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1
"The overall article processing by the Journal was good and I have previously published in this Journal with good citations. I shall ..."
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"The overall article processing by the Journal was good and I have previously published in this Journal with good citations. I shall surely consider the Journal for my future papers and am happy to recommend the Journal to my friends and academic circles. With the publications of good quality papers the Journal's academic journey is expected to excel in near future to receive a good impact factor. Best wishes to the Journal and its editing team. Professor Joseph M Pappachan MD, FRCP "
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Manoj RJ, Fernandez CJ, Nair S, Pappachan JM. Incretin polyagonists as an alternative to bariatric surgery to manage obesity. World J Gastrointest Pathophysiol 2026; 17(1): 118132
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"Dear editors of the World Journal of Gastrointestinal Pathophysiology, I express my gratitude to you for your effective collaboration ..."
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"Dear editors of the World Journal of Gastrointestinal Pathophysiology, I express my gratitude to you for your effective collaboration in preparing this manuscript for publication. I look forward to continued collaboration in preparing manuscripts for publication. I also thank you for distributing my article to authoritative scientists working in the field of gastric cancer prevention and Helicobacter pylori epidemiology. "
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Kotelevets SM. Clinical significance of a possible route of transmission of Candida and Helicobacter pylori associations in gastroduodenal pathology. World J Gastrointest Pathophysiol 2026; 17(1): 118294
3
"All is good! Thank you very much for publishing our article. We have no complaints about the article submission system, the work of ..."
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"All is good! Thank you very much for publishing our article. We have no complaints about the article submission system, the work of the reviewers, the layout of the article, or the publication process in general. The reviewers' comments were clear, relevant, understandable, and did not present any conflicts of interest. "
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Kiseleva Y, Maslennikov R, Poluektova E, Zolnikova O, Sigidaev A, Zharikov Y, Shirokova E, Ivashkin V. Microbiome-immune interactions in autoimmune liver diseases. World J Gastroenterol 2026; 32(12): 115853
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"Very professional process. I appreciate the integrity, the transparency and the time spent to complete the process. After acceptance, ..."
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"Very professional process. I appreciate the integrity, the transparency and the time spent to complete the process. After acceptance, the production process was smooth, and the article was published within the expected time without any delays. Overall, my experience with your journal is excellent and i, as already done, highly recommend it to my colleagues. "
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Attieh P, Al Hazzouri A, Al Qassab M, Mansour E, Rizk N, Karam K, Fiani E, Farhat SG. Gastric intestinal metaplasia: Management and surveillance strategies. World J Gastrointest Pathophysiol 2026; 17(1): 118156
5
"This journal has made a profound impression on me; its operations represent a perfect blend of efficiency and rigor. From submission ..."
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"This journal has made a profound impression on me; its operations represent a perfect blend of efficiency and rigor. From submission to online publication, the entire process runs exceptionally smoothly and swiftly, with a review cycle that is significantly shorter than the field average, greatly reducing wait times. The editorial office’s workflow is highly standardized, with strict scrutiny of manuscript formatting, ethical standards, and academic norms; every detail reflects a high level of professionalism. The reviewers’ comments were not only precise and insightful but also highly constructive, playing a crucial role in clarifying the research approach, enhancing the depth of argumentation, and improving the overall quality of the manuscript. Overall, this is an excellent journal that both respects authors’ time and upholds academic integrity. "
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Yan F, Xue XL, Guo Y, Zhang QR, You RR, Shang J, Wu XP, Geng JW, Gao XH, Ye Q, Liang J, Wang XY, Zeng JY, Chen J, Lin YC, Chen XY, Du Q, Yin WL, Liu L, Wang F, Xu BG, Zhang WH, Xiang HL. Baseline hepatitis B surface antigen and cirrhosis predict extended interferon therapy in chronic hepatitis B: A retrospective study. World J Gastroenterol 2026; 32(12): 116287
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"I would like to extend my sincere appreciation to the editorial team and the reviewers for their professional and efficient handling ..."
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"I would like to extend my sincere appreciation to the editorial team and the reviewers for their professional and efficient handling of our manuscript (Manuscript NO: 115664). The peer review process was rigorous and timely, and the reviewers' insightful comments were instrumental in enhancing the quality of our paper. The online submission system was user-friendly, and the communication from the editorial office was clear and helpful throughout the publication process. We are very satisfied with the final version of our article and the overall experience with World Journal of Gastrointestinal Oncology. We hope the journal will continue to uphold its high standards and publish more impactful research in the field of gastrointestinal oncology. Thank you for your support. "
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Chen QX, Zeng WM, Zhang YB, Cai YC, Lv CB, Sun YQ, Cai LS. Preoperative circulating tumor cells as a prognostic indicator in gastric cancer. World J Gastrointest Oncol 2026; 18(3): 115664
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"I am pleased to share my feedback on the three evaluation surveys regarding my experience with this journal. First, concerning the ..."
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"I am pleased to share my feedback on the three evaluation surveys regarding my experience with this journal. First, concerning the journal's credibility, I found it to be highly reputable with transparent policies and strong ethical standards, which inspired confidence in submitting our work. Second, the peer review process was exceptionally professional and constructive; the reviewers provided insightful and detailed comments that significantly improved the quality of our manuscript, and the review timeline was reasonable. Overall, I am thoroughly satisfied with the entire publishing system. The editorial team was responsive, supportive, and maintained clear communication throughout, making this a smooth and positive experience. I commend the journal for maintaining high standards and fostering an author-friendly environment. This has been one of the best publishing experiences I have had, and I would gladly consider this journal for future submissions. "
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Ning ZX, Xiao JJ, Zhou ZX. Artificial intelligence-assisted endoscopy in the detection of early gastrointestinal cancer: Progress, challenges, and future directions. World J Gastroenterol 2026; 32(12): 115990
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"It is a great honor to see our work, "Clinical and endoscopic characteristics of early gastric signet ring cell carcinoma based on ..."
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"It is a great honor to see our work, "Clinical and endoscopic characteristics of early gastric signet ring cell carcinoma based on Helicobacter pylori infection status," published in the World Journal of Gastrointestinal Oncology. We sincerely thank the editorial team and reviewers for their insightful feedback, which greatly enhanced the rigor and clarity of our manuscript. We also extend our gratitude to all co-authors for their invaluable contributions. We hope our findings will raise clinical awareness of eGSRCC and contribute to more personalized, safe endoscopic management strategies. "
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Lu Q, Xiong F, Gu HC, Peng QZ, Yao J, Li DF, Huang BW, Wang LS. Clinical and endoscopic characteristics of early gastric signet ring cell carcinoma based on Helicobacter pylori infection status. World J Gastrointest Oncol 2026; 18(3): 116561
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"We deeply appreciate the Editor’s insightful suggestions and constructive feedback, which have significantly improved the quality ..."
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"We deeply appreciate the Editor’s insightful suggestions and constructive feedback, which have significantly improved the quality and clarity of this work. We are also thankful for the patience and meticulous attention given to our manuscript during the revision stages. It has been a great honor to have our work handled by such a dedicated editor. "
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Wang XX. Maternal factors contributing to variability in gut microbiota and gastrointestinal function in autism spectrum disorders. World J Psychiatry 2025; 15(12): 109906
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"First I want to express my appreciate, It truely is such an honor to have this wonderful chance to submitted our work on World Journal ..."
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"First I want to express my appreciate, It truely is such an honor to have this wonderful chance to submitted our work on World Journal of Orthopedic . The manuscript submit system and peer review procedure is very friendly and professional. It was a nice experience indeed. Hope we can submit more research to this prestige journal and published on this prestige journal. "
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Li X, Ma SH, Gong HL, Wen J, Li FL, Xiao S. Surface electromyography signal characteristics of lower limb muscles in children with unilateral developmental dysplasia of the hip. World J Orthop 2026; 17(3): 115251
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"I'm very glad that my paper has been published in World Journal of Orthopedics. That is attributed to the diligent and meticulous ..."
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"I'm very glad that my paper has been published in World Journal of Orthopedics. That is attributed to the diligent and meticulous work of the editorial team and the peer review experts. Here, I sincerely thank you all for your time and efforts. Best regards to World Journal of Orthopedics! "
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Yang FC. Avulsion fracture of the ischial tuberosity: Is the current evidence sufficient to resolve the challenges of treatment selection? World J Orthop 2026; 17(3): 113095
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"I would like to take this opportunity to express my sincere appreciation for the journal's professional and thorough editorial process. ..."
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"I would like to take this opportunity to express my sincere appreciation for the journal's professional and thorough editorial process. The feedback provided was exceptionally constructive and insightful. Addressing these valuable comments has substantially strengthened our manuscript and enhanced its overall quality. We are truly grateful for the editors' and reviewers' time and effort. "
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Kou GJ, Shen J, Li LX, Zuo XL, Li YQ. Lactobacillus acidophilus attenuates polyethylene glycol-induced susceptibility to Citrobacter rodentium infection via microbiota modulation. World J Gastroenterol 2026; 32(11): 114335
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"Thank you for providing me the opportunity to publish my work. I am very happy with the review process and response time. I will ..."
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"Thank you for providing me the opportunity to publish my work. I am very happy with the review process and response time. I will definitely contribute in future in the WJEM. I am very happy to be part of Baishideng publishing group. All the process was very smooth and on time. Earlier also we have published with BPG. "
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Bhardwaj S, Pandey S, Ghosh DK, Sharma T, Jain BP. Deciphering the interplay between hypoxia, angiogenesis, and endoplasmic reticulum stress in carcinogenesis: A narrative review. World J Exp Med 2026; 16(1): 115478
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"The World Journal of Nephrology provided a professional and transparent publication process for our study on shear-wave elastography. ..."
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"The World Journal of Nephrology provided a professional and transparent publication process for our study on shear-wave elastography. The peer review was rigorous, offering expert insights into the correlation between imaging and histopathology. Editorial communication was efficient, ensuring a smooth workflow from submission to final production. As an Open Access platform, the journal effectively disseminates specialized clinical findings, maintaining high credibility through thorough editing and global visibility. "
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Prasad R, Verma R, Singh A, Behera MR, Yachha M, Kushwaha RS, Jain M, Agrawal V, Yadav P, Lal H. Renal elasticity assessment in patients of glomerulonephritis by shear-wave elastography and its correlation with histopathology and renal biomarkers. World J Nephrol 2026; 15(1): 116148
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"The editorial process of this journal is exceptionally professional and efficient. Throughout the submission and peer-review stages, ..."
