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 optimize the method of assay for silver sulfadiazine, and to investigate its stability in high temperature, humidity and salt environment. Methods Agilent ZORBAX SB-C₁₈ column was used in HPLC for the determination of silver sulfadiazine with acetonitrile and 0.1% phosphoric acid as mobile phase.The flowing rate was 1.0 ml/min and column temperature was 30℃. Salt spray test chamber was used to simulate the high temperature, humidity and salt environment. The silver sulfadiazine content was assayed at 0, 2, 4, 6, 8, 10, 12 weeks. Results The calibration curve was linear within the range of 4.00～20.00 μg/ml (r=0.9999). The average recovery was 101.47% (RSD=2.33%). The content of silver sulfadiazine cream began to decrease significantly after 4 weeks. Conclusion This method is convenient, accurate and reliable. It can be used for the content determination of silver sulfadiazine in the cream.The results showed that the silver sulfadiazine cream was unstable in the environment of high temperature, humidity and salt. Therefore, environmental impact should be fully considered in transportation, storage and application. For the long-distance navigation mission, protective measures should be taken for its packaging or replace it with more stable products.

Objective To investigate the therapeutic effects of emodin on acute cholestatic hepatitis and mec-hanism thereof. Methods Fifty Sprague - Dawley (SD)rats were randomly divided into 5 groups and were treated with emodin,ursodeoxycholic acid,dexamethasone,or normal saline respectively for 4 days. On the fifth day gastric perfusion of alpha - naphthylisothiocyanate(ANIT)was performed to establish models of choiestatic hepatitis. Four to six hours after the establishment of model the above mentioned agents were given continuously. Forty - eight hours after the model establishment blood samples were collected from abdominal aorta to examine the total bilirubin(TB),direct bilirubin (DB),alanine aminotransferase(ALT),total bile acid(TBA),aspartate aminotransferase(AST),alkaline phosphatase (ALP),gamma glutamine transferase(GGT). Specimen of liver was collected to undergo pathological examination. Real - time PCR was used to detect the mRNA expression of farnesoid X receptor(FXR),small heterodimer partner (SHP ),bile salt export pump (BSEP ),uridine diphosphate glucuronosyltransferase 2 family polypeptide B4 (UGT2B4). Results The serum levels of total bilirubin (TB),direct bilirubin (DB),alanine aminotransferase (ALT),total bile acids (TBA),aspartate aminotransferase (AST),and alkaline phosphatase (ALP)of the model group were respectively (68. 1 ± 26. 1)μmol/ L,(46. 3 ± 20. 1)μmol/ L,(483 ± 228)U/ L,(159. 1 ± 57. 9)μmol/L,(2. 0 ± 0. 5)U/ L,(996 ± 382)U/ L,(324 ± 120)U/ L. The levels of TB,DB,ALT,TBA,AST,ALP of the emodin group were respectively (15. 0 ± 8. 7)μmol/ L,(10. 8 ± 3. 9)μmol/ L,(147 ± 71)U/ L,(60. 1 ± 22. 7)μmol/ L, (295 ± 104)U/ L,(222 ± 59)U/ L,and were all significantly lower than those of the model group (all P < 0. 05). The levels of TB,DB,ALT,TBA,AST,GGT,ALP of the emodin group were all significantly lower than those of the ursode-oxycholic acid group (all P < 0. 05). The levels of TB,DB,ALT,TBA,GGT,AST were all significantly lower than those of the dexamethasone group (all P < 0. 01). The expression levels of FXR,SHP,BSEP,UGT2B4 mRNA in the emodin group (1. 087 ± 0. 285,0. 892 ± 0. 390,0. 902 ± 0. 149,1. 785 ± 0. 403)were all significantly higher than those of the model group (0. 152 ±0. 088,0. 559 ±0. 194,0. 561 ±0. 123,0. 177 ±0. 039,all P <0. 05). Conclusions By decreasing the levels of TB,DB,ALT,TBA,AST,ALP and reducing pathological changes,emodin has a protective effect on cholestatic hepatitis. It has better effects than ursodeoxycholic acid and dexamethasone. These effects may be due to promoting FXR,SHP,BSEP and UGT2B4 expression.

Objective To understand the probability of suicide and demographic characteristics of cancer inpatients and to analyze the correlation between depression and probability of suicide.Methods From June to October 2017, we selected 310 inpatients in oncology department of two hospitals in a province as subjects by convenience sampling. The questionnaire survey was carried out in patients with the general information questionnaire, Patient Health Questionnaire-9 (PHQ-9) and Suicide Probability Scale (SPS). Pearson correlation was used to analyze the correlation between depression and probability of suicide. We also compared the differences of probability of suicide among patients with different characteristics.Results Among 310 cancer inpatients, the score of PHQ-9 was (3.96±3.46) with 7.1％ (22/310) for the incidence of depression;the score of SPS was (57.35±8.38) with 11.0％ (34/310) for the incidence of suicide idea. Depression of patients had a positive correlation with the probability of suicide (r=0.381,P<0.001). There were statistical differences in the probability of suicide among cancer inpatients with different sexes, ages, education levels, marital status and living conditions (P<0.05).Conclusions When evaluating the probability of suicide of cancer inpatients, we should pay attention to high-risk population according to different demographic characteristics. Clinical nursing workers should show solicitude for patients with depressive symptoms and provide timely medication and mental regulation for patients diagnosed with depression.

OBJECTIVE To study the clinical feature among patients with infectious fever and the antimicrobial resistance of infection pathogens.METHODS A retrospective analysis was carried out among 70 cases during recent 3 years.RESULTS The 70 strains of pathogens were isolated from blood and/or bone marrow cultures of 70 patients with infectious fever,40 strains(57.1%) were Gram-positive cocci,in which 8 strains were Staphylococcus aureus,and 32 strains were coagulase negative staphylococci(CONS);30 strains(42.9%) were Gram-negative bacilli,of which the Salmonella and Escherichia coli were the main microorganisms,53.1% of CONS were resistant to oxacillin.There were 5 strains of Gram-negative bacilli that were suspected to produce extended spectrum ?-lactamases(ESBLs),which were resistant to multiple antibiotics,the most active agent against these Gram-negative bacilli with ESBLs was imipenem.CONCLUSIONS The bacteria are mainly Grampositive cocci for the patients with infectious fever in the infectious wards.The Gram-negative bacilli with ESBLs show more multi-drug resistance,we should rationally select antibiotics and decrease the occurrence of drug resistant strains.