeshow test showed that χ 2 values were 0.441 （P＝0.802） and 1.804 （P＝0.406）. In the external validation set， the C-index value was 0.808 [95%CI （0.672， 0.945）]， the χ 2 value of the Hosmer-Lemeshow test was 0.899 （P＝0.638）. CONCLUSIONS The independent predictors of cefoperazone/sulbactam-induced thrombocytopenia include age， baseline PLT， eGFR， nutritional risk and cumulative DDDs. The model has good predictive efficacy and extrapolation ability， which can help clinic identify the potential risk of cefoperazone/sulbactam-induced thrombocytopenia quickly and accurately.

Background At present, the practice of pulmonary rehabilitation for pneumoconiosis in China is in a primary stage. The basis for formulating an individualized comprehensive pulmonary rehabilitation plan is still insufficient, which is one of the factors limiting the development of community-level rehabilitation work. Objective To formulate an exercise prescription based on maximum heart rate measured by cardiopulmonary exercise test (CPET), conduct an individualized comprehensive pulmonary rehabilitation program with the exercise prescription for patients with stable pneumoconiosis, and evaluate its role in improving exercise endurance and quality of life, thus provide a basis for the application and promotion of pulmonary rehabilitation. Methods A total of 68 patients were recruited from the Occupational Disease Prevention Hospital of Jinneng Holding Coal Industry Group Co., Ltd. from April to August 2022 , and were divided into an intervention group and a control group by random number table method, with 34 cases in each group. All the pneumoconiosis patients participated in a baseline test. The control group was given routine drug treatment, while the intervention group received multidisciplinary comprehensive pulmonary rehabilitation treatment on the basis of routine drug treatment, including health education, breathing training, exercise training, nutrition guidance, psychological intervention, and sleep management, whose exercise intensity was determined according to the maximum heart rate provided by CPET. The rehabilitation training lasted for 24 weeks. Patients were evaluated at registration and the end of study respectively. CPET was used to measure peak oxygen uptake per kilogram (pVO₂/kg), anaerobic threshold (AT), carbon dioxide equivalent of ventilation (EqCO₂), maximum metabolic equivalent (METs), and maximum work (W_max). The modified British Medical Research Council Dyspnea Questionnaire (mMRC), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Chronic Obstructive Pulmonary Disease Assessment Test (CAT), and Short Form of Health Survey (SF-36) were used to evaluate the potential effect of the comprehensive pulmonary rehabilitation program. Results Among the included 68 patients, 63 patients were having complete data, then 31 cases were assigned in the control group and 32 cases in the interventional group. Before the intervention, there was no significant difference in pVO₂/kg, AT, EqCO₂, METs, or W_max between the two groups (P>0.05). At the end of the trail, the indicators like pVO₂/kg [(19.81±2.38) mL·(min·kg)⁻¹], AT [(14.48±2.33) mL·(min·kg)⁻¹], METs (5.64±0.69), and W_max [(85.25±14) W] of patients in the intervention group were all higher than those [(13.90±2.37) mL·(min·kg)⁻¹, (11.70±1.94) mL·(min kg)⁻¹, (3.97±0.70), and (61.77±14.72) W, respectively] in the control group (P<0.001); there was no significant difference in EqCO₂ between the two groups (P=0.083). Before the trial, there was no significant difference in mMRC, SAS, SDS, PSQI, or CAT scores between the two groups (P>0.05). At the end of the trail, the mMRC score (1.16±0.57), SAS score (27.93±2.12), SDS score (26.48±1.44), PSQI score (1.08±0.88), and CAT score (4.34±3.28) of patients in the intervention group were lower than those [(2.03±0.83), (35.87±6.91), (34.23±6.65), (5.37±3.03), and (13.87±7.53), respectively] in the control group (P<0.001). The SF-36 scores of bodily pain (94.13±10.72), general health (87.50±5.68), vitality (95.31±5.53), mental health (99.88±0.71), and health changes (74.22±4.42) in the intervention group were higher than those [(71.87±32.72), (65.81±15.55), (74.52±16.45), (86.97±16.56), and (29.84±13.50), respectively] in the control group (P<0.001), and no significant difference was found in social functioning and role emotional scores (P>0.05). Conclusion Comprehensive pulmonary rehabilitation can increase the oxygen intake and exercise endurance of pneumoconiosis patients, ameliorate dyspnea symptoms, elevate psychological state and sleep quality, and improve the quality of life.