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"The editorial process of this journal is exceptionally professional and efficient. Throughout the submission and peer-review stages, the editorial team provided timely updates and constructive feedback that significantly enhanced the quality of our manuscript. I am particularly impressed by the rigorous attention to detail during the final proofreading phase, ensuring that all figures and technical data meet high publication standards. The clear communication and rapid turnaround times made the entire process seamless. I highly recommend this journal to fellow researchers in the field. "
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Huang WJ, Zhao XR, Cao YQ, Huang XZ, Lai WL, Xi Y, Wu HY. Subhepatic ectopic pregnancy in Müllerian anomaly localized by large-field-of-view magnetic resonance imaging: A case report. World J Clin Cases 2026; 14(8): 117957
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""I appreciate your accurate, timely work and cooperation! For this multidisciplinary effort, the reviewer's remarks and recommendations ..."
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""I appreciate your accurate, timely work and cooperation! For this multidisciplinary effort, the reviewer's remarks and recommendations were very beneficial. We look forward to publishing our work in order to develop new scientific partnerships and exchange ideas for other research concerns. On behalf of all the authors, I would like to thank you for accepting our paper for publication. "
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Hegazy M, Fathy M, Ashoush O, Abdelshafy S, Abdelfatah D, Saad S, Abd El-Moniem S, Ibrahim W, Ashraf O, Saleh S, Ahmed T, Adly R, Abdel-Wahab A, Ahmed A, Hussein S, Othman A, Abdelghani A. Egypt’s metabolic dysfunction associated steatotic liver disease: Genetic and dietary nexus, shaping artificial intelligence driven healthier future. World J Gastroenterol 2026; 32(11): 114243
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"I would like to thank the editorial team and reviewers of World Journal of Orthopedics for their professional and efficient handling ..."
[Read more]
"I would like to thank the editorial team and reviewers of World Journal of Orthopedics for their professional and efficient handling of our manuscript. The entire process was smooth, and the constructive feedback helped improve our work. I am satisfied with the experience and would consider submitting again in the future. Wishing the journal continued success. "
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Long JQ, Yang H, Cheng YW, Shen T, Zou JY, Zhang GW. Percutaneous vertebroplasty and compression screw fixation for osteoporotic vertebral fractures with bilateral pedicle fractures: A case report. World J Orthop 2026; 17(3): 117393
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"We are happy and delighted to work with you! The whole process was very interesting and straightforward, leading to a very satisfactory ..."
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"We are happy and delighted to work with you! The whole process was very interesting and straightforward, leading to a very satisfactory final result! We hope for further future cooperation! With BPG we feel that our academic efforts are further enhanced and get stronger! We are grateful to you for your trust! "
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Papamichalis P, Papathanasiou SK, Skoura AL, Oikonomou KG, Xanthoudaki M, Papadogoulas A, Valsamaki A, Plageras D, Papamichalis M, Katsiafylloudis P, Papapostolou E, Mantzarlis K, Koukoulis A, Koukoulis GD, Parisi K, Papapostolou G, Siokas V, Dardiotis E, Chovas A. Correlation between esmolol usage in the acute phase of ischemic stroke and outcomes of patients undergoing intravenous thrombolysis. World J Clin Cases 2026; 14(8): 117167
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"I admire the high level of professionalism demonstrated by the journal, as well as the rigor of its peer-review process. Everything ..."
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"I admire the high level of professionalism demonstrated by the journal, as well as the rigor of its peer-review process. Everything is well organized and clearly managed through the journal’s submission and tracking system. I believe the journal could consider publishing more issues in order to accommodate the growing demand for publication and to further increase its visibility and reach. I would also like to thank the editorial team for their professionalism and commitment. "
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Gazal G, Alsalhani AB, Tarakji B, Nassani MZ. Evidence-based review and clinical practice recommendations for the diagnosis and management of common oral mucosal lesions. World J Exp Med 2026; 16(1): 115535
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"In this case, a 17-year-old woman presented with upper abdominal pain for two weeks. A large irregular-shaped ulcer on the antrum ..."
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"In this case, a 17-year-old woman presented with upper abdominal pain for two weeks. A large irregular-shaped ulcer on the antrum was identified by endoscopy and the C-14 breath test was positive. Quadruple therapy was given to eradicate H. pylori, but her symptoms persisted after treatment. No significant improvement in the antral ulcer was found on secondary gastroscopy. Gynecologic examination observed characteristic vulvar syphilis. Serum tests revealed that she was co-infected with syphilis and HIV. Immunohistochemistry (IHC) staining confirmed the coexistence of H. pylori and T. pallidum in gastric mucosa biopsy. The gastric symptoms rapidly disappeared after anti-syphilis treatment, and she was finally diagnosed with GS, H. pylori and HIV triple infection. "
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Zhang JL, Wei N, Chen TM, Qiu W. Triple infection of gastric syphilis, Helicobacter pylori and human immunodeficiency virus: A case report. World J Gastroenterol 2026; 32(11): 115809
20982 items Read more >>
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" The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. ..."
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" The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied"
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Siyal M, Tahseen MU, Asim M, Niaz TS, Zakaria N, Leghari A, Niaz SK. Slipped and caught in the cecum: Endoscopic retrieval of a migrated foley feeding jejunostomy tube: A case report. World J Clin Cases 2026; 14(8): 118316
2
"Researchers have concluded that elastography can provide an objective assessment of esophageal varices and may serve as a non-invasive ..."
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"Researchers have concluded that elastography can provide an objective assessment of esophageal varices and may serve as a non-invasive screening tool for diagnosis and treatment indication. While abdominal ultrasound follow-up is recommended for patients with chronic liver disease, ultrasound elastography may allow for more appropriate screening of patients requiring esophageal varices via endoscopy. This is expected to reduce the need for upper gastrointestinal endoscopy, which is an uncomfortable procedure for patients, and enable more efficient medical care. Further large-scale prospective studies are needed to further validate the usefulness of this non-invasive assessment "
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Martínez-Díaz FM, Jiménez-Cuevas EA, Morales-Galicia AE, Ramírez-Mejía MM, Qi XS, Poo JL, Méndez-Sánchez N. Toward noninvasive prediction of treatment outcomes in patients with variceal bleeding. World J Gastroenterol 2026; 32(11): 115723
3
"It has long been established that respiratory and digestive diseases coexist in a proportion of patients. This coexistence shares ..."
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"It has long been established that respiratory and digestive diseases coexist in a proportion of patients. This coexistence shares significant pathogenetic mechanisms, including microbial, immunological, and metabolic pathways. The combined clinical manifestations of two different systems often require complex therapeutic interventions.
Thus, in recent years, the lung-gut axis has emerged as equally important, underscoring the complex bidirectional regulatory network between gastrointestinal and respiratory diseases. The clinical coexistence of digestive and respiratory system diseases in the same patient poses both diagnostic and therapeutic challenges, and their management should be rational and effective, aiming to reduce the risk of worsening the underlying diseases.
The treatment of these coexisting pathological conditions requires a deep knowledge of their pathophysiology and significant experience in treating them. The need for cooperation between the gastroenterologist and the pulmonologist for the most rational treatment of patients is self-evident. This cooperation for the treatment of combined digestive diseases with diseases of other systems, in my opinion, will be increasingly required in the coming years, as the common pathogenetic mechanisms are clarified and the therapeutic quiver is enriched with new pharmaceutical agents."
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Huang HJ, Liu PP, Dong DF. Research progress on comorbidity between gastrointestinal and pulmonary diseases from the perspective of the gut-lung axis. World J Gastroenterol 2026; 32(11): 115846
4
"Review summary and Recommendations
1. Clinical Context:
Walled-off pancreatic necrosis (WON) is heterogeneous in clinical course. ..."
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"Review summary and Recommendations
1. Clinical Context:
Walled-off pancreatic necrosis (WON) is heterogeneous in clinical course. While some patients resolve with transmural drainage alone, others deteriorate and require direct endoscopic necrosectomy (DEN). Chronological criteria, such as the 4-week cutoff in the revised Atlanta classification, do not reliably predict clinical trajectory.
2. Key Findings:
o Persistent sepsis, systemic inflammatory response syndrome (SIRS), hypoalbuminemia, anemia, extensive necrosis (>30–40%), and unfavorable anatomical patterns predict drainage failure and DEN requirement.
o Lone et al’s predictive model (AUC 0.892) demonstrates strong discriminative ability, supporting early identification of patients unlikely to respond to drainage alone.
o The concept of “passive drainage failure” captures patients at high risk, characterized by large solid debris, compartmentalized collections, and persistent systemic inflammation.
3. Step-Up vs Upfront DEN:
o Timing should not be guided solely by predefined intervals but by individualized risk assessment.
o Step-up strategies minimize unnecessary interventions but may delay care in high-risk patients.
o Upfront DEN can prevent deterioration in selected patients but carries higher procedural risk if overused.
o Guidelines support necrosectomy in cases of persistent sepsis, cavity compartmentalization, or failure of cavity collapse despite adequate drainage.
4. Safety Considerations:
o DEN is effective but carries 15–30% complication rates, including bleeding, perforation, stent occlusion, and infection exacerbation.
o Deferring DEN in patients with ongoing infection or high necrotic burden may worsen outcomes and complicate later intervention.
o Risk stratification is essential to balance procedural risk against the risk of inaction.
5. Future Directions:
o Integration of multivariate risk models, incorporating clinical, biochemical, and imaging variables, may individualize timing decisions.
o AI and machine learning could enhance predictive accuracy, using longitudinal data and quantitative necrosis assessment.
o The paradigm shift is toward intervention guided by patient-specific risk rather than temporal thresholds.
Recommendations
1. Clinical Practice:
o Implement early risk stratification in all WON cases to identify patients at high risk of drainage failure.
o Reserve step-up strategies for low-to-moderate risk patients and consider early DEN for high-risk phenotypes.
o Monitor clinical, laboratory, and imaging markers closely to guide escalation decisions.
2. Research:
o Validate predictive models like Lone et al’s across larger, multi-center cohorts.
o Investigate AI-driven, real-time risk scoring systems integrating necrosis quantification and host response metrics.
o Explore the interplay of nutritional status, necrosis morphology, and systemic inflammation as modifiers of intervention timing.
3. Guideline Implications:
o Guidelines should emphasize risk-based rather than time-based criteria for DEN.
o Step-up and upfront strategies should be framed as complementary, with risk stratification as the central decision-making tool.
Bottom Line:
Timing of DEN should transition from protocol-driven intervals to personalized, risk-guided decisions. Intervention becomes appropriate when waiting poses greater risk than acting.
