With the accelerating trend of population aging, the number of elderly patients with lung cancer continues to rise, and the disease burden is becoming increasingly heavy. The clinical management of these patients faces severe challenges due to their decreased physiological reserve, complex comorbidities, and significant individual heterogeneity. Consequently, under traditional diagnosis and treatment models, doctors often struggle to identify the individualized risks of elderly patients in a timely and comprehensive manner, which can easily lead to decision biases such as undertreatment or overtreatment. In view of this, this study advocates for the establishment of an umbrella decision-making model specifically tailored for elderly lung cancer patients. Grounded in a multidisciplinary team (MDT) platform, this model deeply integrates oncological indicators with the comprehensive geriatric assessment (CGA) system. By holistically considering multidimensional variables including tumor burden, organ function, frailty index, cognitive status, and social support, the model establishes an operational mechanism characterized by "single entry, precise stratification, and targeted selection". Accordingly, patients can be scientifically triaged into distinct intervention tiers, such as active surveillance, minimally invasive surgery, drug therapy, radiotherapy, and best supportive care, thereby achieving real-time alignment between treatment intensity and patient fitness. This article elaborates on the construction logic and key operational procedures of this novel decision-making framework, aiming to guide clinical practice beyond the limitations of a tumor-centric perspective toward a holistic, dynamic, whole-course management strategy. This transition seeks to ensure optimal quality of life and clinical net benefit for elderly patients alongside survival prolongation.

Objective:To observe the tracer effect of indocyanine green (ICG) surgical coaxial fluorescence projective imaging system (CFPI) and methylene blue (MB) staining method in the sentinel lymph node biopsy (SLNB) of acral malignant melanoma.Methods:Data of patients with acral malignant melanoma requiring SLNB diagnosed in the First Affiliated Hospital of University of Science and Technology of China from March 2020 to October 2022 were retrospectively analyzed. Both ICG and MB were injected intraoperatively to trace the sentinel lymph node (SLN), and SLNB was performed according to fluorescent labeling. Numbers of SLN and metastatic SLN deteted by ICG, MB, ICG combined with MB during operation were recorded. Statistical analysis was performed using Graphpad Prism 6 software, and the detected number of SLN was expressed as Mean±SD, and paired t-test was performed. The detection rate of SLN was expressed by % and χ2 test was used. P<0.05 was considered statistically significant. Results:A total of 21 patients were included, and 62 SLNs were detected, among which 58 (93.5%) were detected by ICG, 41 (66.1%) by MB, and 62 (100.0%) by ICG combined with MB, respectively. The detection rate of ICG was significantly higher than that of MB, with statistical significance ( χ2=22.34, P=0.001). The detected numbers of SLNs by ICG, MB, ICG combined with MB were (2.76±0.23), (1.95±0.21) and (2.95±0.25) /per person, respectively. ICG was significantly more than MB, and the difference was statistically significant ( t=2.60, P=0.013). A total of 10 metastatic SLNs were detected, of which 10 were detected by ICG, 7 by MB, and 10 by ICG combined with MB. Conclusion:Compared with MB, ICG CFPI showed better performance in SLNB, and ICG combined with MB showed better performance than ICG alone.

Objective:To observe the tracer effect of indocyanine green (ICG) surgical coaxial fluorescence projective imaging system (CFPI) and methylene blue (MB) staining method in the sentinel lymph node biopsy (SLNB) of acral malignant melanoma.Methods:Data of patients with acral malignant melanoma requiring SLNB diagnosed in the First Affiliated Hospital of University of Science and Technology of China from March 2020 to October 2022 were retrospectively analyzed. Both ICG and MB were injected intraoperatively to trace the sentinel lymph node (SLN), and SLNB was performed according to fluorescent labeling. Numbers of SLN and metastatic SLN deteted by ICG, MB, ICG combined with MB during operation were recorded. Statistical analysis was performed using Graphpad Prism 6 software, and the detected number of SLN was expressed as Mean±SD, and paired t-test was performed. The detection rate of SLN was expressed by % and χ2 test was used. P<0.05 was considered statistically significant. Results:A total of 21 patients were included, and 62 SLNs were detected, among which 58 (93.5%) were detected by ICG, 41 (66.1%) by MB, and 62 (100.0%) by ICG combined with MB, respectively. The detection rate of ICG was significantly higher than that of MB, with statistical significance ( χ2=22.34, P=0.001). The detected numbers of SLNs by ICG, MB, ICG combined with MB were (2.76±0.23), (1.95±0.21) and (2.95±0.25) /per person, respectively. ICG was significantly more than MB, and the difference was statistically significant ( t=2.60, P=0.013). A total of 10 metastatic SLNs were detected, of which 10 were detected by ICG, 7 by MB, and 10 by ICG combined with MB. Conclusion:Compared with MB, ICG CFPI showed better performance in SLNB, and ICG combined with MB showed better performance than ICG alone.

Objective To investigate the value of heart-type fatty acid-binding protein in the diagnosis of early myocardial infarc-tion.Methods In 186 cases of suspected acute myocardial infarction due to chest pain,chest tightness for 3 h,plasma CK-MB, troponin-I(CTn-I)and heart-type fatty acid-binding protein(H-FABP)were detected.The sensitivity and specificity in diagnosing early myocardial infarction were compared among 3 kinds of indexes.Results Compared with the non-infarction group and the con-trol group,plasma CK-MB,CTn-I and H-FABP in the acute myocardial infarction group were significantly increased (P <0.05 );compared with CK-MB and CTn-I,the sensitivity of H-FABP to the diagnosis of acute myocardial infarction within 3 h was higher, but its specificity was lower than that of CTn-I and higher than that of CK-MB.Conclusion For the patients with acute myocardial infarction within 3 h after onset,detecting H-FABP can increase the diagnostic rate of early myocardial infarction to a certain extent.