Discussion of Clinical Cases

1. Research progress on the effect of human umbilical cord mesenchymal stem cells (hUC-MSCs) on lung cancer
   Lung cancer is one of the most common malignancies with the highest morbidity and mortality in the world, and the existing treatment methods often face challenges such as toxic side effects and drug resistance. Human umbilical cord mesenchymal stem cells (hUC-MSCs) have become a promising new strategy in cancer treatment due to their unique biological characteristics (e.g., self-renewal, multi-differentiation and immune regulation). This paper reviews the mechanism of hUC-MSCs in regulating the proliferation, apoptosis, invasion and metastasis of lung cancer cells and tumor microenvironment, and discusses the dual effect of HUC-MSCs in promoting or inhibiting cancer. In addition, this paper also discusses the engineering transformation strategy of hUC-MSCs as gene and drug carriers, which provides a new research idea and theoretical basis for the development of hUC-MSC-based targeted therapy for lung cancer.
2. Kawasaki disease with G6PD deficiency: A case report and literature review

   Objective: Kawasaki disease (KD) is the leading cause of acquired heart disease in children. Aspirin is widely used in KD management, but its use in glucose-6-phosphate dehydrogenase (G6PD) deficiency is challenging due to the risk of hemolysis. This report discusses the management of KD in a child with G6PD deficiency.

   Case presentation: A 2-year-7-month-old girl presented with fever, jaundice, and rash. She developed classic KD symptoms, including conjunctival injection, strawberry tongue, and limb edema, with laboratory findings of elevated inflammatory markers, anemia, and thrombocytosis. Diagnosed with KD, she was treated with IVIG, dipyridamole, and low-dose aspirin to mitigate hemolysis risk. The patient recovered without complications, and follow-up revealed no coronary artery abnormalities.

   Conclusions: Low-dose aspirin combined with other antiplatelet agents, such as dipyridamole, may have been safely used in this patient with G6PD deficiency. Individualized treatment strategies are essential, and further research is needed to optimize aspirin use in this population.

3. Bacterial biofilms: Basic characteristics and strategies for the treatment of bacterial wound infections
   Bacterial biofilms (BFs) are widely present in nature, and more than 99% of bacteria can form BF, which is an important factor leading to persistent infection of refractory wound and repeated infection. The formation of BF is a dynamic cyclic process involving various physical, chemical and biological processes, mainly including bacterial attachment, BF formation and maturation, and bacterial diffusion. The bacteria in bacterial biofilms are more resistant to antibiotics and disinfectants, and more resilient to environmental changes, which presents many challenges in treatment. This article reviews the basic characteristics, resistance mechanisms and treatment strategies of BF. At present, there are many studies on the treatment of BF, which need to be selected according to the specific situation and pathophysiological process of wound infection, and can be used as a single method or in combination. This article introduces some treatment methods to provide a reference for the clinical prevention and treatment of BF.
4. Efficacy of cyclosporin eye drops in the treatment of dry eye after cataract surgery

   Objective: To explore the value of cyclosporin eye drops in treating dry eye after cataract surgery.

   Methods: A total of 150 patients with dry eye after cataract surgery were randomly divided into group A (n = 50), group B (n = 50), and group C (n = 50). Artificial tears combined with cyclosporin eye drops were used in group A, artificial tears were used in group B, and no dry eye medication was used in group C. The clinical efficacy, ocular surface function and tear inflammatory factor level before and after surgery were compared between the groups.

   Results: The total effective rate of group A was 96.00%, which was significantly higher than that of group B and group C (p < .05); three months after surgery, the levels of corneal fluorescein staining score (FL score), tear meniscus height (TMH) and tear inflammatory factors [interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor (TNF-α)] in group A were lower than those in group B, and those indicators in group B were lower than those in group C, and the difference between the two groups was statistically significant (p < .05); three months after surgery, Schirmer test (SIT) and break-up time (BUT) in group A were higher than those in group B, and those indicators in group B were higher than those in group C, and the difference between the two groups was statistically significant (p < .05).

   Conclusions: The effect of cyclosporin eye drops in treating dry eye after cataract surgery is satisfactory, significantly improving the ocular surface function and reducing the level of tear inflammatory factors, which is worthy of promotion.

5. Afebrile Kawasaki disease: A case report

   Objective: Kawasaki disease (KD) is an acute, self-limiting vasculitis and the most common cause of acquired heart disease in children under 5 years old. Despite over 50 years of research, the etiology and long-term prognosis of KD remain unclear.

   Case presentation: A 2-year-7-month-old boy presented with all the typical KD symptoms, including conjunctival injection, cracked lips, strawberry tongue, and membranous desquamation of the fingers and toes, but without fever. The patient was admitted with a 9-day history of peeling skin on his fingers, and no history of illness or fever in the past two weeks. Laboratory tests revealed elevated platelet count. An echocardiogram showed normal coronary arteries. The patient was diagnosed with KD and treated with low-dose aspirin and dipyridamole. He was discharged on the third day and showed complete symptom resolution and normal coronary arteries at follow-up.

   Conclusions: This case report describes an instance of afebrile KD, emphasizing the need for clinical vigilance and comprehensive assessment for diagnosis and treatment. Afebrile KD poses a diagnostic challenge as fever is a major diagnostic criterion. However, clinicians should consider afebrile KD when other clinical features and laboratory results suggest KD, and initiate appropriate treatment to prevent severe complications like coronary artery lesions. This case underscores the importance of early diagnosis, timely intervention, and multidisciplinary team collaboration for effective management of KD.