"
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Singeap AM, Chiriac S, Minea H, Trifan A. Between step-up and upfront intervention: Risk stratification as the missing link in timing endoscopic necrosectomy. World J Gastrointest Endosc 2026; 18(3): 116865
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"This is a high-level evaluation of a study or meta-analysis that summarizes its overall quality, reliability, strengths, limitations, ..."
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"This is a high-level evaluation of a study or meta-analysis that summarizes its overall quality, reliability, strengths, limitations, and clinical relevance without going into excessive technical detail. It’s the type of assessment a clinician, journal reviewer, or guideline committee might write to quickly judge how much weight to give the study’s findings.
Overall Quality:
The meta-analysis includes 17 randomized controlled trials with 1,689 patients, representing a moderate-to-high-quality evidence base. The search strategy was comprehensive, covering multiple international and Chinese databases, which minimizes publication bias.
Strengths:
• Large, pooled sample size with randomized controlled trial design.
• Direct comparison between minimally invasive ES and standard TS.
• Evaluates both efficacy and safety, including recovery time and costs.
• Clinically relevant outcomes such as bleeding, prolapse, complications, and hospital stay.
Limitations:
• Variation in ES and TS techniques across studies may introduce heterogeneity.
• Follow-up durations were not consistently reported, limiting assessment of long-term outcomes and recurrence.
• Most studies had relatively small individual sample sizes, which may affect statistical power for less common complications.
Clinical Relevance:
• Provides strong evidence that ES is a safe, effective, and cost-efficient alternative to TS.
• Supports adoption of ES as a first line minimally invasive option for internal hemorrhoid treatment, especially for patients seeking faster recovery.
Conclusion:
The meta-analysis is methodologically sound and clinically meaningful. While some heterogeneity exists, the findings are consistent and indicate that ES offers meaningful advantages over TS in terms of safety, recovery, and cost. Further large-scale, multicenter studies with standardized protocols would strengthen the evidence base.
"
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Wu SY, Chen YS, Li XH, Yu TJ, Xie F, Jiang QF, Lan Y, He P, Li SC, Li WS, Chen WD. Efficacy and safety of endoscopic sclerotherapy vs traditional surgery in the treatment of internal hemorrhoids: A meta-analysis. World J Gastrointest Endosc 2026; 18(3): 116697
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"Summary: This study presents an exploratory analysis of bilateral upper limb sEMG activity in an experienced endoscopist during ..."
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"Summary: This study presents an exploratory analysis of bilateral upper limb sEMG activity in an experienced endoscopist during simulated colonoscopy, focusing on different bowel loop configurations. Key findings include:
• Muscle activation and fatigue: Complex loops significantly increase muscle load and fatigue, particularly in the left extensor digitorum and stabilizing muscles like the left flexor carpi radialis and right middle deltoid.
• Bilateral asymmetry: The left arm consistently sustains high activation, while the right arm shows task-specific activation, suggesting differential biomechanical demands for gross stabilization versus fine manipulation.
• Correlation with procedure duration: Longer insertion times are associated with more rapid fatigue in stabilizer muscles.
• Implications: These results objectively demonstrate increased biomechanical demand during challenging colonoscopy maneuvers, supporting the need for ergonomic interventions, workload management, and device design optimization.
Strengths:
• Comprehensive sEMG analysis across 14 bilateral muscles with high temporal resolution (1500 Hz).
• Clear differentiation of muscle load and fatigue patterns across loop types.
• Quantitative correlation between loop complexity, insertion time, and fatigue metrics.
• Direct applicability to ergonomic and occupational health improvements in endoscopy.
Limitations:
• Single-operator study limits generalizability.
• Simulation model may not fully capture anatomical variability and real-world procedural stress.
• Small sample size; statistical power and inter-operator variability not addressed.
Recommendations:
1. Manuscript refinement: Emphasize novelty and clinical relevance, particularly the practical applications for ergonomic device design and occupational safety protocols.
2. Future research: Recommend multi-operator studies to validate muscle activation patterns across experience levels and real-world procedures.
3. Ergonomic integration: Suggest incorporating findings into colonoscopy training programs and device evaluation to reduce repetitive strain injuries.
4. Data visualization: Consider additional heatmaps or muscle activation timelines to highlight asymmetry and fatigue progression, enhancing interpretability for clinicians.
Overall Assessment:
The study provides valuable, objective biomechanical data supporting ergonomic improvements in colonoscopy. With minor clarifications and broader context regarding clinical translation, this manuscript is suitable for publication in this journal focusing on endoscopy, and also journals directing occupational health, or medical ergonomics.
"
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Wang RG, Wang YQ, Cao H. Bilateral upper limb surface electromyography analysis during single-operator colonoscopy: Implications for ergonomics and occupational health. World J Gastrointest Endosc 2026; 18(3): 116646
7
"Summary:
This retrospective cross-sectional study evaluated 801 patients with inoperable esophageal malignancies undergoing ..."
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"Summary:
This retrospective cross-sectional study evaluated 801 patients with inoperable esophageal malignancies undergoing self-expandable metallic stent (SEMS) placement using the vertebral column and diaphragm as fluoroscopic landmarks. Patients ranged from 18–95 years (mean 50 ± 15), with 50.9% female. Dysphagia was the presenting symptom (mean duration 3.84 months), and squamous cell carcinoma was the predominant histology (74.16%). Tumors most commonly involved the middle third of the esophagus, and inoperability was primarily due to distant metastases (52.81%). Tracheoesophageal fistula was present in 6%, and the mean stricture length was 8.4 cm. Pre-stent dilatation was required in 17.4% of patients. SEMS lengths ranged from 8–18 cm. The landmark-based technique achieved 100% technical success without major immediate adverse events. Repeat interventions were minimal (1.87% re-stenting for tumor overgrowth; 1.37% dilatation for tumor ingrowth).
Reviewer Comments:
Strengths:
*Large patient cohort with comprehensive demographic and tumor characteristics.
*Clear demonstration of technical feasibility and safety of landmark-based SEMS placement.
*Low rates of immediate complications and repeat interventions indicate procedural reliability.
Limitations:
*Retrospective design limits causal inference and generalizability.
*Lack of comparative data with conventional SEMS placement techniques.
*No formal assessment of patient-reported outcomes (e.g., dysphagia relief scores, quality of life).
*Long-term stent patency and survival data are not reported.
Recommendations:
*Consider prospective, comparative studies to validate the landmark-based approach against standard techniques.
*Include standardized patient-centered outcomes (dysphagia scoring, nutritional status, and quality of life).
*Explore the applicability of this technique in anatomically complex or upper esophageal tumors.
*Discussion could be strengthened by addressing limitations related to stent type, tumor morphology, and fluoroscopic variability.
Overall Assessment:
The study presents a practical, reproducible technique for SEMS placement using vertebral and diaphragmatic landmarks with excellent technical success. The findings are clinically relevant, particularly for high-volume centers performing palliative esophageal stenting. Future prospective studies are warranted to assess long-term outcomes and patient-centered benefits."
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Siyal M, Asim M, Qureshi S, Ghazanfar S, Siddiqui AR, Ahmed N, Altaf A, Zakaria N, Yaseen A, Kakar F, Kadir S, Hasan MK, Niaz SK. Navigating self-expandable metallic stent placement in inoperable esophageal malignancies: A landmark-based technique using the vertebral column and diaphragm. World J Gastrointest Endosc 2026; 18(3): 116060
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"This study underscores the importance of considering systemic immune modulation in H. pylori infection, particularly in DU patients, ..."
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"This study underscores the importance of considering systemic immune modulation in H. pylori infection, particularly in DU patients, and may inform future research on cytokine-mediated disease mechanisms and potential therapeutic strategies. Further, the study bridges gap between gastroenterology and systemic immunology, showing that H. pylori eradication can have meaningful systemic effects, which is clinically relevant for patient care, risk assessment, and possibly long-term outcomes. Furthermore, the findings suggest that H. pylori eradication confers systemic immunological benefits beyond the resolution of gastric pathology, including a distinct anti-inflammatory shift in duodenal ulcer patients. Incorporating disease-specific immune responses into clinical practice could support more personalized post-eradication monitoring and management. Future guidelines might consider systemic inflammation outcomes as an additional rationale for timely eradication, particularly in patients at risk for inflammation-related comorbidities."
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de Melo FF, Lemos FFB, Leal RAOS, Rocha GA, de Magalhães Queiroz DM. Helicobacter pylori eradication is associated with systemic anti-inflammatory shift in duodenal ulcer patients compared to those with gastritis. World J Gastrointest Endosc 2026; 18(3): 116958
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"Review Summary Report
Review Notes:
• The study addresses an important clinical question and provides practical guidance for ..."
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"Review Summary Report
Review Notes:
• The study addresses an important clinical question and provides practical guidance for treatment selection.
• Retrospective design and relatively small sample size, especially in the stent group, limit the strength of conclusions.
• Cost-effectiveness data are valuable but could be strengthened with more detailed breakdowns (e.g., procedural vs. post-procedural costs).
• Future prospective studies or randomized trials could validate these findings and refine patient selection criteria for SEMS use.
"
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Yuan HF, Liu P, Guo CQ, Bi YH. Comparative study of self-expandable stent placement, bougie dilation, and balloon dilation for post-inflammatory oesophageal strictures. World J Gastrointest Endosc 2026; 18(3): 117303
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"The manuscript addresses a highly relevant and timely topic in medical education. The focus on VR-based endoscopy training is ..."
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"The manuscript addresses a highly relevant and timely topic in medical education. The focus on VR-based endoscopy training is well-motivated given patient safety concerns and the growing adoption of simulation-based methods. The systematic review methodology is appropriate, and the results are clearly summarized. Overall, the manuscript is of interest to readers in gastroenterology, medical education, and simulation-based training.
• Significance: Addresses a highly relevant topic in endoscopy training and patient safety; VR-based training is of growing interest.
• Strengths:
o Clear focus on multiple endoscopic procedures (EGD, colonoscopy, ERCP, EUS).
o Adherence to PRISMA 2020 guidelines is noted.
o Quantitative outcomes (odds ratios, P-values, competency scores) enhance rigor.
o Balanced conclusion emphasizes VR as an adjunct to conventional training.
• Major Points for Revision:
o Provide detailed search strategy (databases, terms, date range) and inclusion/exclusion criteria; consider adding a PRISMA flow diagram.
o Clarify study selection and screening process; report if independent reviewers were used.
o Include risk-of-bias assessment for included studies using standard tools (e.g., Cochrane RoB 2, ROBINS-I).
o Discuss heterogeneity across studies (simulator type, trainee experience, training duration) and its impact on results.
o Address clinical relevance beyond skill metrics (e.g., patient outcomes, procedural complications, skill retention).
o Standardize outcome reporting for clarity (odds ratios, mean ± SD, pass rates).
• Minor Points:
o Ensure consistent abbreviation usage (GIE vs GI endoscopy).
o Simplify complex sentences for readability.
o Include review registration information if available (e.g., PROSPERO).
• Recommendation: Minor to moderate revision; manuscript is strong but would benefit from enhanced methodological transparency and discussion of heterogeneity and clinical impact.
"
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Gadour E, Miutescu B, Nica C, Taheri E, Al Saeed Z, Raheem B, Facciorusso A, AlQahtani MS. Virtual reality training for gastrointestinal endoscopy: A systematic review of efficacy and outcomes. World J Gastrointest Endosc 2026; 18(3): 117820
11
"Overall Assessment: This manuscript addresses a highly relevant and timely topic, evaluating the diagnostic performance of AI-assisted ..."
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"Overall Assessment: This manuscript addresses a highly relevant and timely topic, evaluating the diagnostic performance of AI-assisted colonoscopy for real-time colorectal polyp histology. The study is well-structured, with rigorous methodology and clear presentation of results. The findings, demonstrating that AI outperforms human endoscopists—particularly in less experienced operators—are clinically important. However, several aspects require clarification and elaboration to strengthen the manuscript’s impact and reproducibility.
Major Comments: Search Strategy & Study Selection: Please provide full details of the literature search, including databases, search terms, date range, and inclusion/exclusion criteria. A PRISMA flow diagram would enhance transparency.
Quality Assessment: Include a table summarizing QUADAS-2 risk of bias assessments for all studies. Clarify how studies with high risk of bias were considered in analyses.
Heterogeneity: Substantial heterogeneity (I² = 74.3%) is reported. Consider subgroup or meta-regression analyses based on AI type, polyp characteristics, or endoscopist experience to explore sources of variability.
Statistical Analysis: Clarify whether hierarchical or bivariate models were considered, as these are often preferred in diagnostic accuracy meta-analyses.
Clinical Interpretation: Discuss the practical significance of AI’s improved accuracy, including potential impact on management decisions, optical biopsy strategies, and clinical workflows.
Limitations: Explicitly address publication bias, spectrum bias, and generalizability of AI algorithms across centers. Also, note that AI technology is rapidly evolving, which may limit applicability of current findings.
Minor Comments: Clarify the definition of “human experts” (experience, certification).
*Specify polyp types included in the analysis.
*Consider tables summarizing AI algorithms, training/validation datasets, and imaging modalities.
*Streamline some sentences for readability and consistency in terminology.
*Briefly mention future considerations such as cost-effectiveness, regulatory, and ethical implications of AI deployment.
Recommendation: The manuscript is important and of high interest, but minor to moderate revisions are required to clarify methodology, address heterogeneity, and strengthen discussion of clinical applicability and limitations."
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Curlej P, Soldera J. Artificial intelligence in predicting colorectal polyp histology: Systematic review and meta-analysis of diagnostic accuracy in real-time procedures. World J Gastrointest Endosc 2026; 18(3): 116381
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"Post-ERCP pancreatitis (PEP) is comprehensive and clearly outlined both epidemiology and pathophysiology. The discussion appropriately ..."
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"Post-ERCP pancreatitis (PEP) is comprehensive and clearly outlined both epidemiology and pathophysiology. The discussion appropriately highlights the multifactorial nature of PEP and effectively integrates patient- and procedure-related risk factors. The emphasis on individualized risk assessment and evidence-based preventive strategies is well-placed. To further strengthen the manuscript for a critical audience, consider the following suggestions:
1. Clarify incidence ranges: You report an incidence of 3–15% in general populations and up to 40% in high-risk patients. Providing references for these ranges and defining “high-risk” explicitly (e.g., presence of multiple risk factors, prior pancreatitis, or sphincter of Oddi dysfunction) would enhance clarity.
2. Risk factor hierarchy: While multiple risk factors are listed, it may be helpful to indicate which factors carry the strongest evidence or highest odds ratios, perhaps in a table or figure. This helps readers quickly gauge clinical impact.
3. Preventive strategies: The paragraph mentions rectal NSAIDs, pancreatic stenting, hydration, and precut sphincterotomy. It could be strengthened by briefly noting the level of evidence or guideline recommendation for each (e.g., ESGE or ASGE guidelines), distinguishing strategies supported by strong randomized trials versus observational data.
4. Pharmacologic agents: The statement that agents like somatostatin, gabexate, and nafamostat have inconsistent efficacy is accurate, but citing meta-analyses or systematic reviews would make this more authoritative.
5. Emerging tools: Mentioning AI and risk prediction models is forward-looking. Consider briefly highlighting specific models that have shown promise or limitations, to give readers a sense of current clinical applicability.
6. Future directions: The call for standardization and validation is important. You might also suggest exploring combination preventive strategies and personalized approaches based on risk stratification, which would align with precision medicine trends.
Overall, the paragraph is well-structured and readable, with a clear progression from epidemiology to pathogenesis, risk factors, prevention, and future directions. Addressing the points above would enhance rigor and utility for a specialist audience.
"
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Xu PW, Xu QQ, Yu Y, Jiao Y, Liu YH, Yang L. Risk factors and prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis. World J Gastrointest Endosc 2026; 18(3): 115736
13
"Clinically, the report is worthy. It clearly frames the problem, current solutions, and future directions. Cholangiocarcinoma is an ..."
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"Clinically, the report is worthy. It clearly frames the problem, current solutions, and future directions. Cholangiocarcinoma is an aggressive malignancy often diagnosed at an advanced stage due to nonspecific symptoms. Conventional imaging and ERCP-based sampling have limited sensitivity, with reported diagnostic yields of 50–70% for tissue acquisition. Digital single-operator cholangioscopy improves diagnostic accuracy to 85–95% through direct visualization and targeted biopsies and facilitates therapeutic interventions, including biliary drainage, stenting, photodynamic therapy, and radiofrequency ablation, with procedural complication rates typically <5%. Despite these advances, interobserver variability, operator expertise, and limited long-term outcome data remain challenges. Integration of artificial intelligence shows preliminary promise in real-time lesion characterization but requires prospective validation. Future studies should define comparative effectiveness, patient-centered outcomes, and standardized protocols to optimize cholangioscopy in multidisciplinary CCA management."
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Musalia JG, Alzayyat S, Aljahdli ES, Al-Lehibi A, Lara LF, Gabr M. Cholangioscopy in the diagnosis and management of cholangiocarcinoma. World J Gastrointest Endosc 2026; 18(3): 115412
14
"The paper presents a clear and well-structured case report describing delayed intramural hematoma following Endoscopic submucosal ..."
[Read more]
"The paper presents a clear and well-structured case report describing delayed intramural hematoma following Endoscopic submucosal dissection for a laterally spreading tumor. The case narrative is logical, clinically relevant, and supported by follow-up demonstrating complete resolution and a well-healed scar, which strengthens the clinical outcome.
However, the scientific contribution is limited by several factors. The conclusion overgeneralizes from a single case, suggesting that conservative therapy is effective without acknowledging that broader evidence is required. The article also does not clearly define the novelty of the case relative to previously reported intramural hematomas after ESD. In addition, important clinical and procedural details such as lesion size, risk factors, hematoma characteristics, and rationale for management are lacking. The discussion of mechanisms and alternative treatment approaches is also minimal.
Overall, the report is clinically informative but primarily descriptive, and it would be strengthened by clarifying its novelty, providing more procedural detail, and moderating the conclusion to reflect the limitations of a single-case observation.
"
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Xu YL, Zhang ML, Zhou HJ, Gao PJ, Zhang XN, Rao M. Giant rectal intramural hematoma following endoscopic submucosal dissection successfully treated with conservative therapy: A case report. World J Gastrointest Endosc 2026; 18(3): 115257
15
"This article interprets the 5% plateau time model for colonoscopy in colonic diverticular bleeding and emphasizes that a 40-minute ..."
[Read more]
"This article interprets the 5% plateau time model for colonoscopy in colonic diverticular bleeding and emphasizes that a 40-minute observation period should be treated as a flexible minimum floor rather than a rigid rule. By framing observation time as a “time-to-yield” curve, we propose practical strategies for computed tomography-stratified targets, a 20-25-minutes quality checkpoint, individualized shortening in high-risk patients and structured documentation. These suggestions aim to improve time efficiency and operational quality in the management of acute lower gastrointestinal bleeding."
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Li C, Liu YQ, Wang HX. Feasibility of a forty-minute post-colonoscopy observation period for diverticular bleeding: Assessing the five per cent plateau model. World J Gastrointest Endosc 2026; 18(3): 115049
16
"This article addresses an important and clinically relevant issue in the management of acute caustic ingestion: the optimal role of ..."
[Read more]
"This article addresses an important and clinically relevant issue in the management of acute caustic ingestion: the optimal role of esophagogastroduodenoscopy versus computed tomography in early triage and risk stratification. The authors clearly describe the strengths of early endoscopic evaluation, particularly its role as the gold standard for grading mucosal injury when performed within 12–24 hours. The manuscript also appropriately highlights the growing role of cross-sectional imaging, emphasizing how computed tomography can detect transmural injury and extra-luminal complications such as necrosis, perforation, mediastinitis, and peritonitis findings that may not be fully appreciated endoscopically.
The paper effectively frames these modalities as complementary rather than competing diagnostic tools. This balanced perspective reflects current clinical thinking and has practical relevance for emergency and gastroenterology teams managing caustic ingestion.
However, several areas could be strengthened to enhance the manuscript’s impact. First, the discussion of CT would benefit from greater attention to the heterogeneity of imaging protocols and the lack of universally accepted CT grading systems for caustic injury. Second, a more structured comparison of diagnostic accuracy, predictive value for complications, and influence on clinical decision-making (e.g., surgical referral) would improve the clinical utility of the review. Third, incorporation of a proposed triage algorithm integrating both modalities could provide readers with clearer practical guidance.
Overall, this is a timely and useful review that synthesizes the evolving literature on diagnostic strategies in caustic ingestion. With additional clarification of imaging criteria, standardization challenges, and clinical decision pathways, the manuscript would provide even stronger guidance for clinicians managing this high-risk emergency.
"
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Singh AK, Birda CL, Kochhar R. Optimizing triage in acute caustic ingestion: Choosing between endoscopy and computed tomography. World J Gastrointest Endosc 2026; 18(3): 114327
17
"This is a valuable case report illustrating the diagnostic challenges of abdominal presentations of hereditary angioedema. With modest ..."
[Read more]
"This is a valuable case report illustrating the diagnostic challenges of abdominal presentations of hereditary angioedema. With modest revisions—particularly expanding the clinical description and strengthening the discussion of the genetic findings—the manuscript would make a useful contribution to the literature. The manuscript would benefit from expanded clinical detail, stronger discussion of the mutation, and clearer differentiation between hereditary and acquired angioedema. Addressing these issues will significantly improve the clarity and impact of the case report."
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Matsuura K, Ueda C, Hashimura C, Yakushiji H, Horiuchi T. Hereditary angioedema with recurrent abdominal pain in a patient with a novel SERPING1 gene mutation: A case report. World J Gastrointest Endosc 2026; 18(3): 113096
18
"This review article summarizes the current knowledge regarding the structure and role of the gut–brain axis, particularly in the ..."
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"This review article summarizes the current knowledge regarding the structure and role of the gut–brain axis, particularly in the context of acute brain injury. The major components include direct connections between the intestines and the brain through neurological and hormonal systems, as well as indirect communication mediated by intestinal flora and inflammatory cytokines. The structural participants include the autonomic nervous system, comprising both sympathetic and parasympathetic pathways, and the hypothalamic–pituitary–adrenal axis.
Within these systems, a vicious cycle may easily develop. Brain inflammation can lead to systemic inflammatory spillover, which may induce increased intestinal permeability (“leaky gut”). This, in turn, can further exacerbate systemic inflammation and subsequently worsen brain inflammation.
Potential therapeutic approaches discussed in the manuscript include vagus nerve stimulation, prebiotics and probiotics, fecal microbiota transplantation, and nutritional support. However, the content of the manuscript is largely redundant and does not present novel therapeutic concepts. In addition, the manuscript lacks detailed discussion of the underlying mechanisms and does not provide specific guidance for clinical practice. Overall, the manuscript remains largely descriptive and narrative rather than presenting a rigorous scientific analysis."
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Zhao X, Zhang W, Zhang Y, Liu XA. Gastrointestinal dysfunction after brain injury: Mechanisms and the role of the brain-gut axis. World J Gastroenterol 2026; 32(10): 115731
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" The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. ..."
[Read more]
" The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied."
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Ribeiro Junior MAF, Dib Possiedi R, Stefani Pacheco L, de Cesaro Schpchacki N, Nafeesa Hashim S, Monteiro Tavares Pereira B. Direct peritoneal resuscitation in sepsis and intra-abdominal infection: A scoping review. World J Clin Cases 2026; 14(7): 118719
20
"Traditional Chinese Medicine has demonstrated satisfactory preclinical and clinical efficacy in patients with IBD. The data from the ..."
[Read more]
"Traditional Chinese Medicine has demonstrated satisfactory preclinical and clinical efficacy in patients with IBD. The data from the review under comment demonstrate that TCM primarily acts through a holistic approach, affecting multiple signaling pathways and other immunological mechanisms, including the composition of the gut microbiota, intestinal barrier integrity, autophagy, and gene expression. TCM treats IBD by synergistically modulating immunity, repairing the intestinal barrier, restoring the gut microbiota, and regulating inflammatory pathways and autophagy. In recent years, a large number of research papers, mainly by Chinese researchers, have sought to identify the therapeutic components of these treatments on the one hand and to investigate their mechanisms of action on the other. Moreover, clinical data and meta-analyses of randomized controlled trials support the effectiveness of PKI. Taken together, these actions will provide PKI with a scientific basis and foundation for its results. It is truly remarkable that both the large pharmaceutical industries and the health providers, as well as the officials of various countries, do not fund large multicenter studies that use PKI or the so-called Alternative Medicine in patients with IBD, at least as a complementary treatment to traditional Western medicine. I believe that the path towards this direction is inevitable in the coming years. Congratulations to the authors of the review."
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Zeng SH, Jiang XY, Lin DR, Zhang WJ, Wu YQ, Xu L, Guo SJ. Mechanisms and therapeutic potential of traditional Chinese medicine for inflammatory bowel disease. World J Gastroenterol 2026; 32(10): 115821
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Peer-Reviewers and Manuscript Statistics
- Editorial board members
- 2263
- Peer-reviewers
- 36549
- Manuscripts received today
- 33
- Manuscript reviews today
- 40
- Unhandled manuscripts today
- 192
- Active peer-reviewers today
- 761
- Reviewer acceptance today
- 51
- Reviewer refusals today
- 45
- Total accepted manuscripts
- 40777
- Total rejected manuscripts
- 45020
- Total peer-reviewers
- 4737177
- Total submissions
- 38451
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1
"This letter to the Editor notes the potential significance of clinical situation in patients who suffer from emphysematous ..."
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"This letter to the Editor notes the potential significance of clinical situation in patients who suffer from emphysematous pyelonephritis. This is very important. Clinical findings and symptoms must be the cornestone in these conditions in order to avoid the worse outcomes of patients. In addition, the Modified National Early Warning Score 2 based on physiological situation of patient shoud be very helpfull, as well as computed tomography findings. "
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Sevik C, Erbin A, Canat HL. Integrating Modified National Early Warning Score 2, computed tomography staging, and laboratory markers for enhanced prognostic stratification in emphysematous pyelonephritis. World J Nephrol 2026; 15(1): 113952
2
"This manuscript defined as Editorial is generally good, but it mildly offers new lights in concept of diabetic nephropathy ..."
[Read more]
"This manuscript defined as Editorial is generally good, but it mildly offers new lights in concept of diabetic nephropathy complications and its progression in death. Pathophysiology paragragh is better than the other parts of manuscript. Addiotionally, inequalities and differences between racial and ethic groups were noted, which is not usual in other published manuscripts. "
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Gembillo G, Ricca MF, Santoro D. Diabetes-related renal complications: Insights on the impact of diabetic kidney disease on mortality. World J Nephrol 2026; 15(1): 108432
3
"Reader’s code: 00106360 Commentary on the Article Impact of metabolic dysfunction-associated steatotic liver disease on liver ..."
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"Reader’s code: 00106360 Commentary on the Article Impact of metabolic dysfunction-associated steatotic liver disease on liver metastasis and survival in pancreatic cancer The study by Chon HY et al. examines the impact of metabolic dysfunction-associated steatotic liver disease (MASLD) on liver metastasis and survival in patients with Pancreatic Ductal Adenocarcinoma. Using a large retrospective cohort of 2123 patients, the authors assessed hepatic steatosis primarily through the hepatic steatosis index (HSI) and additionally validated findings using CT-based measurements of liver fat. The study found no significant association between MASLD and the presence of liver metastasis at diagnosis or during follow-up, suggesting that hepatic steatosis may not be a key determinant of metastatic spread in pancreatic cancer (Chon et al., 2026). The findings contrast with previous research in other malignancies, such as colorectal and breast cancers, where hepatic steatosis has been reported to influence liver metastasis risk or metastasis-free survival (van Saane et al., 2019; Wu et al., 2020). In the present study, tumor size and elevated CA19-9 levels were the main predictors of liver metastasis, while diabetes mellitus was associated with improved survival outcomes, possibly reflecting earlier detection among diabetic patients (Chon et al., 2026). Critical Appraisal of the Study The study by Chon HY and colleagues evaluates the relationship between metabolic dysfunction-associated steatotic liver disease (MASLD) and liver metastasis in patients with Pancreatic Ductal Adenocarcinoma. Using a large retrospective cohort of 2123 patients, the authors investigated whether hepatic steatosis, measured by the hepatic steatosis index (HSI), influences the development of liver metastasis and overall survival. Strengths One of the major strengths of this study is its large sample size and long study period (2006–2021), which enhances the statistical power and reliability of the findings. The authors used robust statistical methods, including logistic regression and Cox proportional hazards models, to analyze risk factors for both baseline and newly developed liver metastases. Another notable strength is the additional CT-based validation in a subgroup of patients, which helps corroborate the HSI-based assessment of hepatic steatosis. The study also carefully adjusted for multiple potential confounders such as age, BMI, diabetes, lipid profile, tumor size, and CA19-9 levels. Limitations Despite these strengths, several limitations should be considered. First, the retrospective design limits the ability to establish causal relationships. Second, the primary assessment of hepatic steatosis relied on the HSI, an indirect surrogate marker derived from BMI and liver enzyme ratios, which may be influenced by cancer-related factors such as cachexia, inflammation, or biliary obstruction. Third, important pathological variables (e.g., lymph node status, lymphovascular invasion, and perineural invasion) were not consistently available and therefore could not be included in the multivariate models. Additionally, the CT-based validation was limited to a subset of patients, which may introduce selection bias. Clinical Implications Clinically, the findings suggest that MASLD may not be a significant determinant of liver metastasis in pancreatic cancer, contrasting with observations in other malignancies. Instead, established markers such as tumor size and elevated CA19-9 levels appear to remain more reliable predictors of metastatic risk and mortality. These results highlight the aggressive biological behavior of pancreatic cancer, where tumor-driven mechanisms may outweigh the influence of underlying hepatic metabolic conditions. Future prospective studies incorporating advanced imaging, histologic confirmation, and molecular analysis of the tumor–liver microenvironment are needed to further clarify the role of MASLD in pancreatic cancer progression. Despite its strengths, including a large sample size and robust statistical modeling, the retrospective design and reliance on HSI rather than histologic confirmation limit the ability to establish causality. Nevertheless, this study contributes important evidence suggesting that the relationship between MASLD and metastasis may be cancer-specific and biologically complex. Reference Chon HY, Rhee H, Kim J, et al. Impact of metabolic dysfunction-associated steatotic liver disease on liver metastasis and survival in pancreatic cancer. World Journal of Gastroenterology. 2026;32(11):115488. van Saane AM, et al. Non-alcoholic fatty liver disease and colorectal liver metastasis risk. Liver International. 2019. Wu W, et al. Hepatic steatosis and liver metastasis-free survival in breast cancer. Cancer Medicine. 2020. "
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Chon HY, Rhee H, Kim J, Leem G, Jo JH, Chung MJ, Park JY, Bang S, Park SW, Kim SU, Lee HS. Impact of metabolic dysfunction-associated steatotic liver disease on liver metastasis and survival in pancreatic cancer. World J Gastroenterol 2026; 32(11): 115488
4
"Esophageal variceal bleeding is one of the most severe complications of cirrhotic portal hypertension, associated with high rates ..."
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"Esophageal variceal bleeding is one of the most severe complications of cirrhotic portal hypertension, associated with high rates of rebleeding and mortality. Although endoscopic variceal band ligation (EVBL) is currently the standard treatment, its reliance on repeated endoscopic follow-up presents challenges, including invasiveness, high resource consumption, and poor patient tolerance. This study focuses on the potential application of multiparametric ultrasound (MP-US) in predicting outcomes following EVBL, proposing a novel follow-up strategy that is noninvasive, individualized, and reproducible, with significant promise for clinical translation. The article begins with the clinical burden of EVB, progressively introduces the limitations of current diagnostic and therapeutic approaches, and naturally transitions to the technical advantages and research evidence supporting MP-US, culminating in future research directions. The structure is well-organized, and the logic is rigorous. The critical analysis of existing technologies is insightful. The article objectively highlights the limitations of HVPG and repeated endoscopy, particularly their inaccessibility in resource-limited settings. It also provides a reasonable evaluation of the shortcomings of noninvasive tools such as the Baveno criteria and elastography in predicting postprocedural outcomes, reflecting the authors' deep understanding of clinical realities. The analysis of MP-US's clinical application is thorough. By integrating measurements of liver stiffness, spleen stiffness, and perfusion imaging, MP-US enables a comprehensive assessment of portal hypertension from both structural and hemodynamic perspectives, overcoming the limitations of traditional single-parameter prediction models. Citing data from Ainora et al, the study demonstrates the potential of MP-US in predicting variceal eradication and guiding individualized follow-up. The outlook on future research directions is instructive. The article notes that current studies are mostly small-sample, single-center designs lacking standardized operating and interpretation protocols, and calls for multicenter, prospective studies to validate the clinical value of MP-US—a recommendation with practical significance. Figure 1 is highly informative, clearly illustrating the evolutionary pathway from invasive to noninvasive diagnostic tools, facilitating readers' understanding of technological advancements. Areas for improvement and suggestions: The issue of MP-US technical standardization requires further clarification. Although the article mentions that MP-US is influenced by factors such as operator experience and equipment variability, it does not delve deeply into how to achieve standardized operation and interpretation; future research should focus on this aspect. A cost-effectiveness analysis is lacking. While MP-US has the potential to reduce the frequency of endoscopic examinations, its high equipment costs and reliance on contrast agents may limit its widespread adoption in certain regions. Future studies should incorporate health economic evaluations. The integration of AI with MP-US warrants further exploration. The article mentions the application of AI in endoscopic measurement but does not explore the possibility of combining AI with MP-US. Future research could investigate AI-based automated analysis of MP-US images and risk prediction models. This study, with its clear logic, solid literature support, and forward-looking perspective, systematically elaborates on the potential application of MP-US in post-EVBL follow-up. It not only provides clinicians with new diagnostic and therapeutic insights but also points future researchers toward promising directions. If further advancements are made in MP-US standardization, multicenter validation, and AI integration, it holds the potential to achieve truly noninvasive, precise, and individualized management of portal hypertension in patients with cirrhosis. "
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Martínez-Díaz FM, Jiménez-Cuevas EA, Morales-Galicia AE, Ramírez-Mejía MM, Qi XS, Poo JL, Méndez-Sánchez N. Toward noninvasive prediction of treatment outcomes in patients with variceal bleeding. World J Gastroenterol 2026; 32(11): 115723
5
"This systematic review of 8 randomized trials (1758 participants) rigorously evaluates adjunctive pharmacotherapies for diuretic ..."
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"This systematic review of 8 randomized trials (1758 participants) rigorously evaluates adjunctive pharmacotherapies for diuretic resistance in acute decompensated heart failure (ADHF), adhering to PRISMA guidelines and using Cochrane’s RoB 2.0 for bias assessment. Key findings show proximal nephron-targeted agents (acetazolamide, SGLT2 inhibitors) and distal thiazide diuretics effectively boost decongestion: acetazolamide raises successful decongestion rates (42.2% vs 30.5%), SGLT2 inhibitors enhance urine output and reduce worsening HF, while thiazides prompt greater weight loss but increase renal dysfunction risk. Notably, older agents (high-dose spironolactone, low-dose dopamine/nesiritide) yield no meaningful clinical benefits. The review’s strength lies in its exclusive focus on randomized trials, but heterogeneity in endpoints and short follow-up limit generalizability. It provides a mechanistically guided, stepwise clinical framework for ADHF management, emphasizing personalized adjunct selection, and identifies the need for large head-to-head trials and long-term outcome research to address existing evidence gaps. "
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Patel V, Zameer R, Kumar B, Das M. Adjunctive pharmacologic therapies for diuretic resistance in acute decompensated heart failure: Systematic review of randomized trials. World J Meta-Anal 2026; 14(1): 118496
6
"The article raises critical issues regarding healthcare expenditure and the anesthesiologist’s responsibility in cost containment. ..."
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"The article raises critical issues regarding healthcare expenditure and the anesthesiologist’s responsibility in cost containment. While the narrative is informative, a more quantitative economic comparison and inclusion of updated guidelines or contemporary practice data would strengthen the conclusions. Additionally, deeper exploration of medico-legal concerns and institutional resistance could enhance its practical impact. Nevertheless, the review addresses a clinically meaningful topic. "
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Karim HMR. Healthcare delivery cost and anesthesiologists: Time to have a greater role and responsibility. World J Anesthesiol 2019; 8(3): 19-24
7
"I read with great interest the study by Khalifa et al. published in the World Journal of Orthopedics, evaluating the impact of surgeon ..."
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"I read with great interest the study by Khalifa et al. published in the World Journal of Orthopedics, evaluating the impact of surgeon handedness on radiological and functional outcomes following primary total knee arthroplasty (TKA). The authors should be commended for addressing an underexplored yet clinically relevant surgeon-related variable in arthroplasty practice. The finding that overall limb alignment and functional outcomes were not significantly influenced by operating on the dominant versus non-dominant side is reassuring. However, the increased incidence of tibial component malalignment (MPTA outliers) on the non-dominant side highlights an important technical nuance that may have implications for implant longevity, particularly in mechanically aligned TKA performed with conventional instrumentation. The subgroup analysis comparing intramedullary and extramedullary tibial guides is particularly interesting, suggesting that technique selection may interact with laterality. These findings underscore the potential value of ergonomic optimization and heightened intraoperative vigilance when operating on the non-dominant side. Future prospective studies incorporating sagittal and rotational alignment parameters, inclusion of left-handed surgeons, and long-term survivorship data would further clarify the clinical significance of these observations. Additionally, evaluating whether navigation or robotic assistance mitigates the subtle asymmetries associated with surgeon handedness could provide valuable insights. Overall, this study contributes meaningfully to the ongoing discussion regarding modifiable surgeon-related factors influencing TKA precision and outcomes. "
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Khalifa AA, Abdelaal AM, Moustafa MM. Does surgeon handedness affect the outcomes after primary total knee arthroplasty? A retrospective cohort study. World J Orthop 2026; 17(2): 113696
8
"I would like to congratulate the authors on this clinically relevant study. The authors provided a conclusion that differs from ..."
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"I would like to congratulate the authors on this clinically relevant study. The authors provided a conclusion that differs from previously published results. ETV is generally considered renal-neutral and is commonly used in DCLD due to its renal safety. The statement that ETV is associated with a greater decrease in GFR than TMV is overfitting, as it is a retrospective study. The Difference in decline of approximately 4 mL/min/1.73 m² is very small and may not be clinically meaningful in patients with normal GFR, even though it is statistically significant. The conclusion should be interpreted with caution and requires additional long-term prospective studies to substantiate this claim. Furthermore, the authors did not report any additional adverse events during the study period. "
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Ma SP, Wang L, Zhang YL, Wan X, Liu Q, Tang YL, Malhi LR, Ge SF. Effects of tenofovir amibufenamide and entecavir on estimated glomerular filtration rate in treatment-naïve patients with chronic hepatitis B. World J Hepatol 2026; 18(2): 114346
9
"I congratulate the authors on this relevant study on this study. As the authors pointed out, Klebsiella is the leading cause of liver ..."
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"I congratulate the authors on this relevant study on this study. As the authors pointed out, Klebsiella is the leading cause of liver abscesses in Asia and is increasingly prevalent in India. It is important to have culture reports at various time points, as they will help us in deciding empirical antibiotics. The authors have shown that the isolated organisms are highly resistant to ampicillin and have low resistance to cephalosporins and carbapenems. With this large amount of data, the authors would have identified the poor prognostic predictors of PLA and treatment outcome. The authors did not present the data on complications of these abscess such as biliary fistula "
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Mai-Phan TA, Thai KP, Le KL, Pham TN, Tran MQ, Pham PC, Duong NNQ, Trinh MT, Le NK. Klebsiella pneumoniae as leading cause of pyogenic liver abscess: Three years study in Southern Vietnam. World J Hepatol 2026; 18(2): 113695
10
"Wang and Pan present an editorial that meaningfully extends the discussion of ERAS in elderly gastric cancer patients beyond ..."
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"Wang and Pan present an editorial that meaningfully extends the discussion of ERAS in elderly gastric cancer patients beyond feasibility toward biologically grounded recovery. Building on prior evidence by Li et al. demonstrating the safety and protocol adherence of ERAS in older adults. The authors appropriately emphasize physiological heterogeneity, frailty, and resilience as key determinants of postoperative outcomes rather than chronological age alone. The proposed multidomain framework integrating nutritional inflammatory balance, circadian regulation, psychological resilience, and digital monitoring, offers an important conceptual advance. However, many of these strategies rely on resource intensive multidisciplinary teams, biomarker surveillance, and wearable technologies, which may limit generalizability outside high-volume or well-resourced centers. Future efforts may benefit from parallel development of simplified, scalable ERAS adaptations for elderly patients. Overall, this editorial provides a valuable roadmap for evolving ERAS from protocol compliance toward patient-centered, biologically informed recovery in an aging surgical population. "
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Wang G, Pan SJ. From feasibility to biological recovery: Reframing enhanced recovery pathways after surgery in elderly gastric cancer patients. World J Gastroenterol 2026; 32(7): 116264
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"This Editorial thoroughly explores the field of AI use in diagnostic radiology. It provides a complete overview of the potential and ..."
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"This Editorial thoroughly explores the field of AI use in diagnostic radiology. It provides a complete overview of the potential and the current applications of AI in the field with great potential, strong diagnostic performance but in my opinion it does spotlight with the due consideration the potential drawbacks coming from the extensive use of AI in the clinical field. The enthusiasm generated from the high precision and performance and the consequent advantages in terms of resource and time save for operators outpaced evaluation of broader consequences. Concerns include trainee deskilling, automation bias, unclear medicolegal accountability, and inequitable access due to infrastructure demands. The authors emphasize that technical accuracy alone is insufficient and call for longitudinal studies, training models that preserve independent reasoning, and deployment strategies that address equity. Without systematic assessment of professional, clinical, and societal impacts, AI adoption risks being driven by non-evidence-based factors. "
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He ZX, Wang J, Yang JS. Expanding the applications of artificial intelligence in emergency radiology: Advancing precision medicine and resource efficiency. World J Radiol 2026; 18(1): 117814
12
"This study demonstrates that presenilin-1 (PS-1) is significantly associated with β-catenin activation, PTEN phosphorylation, advanced ..."
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"This study demonstrates that presenilin-1 (PS-1) is significantly associated with β-catenin activation, PTEN phosphorylation, advanced tumor stage, and poor survival in gastric cancer. The combination of clinical data and functional assays strengthens the evidence for the PS-1/β-catenin/p-PTEN axis in promoting invasion and metastasis. These findings highlight a potential therapeutic target for gastric cancer treatment. "
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Lin X, Lin GF, Gu FT, Li YL. Increasing expression of presenilin 1, β-catenin, and p-PTEN and its regulatory roles on cell invasion in gastric cancer. World J Gastrointest Oncol 2026; 18(2): 115689
13
"In this paper, the tumor indicators of patients with gastric cancer after operation were detected and analyzed. It was found that ..."
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"In this paper, the tumor indicators of patients with gastric cancer after operation were detected and analyzed. It was found that CEA and AFP were closely related to the recurrence of gastric cancer, which provided a good basis for judging the health level of patients with gastric cancer after operation. But it also needs the support of large-scale clinical data. At the same time, patients with gastric cancer need more tumor indicators to explore a better combination for judging the prognosis of patients with gastric cancer. "
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Duan XX, Yu X, Zhou L. Timeliness of postoperative serum carcinoembryonic antigen monitoring for predicting recurrence after gastric cancer surgery. World J Gastrointest Surg 2026; 18(1): 114309
14
"Dear Editor, I am writing in response to your invitation to comment on the prospective study by Güneş et al., entitled “Diagnostic ..."
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"Dear Editor, I am writing in response to your invitation to comment on the prospective study by Güneş et al., entitled “Diagnostic value of interleukin-8 in colon cancer,” published in your esteemed journal. The authors provide valuable data reinforcing the role of interleukin-8 (IL-8) as an independent diagnostic biomarker in colon adenocarcinoma. Their work rightly concludes that IL-8 holds promise, particularly as part of a multi-marker panel. I would like to extend this discussion by contextualizing IL-8 within the current, rapidly evolving biomarker landscape of colorectal cancer (CRC), as recently elaborated in an editorial on this topic. The future of CRC management lies in a dynamic, multi-layered biomarker strategy that integrates three key pillars: 1) Mismatch repair (MMR) status to dictate therapeutic class (chemotherapy vs. immunotherapy); 2) Perioperative carcinoembryonic antigen (CEA) for immediate risk stratification, especially within microsatellite stable (MSS) disease; and 3) Postoperative circulating tumor DNA (ctDNA) as a dynamic tool to guide treatment intensity and de-escalation, as definitively demonstrated by the recent AGITG DYNAMIC-III trial. In this framework, the findings on IL-8 by Güneş et al. present a compelling opportunity. While its standalone diagnostic accuracy (AUC=0.68) is moderate, its independent predictive value suggests a distinct biological role, likely rooted in its pro-inflammatory and angiogenic functions. This positions IL-8 not as a replacement for the aforementioned pillars, but as a potential complementary element, particularly within the MSS cohort. Specifically, IL-8 could enhance the second pillar (risk stratification) by providing additional biological granularity. For instance, in MSS patients with normal or borderline CEA levels, an elevated IL-8 might signal a more aggressive tumor biology driven by inflammation, potentially identifying a subset that would benefit from closer surveillance or adjuvant therapy. Furthermore, given its link to angiogenesis and immune modulation, IL-8 merits investigation as a predictive biomarker for responses to anti-angiogenic therapies (e.g., bevacizumab) and possibly immunotherapy, even in MSS/pMMR tumors. Therefore, I propose that the next logical step for research, as inspired by both this study and the broader editorial perspective, is to evaluate IL-8 within integrated multi-marker panels. Combining IL-8 with CEA, ctDNA, and potentially other inflammatory markers (e.g., CRP) in algorithm-driven models could significantly improve diagnostic sensitivity, prognostic stratification, and predictive accuracy. This approach aligns perfectly with the paradigm of dynamic precision oncology, where multiple data streams are synthesized to guide personalized therapeutic navigation. I congratulate the authors on their contribution and thank you for the opportunity to share these perspectives, hoping they may stimulate further research into the integrative potential of IL-8 within the modern CRC biomarker ecosystem. Sincerely, Pr Nabil Ismaili Mohammed VI University of Sciences and Health (UM6SS), Mohammed VI Foundation of Sciences and Hrealth (FM6SS), Casablanca, Morocco, nismaili@um6ss.ma, 0000-0001-5786-5134 "
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Güneş G, Fırat Oğuz E, Kayılıoğlu I, Dinç T. Diagnostic value of interleukin-8 in colon cancer: Prospective, case-control study. World J Gastrointest Surg 2026; 18(1): 115444
15
"Systemic antifungal therapy is the backbone of treatment for invasive fungal infections, but it carries an under-recognized burden ..."
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"Systemic antifungal therapy is the backbone of treatment for invasive fungal infections, but it carries an under-recognized burden of endocrine and physiological toxicity. The review by Thakkar et al. (2026) provides an important framework for understanding how these agents affect human cytochrome P450 enzymes and renal function, leading to adrenal insufficiency, mineralocorticoid excess, and electrolyte abnormalities. This review deserves recognition, and adding a global perspective to it could provide new recommendations. If possible, I would like to submit a letter addressing this perspective. "
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Thakkar S, Kantroo V, Nagendra L, Dutta D, Kamrul-Hasan ABM, Kalra S, Bhattacharya S. Endocrine consequences of antifungal therapy: A missed entity. World J Clin Cases 2026; 14(2): 117140
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"I read with interest the study comparing the ASGE lexicon and the AGREE classification for adverse events in gastrointestinal ..."
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"I read with interest the study comparing the ASGE lexicon and the AGREE classification for adverse events in gastrointestinal endoscopy. The authors are to be commended for their rigorous analysis of a large institutional registry and for highlighting the conceptual differences between two widely used adverse event frameworks. The high concordance observed between ASGE and AGREE confirms that both systems are robust for capturing clinically significant complications. However, the discordance noted for transient cardiorespiratory and sedation-related events raises an important interpretive issue. The ASGE lexicon intentionally captures such occurrences as “incidents,” supporting quality improvement and preventive strategies, whereas AGREE excludes many of these events by design, prioritising clinical consequence and post-procedural intervention. While this approach improves specificity, it may inadvertently narrow the safety signal. From a patient-centred perspective, events such as inadequate sedation, procedural discomfort, or transient hypoxia—although self-limiting—can significantly influence patient-reported experience, satisfaction, and trust in endoscopic services. These experiential harms may not require escalation of care yet remain meaningful to patients and may affect willingness for repeat procedures. Their exclusion from adverse event datasets risks underestimating quality concerns that are increasingly relevant in value-based care. The study also underscores that adverse event classification represents only one dimension of endoscopy quality. Domains such as procedural appropriateness, missed or delayed diagnoses, bowel preparation adequacy, photodocumentation quality, scheduling delays, and patient-initiated procedure termination are not captured by adverse event frameworks but are integral to comprehensive quality assessment. In summary, while standardised adverse event classification remains essential for benchmarking and safety governance, it should be complemented by patient-reported experience measures and broader quality indicators. A multidimensional framework integrating safety, experience, and appropriateness may better align endoscopy quality metrics with contemporary patient-centred practice. "
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Corsi O, Martinez R, Aguirre J, Friedrich I, Galeno V, Jimenez V, Briones P, Díaz LA, Espino A, Vargas JI. Application of a novel adverse event classification scale in a Latin American gastrointestinal endoscopy unit. World J Gastrointest Endosc 2026; 18(1): 111384
17
"This minireview provides a timely and balanced synthesis of the evolving role of endoscopic ultrasound-guided radiofrequency ablation ..."
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"This minireview provides a timely and balanced synthesis of the evolving role of endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) in the management of pancreatic neuroendocrine tumors (pNETs). The authors appropriately frame EUS-RFA as a promising yet still selective therapeutic option, and the “lights and shadows” construct is effective in highlighting both its clinical potential and its current limitations A major strength of the article lies in its comprehensive collation of published clinical experience across functioning and non-functioning pNETs. The tabulated summaries are particularly valuable for readers seeking an overview of technical success, clinical response, and adverse event profiles. Importantly, the authors avoid overstating efficacy and consistently acknowledge the predominance of retrospective series, limited follow-up durations, and heterogeneity in response definitions—an intellectua rigour that strengthens the manuscript. From a conceptual standpoint, the review highlights a key paradigm shift: EUS-RFA is no longer merely a salvage or palliative modality, but a potential intermediate option within the “grey zone” of small, low-grade pNETs, especially in patients unfit for surgery or those prioritizing minimally invasive approaches. This raises an important clinical question not fully resolved in current guidelines—whether EUS-RFA should eventually be positioned as a disease-modifying therapy rather than an alternative to surveillance. The discussion on radiological response assessment underscores a critical unmet need in the field. The lack of standardized imaging endpoints, timing of follow-up, and correlation with long-term oncologic outcomes limits meaningful comparison across studies. Future consensus on response metrics—possibly integrating contrast-enhanced harmonic EUS, cross-sectional imaging, and biochemical markers—would significantly enhance interpretability and clinical adoption. Finally, the article appropriately calls attention to procedural standardization and risk mitigation, particularly regarding pancreatitis prevention and proximity to the main pancreatic duct. These considerations will be central if EUS-RFA is to move beyond expert centers into broader clinical practice. Overall, this review serves as a valuable reference for gastroenterologists, endosonographers, and multidisciplinary teams managing pNETs. It also clearly delineates the research priorities required before EUS-RFA can be fully integrated into evidence-based treatment algorithms. "
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Tringali A, Caiazzo A. Role of endoscopic ultrasound in the treatment of pancreatic neuroendocrine tumors: Lights and shadows of endoscopic ultrasound-guided radiofrequency ablation. World J Gastrointest Endosc 2026; 18(1): 113617
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"Commentary: Clinical Considerations in Immunocompromised Patients With Edwardsiella tarda–Associated Spontaneous Bacterial Peritonitis ..."
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"Commentary: Clinical Considerations in Immunocompromised Patients With Edwardsiella tarda–Associated Spontaneous Bacterial Peritonitis The case report by Usuda et al., recently published in the World Journal of Clinical Cases, represents a notable contribution to clinical microbiology by documenting, to the best of current knowledge, the first reported case of spontaneous bacterial peritonitis (SBP) caused by Edwardsiella tarda in an immunocompromised patient undergoing dialysis [1].This report substantially expands the recognized infectious spectrum in patients with end-stage renal disease (ESRD) and underscores the need for heightened clinical awareness of atypical and opportunistic pathogens in this vulnerable population. One particularly commendable aspect of this report is the authors’ detailed discussion of the virulence mechanisms of E. tarda. The organism’s capacity to survive and replicate within macrophages plays a pivotal role in its pathogenicity, especially in hosts with compromised cellular immunity [2,3]. In the present case, the coexistence of diabetic nephropathy and long-term dialysis likely created a permissive immunological milieu that facilitated this opportunistic infection. Such intracellular persistence provides a plausible explanation for the severe and insidious clinical course observed, even in the absence of classical epidemiological exposures such as raw seafood consumption or contact with freshwater environments. Equally noteworthy is the authors’ adherence to principles of antimicrobial stewardship. The stepwise transition from empirical broad-spectrum therapy with cefmetazole to targeted, de-escalated treatment using cefalexin—guided by comprehensive antimicrobial susceptibility testing (Table 3)—offers a valuable therapeutic reference for clinicians managing similarly rare infections. Nevertheless, building on the authors’ insightful acknowledgment of the limitations surrounding “ascites culture conversion,” I would like to propose a more structured and rigorous framework for defining treatment endpoints in such high-risk cases. While clinical and symptomatic improvement remains an essential marker of response, it may be insufficient when dealing with pathogens such as E. tarda, which possess the ability to persist intracellularly [4,5]. Accordingly, I suggest an integrated “imaging-to-microbiology” strategy prior to antibiotic discontinuation. First, advanced imaging modalities—such as abdominal computed tomography or high-resolution ultrasonography—should be systematically incorporated to objectively assess the resolution of ascites. Complete radiological absorption of ascitic fluid would substantially strengthen the clinical justification for treatment cessation. Conversely, if residual ascites is detected, even in minimal or loculated forms, reliance on systemic inflammatory markers such as C-reactive protein or leukocyte counts alone may be misleading. Given the organism’s persistence potential [3], repeat diagnostic paracentesis should be strongly considered to confirm microbiological eradication. This dual confirmation—radiological and microbiological—would provide a more robust and evidence-based rationale for terminating antimicrobial therapy [6], thereby reducing the risk of relapse in immunocompromised patients. In conclusion, while this case report fills an important gap in the current literature, it also highlights the need to refine discharge and treatment-completion criteria for rare causes of SBP. Adoption of an imaging-guided microbiological confirmation strategy may enhance the precision of clinical decision-making and ultimately improve long-term outcomes in patients with complex comorbidities. 参考文献 [1]Usuda D , Furukawa D, Imaizumi R et al. Spontaneous bacterial peritonitis due to Edwardsiella tarda in an immuno-compromised dialysis patient: A case report and review of literature. World J Clin Cases 2026,6; 14(1): 115102. [2][2]Qin L, Li F, Wang X, Sun Y, Bi K, Gao Y. Proteomic analysis of macrophage in response to Edwardsiella tarda-infection. Microb Pathog, 2017; 111: 86-93 [RCA] [PMID: 28826764 DOI: 10.1016/j.micpath.2017.08.028] [3]Zhang L, Ni C, Xu W, Dai T, Yang D, Wang Q, Zhang Y, Liu Q. Intramacrophage Infection Reinforces the Virulence of Edwardsiella tarda. J Bacteriol 2016; 198: 1534-1542 [RCA] [PMID: 26953340 DOI: 10.1128/JB.00978-15] [4]An L, Chan JL, Nguyen M, Yang S, Deville JG. Case Report: Disseminated Edwardsiella tarda infection in an immunocompromised patient. Front Cell Infect Microbiol 2023; 13: 1292768 [RCA] [PMID: 38053529 DOI: 10.3389/fcimb.2023.1292768] [5]Matsukawa H, Usuda D, Takami H, Nomura T, Sugita M. A Case of Edwardsiella tarda Infection With Iliopsoas Abscess Following Acute Pyelonephritis. Cureus 2024; 16: e58868 [RCA] [PMID: 38800258 DOI: 10.7759/cureus.58868] [6]A Rimola , G García-Tsao, M Navasa, L J Piddock, R Planas, B Bernard, J M Inadomi. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. International Ascites Club. J Hepatol, 2000; 32(1):142-53[RCA][PMID: 10673079 DOI: 10.1016/s0168-8278(00)80201-9] "
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Usuda D, Furukawa D, Imaizumi R, Ono R, Kaneoka Y, Nakajima E, Kato M, Sugawara Y, Shimizu R, Inami T, Kawai K, Matsubara S, Tanaka R, Suzuki M, Shimozawa S, Hotchi Y, Osugi I, Katou R, Ito S, Mishima K, Kondo A, Mizuno K, Takami H, Komatsu T, Nomura T, Sugita M. Spontaneous bacterial peritonitis due to Edwardsiella tarda in an immuno-compromised dialysis patient: A case report and review of literature. World J Clin Cases 2026; 14(1): 115102
19
"This paper presents a systematic retrospective analysis of the incidence and clinical significance of gallstones and gallbladder wall ..."
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"This paper presents a systematic retrospective analysis of the incidence and clinical significance of gallstones and gallbladder wall thickening in patients with liver cirrhosis, offering valuable clinical observations for practitioners. The study clearly indicates that the prevalence of gallbladder abnormalities—including gallstones and asymptomatic wall thickening—is significantly higher in patients with cirrhosis, especially in the decompensated stage, compared to the general population. This finding aligns with previous research and further supports the pivotal role of portal hypertension and hepatic dysfunction in the development of gallbladder pathology. Notably, the authors emphasize that these imaging findings are often related to cirrhosis itself rather than being indicators of acute cholecystitis. This distinction is clinically important, as it can help prevent unnecessary interventions—such as misdiagnosis and surgery for presumed acute cholecystitis—particularly in asymptomatic individuals. Moreover, the study suggests that gallbladder abnormalities correlate more strongly with the decompensated state of cirrhosis than with its etiology, providing a fresh perspective on the mechanisms underlying gallbladder changes in these patients. However, several limitations should be acknowledged. First, the retrospective design and single-center sample may limit the generalizability of the results. Second, the study lacks in-depth analysis of subgroups based on the etiology of cirrhosis, leaving it unclear whether findings differ notably in non-alcoholic liver disease patients. Finally, potential influencing factors such as gallbladder motility and medication use were not systematically evaluated, even though they may contribute to wall thickening and stone formation. Overall, this paper offers practical clinical insights into the imaging assessment of the gallbladder in cirrhotic patients. Future prospective, multicenter studies incorporating more pathophysiological parameters—such as gallbladder motility and bile composition—could help further elucidate the complex relationship between cirrhosis and gallbladder disorders and contribute to optimized clinical decision-making. "
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Tsankof A, Protopapas AA, Kyritsi V, Gogou C, Kyziroglou M, Papathanasiou E, Chatzikosma C, Michalopoulos A, Savopoulos C, Protopapas AN. Gallstones and gallbladder wall thickening in patients with cirrhosis: Prevalence and clinical impact. World J Clin Cases 2026; 14(1): 114043
20
"This meta-analysis systematically retrieved and synthesized evidence from 30 randomized controlled trials (RCTs) involving nearly ..."
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"This meta-analysis systematically retrieved and synthesized evidence from 30 randomized controlled trials (RCTs) involving nearly 17,000 patients, providing the most comprehensive assessment to date on the efficacy of indomethacin for preventing post-ERCP pancreatitis (PEP). It offers valuable, up-to-date evidence-based references for clinical practice, and the authors' efforts are highly commendable. Nevertheless, while acknowledging its contributions, two critical methodological limitations must be highlighted, which may compromise the interpretation and generalizability of its findings. The present commentary aims to identify two key methodological flaws in this meta-analysis that seriously undermine the statistical validity and clinical interpretability of its results. First, the authors inappropriately disaggregated seven multi-arm randomized controlled trials into multiple independent pairwise comparisons for inclusion in the analysis. This practice directly violates the core assumption of data independence in meta-analyses: different comparison groups derived from the same trial are correlated due to the shared control arm. Treating these as independent samples artificially inflates the total sample size, misestimates the weight of each study, and leads to an inappropriate narrowing of confidence intervals, thereby increasing the risk of Type I or Type II errors. Second, the definition of the "control group" in the study encompasses interventions with extremely high clinical heterogeneity, including placebo, normal saline, other active medications (e.g., diclofenac, somatostatin), and invasive procedures (e.g., pancreatic duct stenting). Pooling these controls with vastly different mechanisms of action and therapeutic efficacies renders the reported pooled relative risk (RR = 0.85) clinically meaningless. Furthermore, the high heterogeneity observed (I² = 79%) is most likely attributable to this flawed methodological design. In summary, the aforementioned issues cast doubt on the statistical credibility of the primary conclusion—that "indomethacin does not significantly reduce the incidence of PEP"—and also make it difficult to provide a reasonable clinical interpretation for practice. Given that this review incorporates multiple interrelated interventions for comparison, network meta-analysis would represent a more appropriate methodological framework. It can rigorously integrate data from multi-arm trials and simultaneously evaluate the relative efficacy of all relevant preventive strategies. "
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Tian F, Huang ZC, Khizar H, Qiu K. Efficacy of indomethacin for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: A comprehensive meta-analysis of randomized controlled trials. World J Gastroenterol 2026; 32(1): 113232
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