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1
Wazir HU, Reza IMK, Sajjad M, Inam N, Fida T, Fatima N, Sharif A, Ullah I, Naz S, Humaira, Khan MJ, Dad A, Sajid HMM, Kumari U, Surani S. Efficacy of acetaminophen compared to ibuprofen for patent ductus arteriosus in preterm neonates: A systematic review and meta-analysis. World J Cardiol 2026; In press
2026-03-23 | Browse: 6 | Download: 0
2
Li XH, Sun YY, Chen TT, Yang F, Lai ZB, He J. Surgical management of dysphagia at the oropharyngeal-esophageal junction due to cervical spondylosis: Two case reports. World J Gastrointest Surg 2026; In press
2026-03-23 | Browse: 2 | Download: 0
3
Akazawa Y, Ohtani M, Murata Y, Tanaka T, Nosaka T, Takahashi K, Naito T, Nakamoto Y. Three-dimensional psoas muscle volume and longitudinal changes as predictors of outcomes in older patients with advanced pancreatic cancer. World J Gastroenterol 2026; In press
2026-03-23 | Browse: 3 | Download: 0
4
Chen ML, Ma X, Xiao L, Chen TT, Luo ZL, Xie XD. Posterior approach to Calot’s triangle in situs inversus totalis: A case report and review of literature. World J Gastrointest Surg 2026; In press
2026-03-23 | Browse: 2 | Download: 0
5
Zhen J, Li YL, Xu YF, Guo LJ, Chen W. Study on risk factors and interaction effects of delirium in patients with severe pneumonia in intensive care unit. World J Psychiatry 2026; In press
2026-03-23 | Browse: 2 | Download: 0
6
Roberge J, Blair N, Hajjar A, Waller J, Tcheremissine OV. Bridging the gap: Virtual psychiatric transition of care from acute to outpatient settings. World J Psychiatry 2026; In press
2026-03-23 | Browse: 2 | Download: 0
7
Sun YT, Wang XW, Mongardini FM, Ling LM, Ma LA, Xiao Q. Subcutaneous emphysema due to rectal perforation: A case report. World J Gastrointest Surg 2026; In press
2026-03-23 | Browse: 6 | Download: 0
8
Mishra S, Dhar J, Crinò SF, Samanta J. Technical overview of difficult biliary cannulation in endoscopic retrograde cholangiopancreatography: A guide for the endoscopist. World J Gastroenterol 2026; In press
2026-03-23 | Browse: 3 | Download: 0
9
Wang H, Guo HT, Shen J, Zhang F, Jiang YJ, Liu ZX. Assessment of the value of complication risk prediction models following interventional therapy for hepatocellular carcinoma in nursing decision-making. World J Gastroenterol 2026; In press
2026-03-23 | Browse: 3 | Download: 0
10
Qiang WD, Wei Q, Yang B, Chen WJ, Lin CQ, Li YX. Radiotherapy-free neoadjuvant strategy using sintilimab plus XELOX in locally advanced rectal cancer: A single-arm phase II trial. World J Gastroenterol 2026; In press
2026-03-23 | Browse: 2 | Download: 0
11
Gao HF, Zhang K, Cheng CS, Shen YH, Chen H. FNDC5 enhances quercetin-induced anoikis in pancreatic adenocarcinoma cells via focal adhesion kinase-dependent mechanisms. World J Gastrointest Oncol 2026; In press
2026-03-23 | Browse: 5 | Download: 0
12
Nguyen BT, Vo LT, Pham UH, Tran HN, Dang OHT, Nguyen DT, Tran TTH, To LT, Do VC, Nguyen TT. Clinical recovery of severe infantile Angiostrongylus cantonensis meningoencephalomyelitis treated with pulse methylprednisolone: A case report and review of literature. World J Clin Pediatr 2026; In press
2026-03-23 | Browse: 5 | Download: 0
13
Li CP, Lv YM. Carbon dioxide embolism during salvage transanal total mesorectal excision in “frozen pelvis”: Two case reports. World J Gastrointest Surg 2026; In press
2026-03-23 | Browse: 3 | Download: 0
14
Dar PM, Arumugam SK, Hakim S, Peralta R, El-Menyar A, Rizoli S, Al-Thani H. Force analysis of mechanism and pattern of spinal trauma in sand dune vehicle crash: Five case reports. World J Clin Cases 2026; In press
2026-03-23 | Browse: 3 | Download: 0
15
Ke FY, Chen H, Liu JS, Li WC, Dhamija G, Viroja RD, Chen GP, Zhou XC. Clinical value of computed tomography-based three-dimensional reconstruction of the pelvis and mesorectum in middle to low rectal carcinoma. World J Gastrointest Surg 2026; In press
2026-03-23 | Browse: 5 | Download: 0
16
Wong FHA, See KC. Critical care considerations in rhabdomyolysis-associated acute kidney injury and kidney replacement therapy. World J Nephrol 2026; In press
2026-03-23 | Browse: 3 | Download: 0
17
He YL, Yin XH, Xu XT, Juan Li, Meng QH. Glucocorticoid therapy in acute liver failure: Survival outcomes, predictors, and a response prediction model. World J Hepatol 2026; In press
2026-03-23 | Browse: 5 | Download: 0
18
Sun YQ, Su J, Ye KN, Chen QX, Kang EZ, Lv CB, Lian MQ, Zeng WM, Zhang YB, Cai LS. High cyclin-dependent kinase 5 expression promotes tumor progression in gastric neuroendocrine carcinoma. World J Gastroenterol 2026; In press
2026-03-23 | Browse: 4 | Download: 0
19
Feng Y, Liu SN, Xu SJ, Feng YZ, Yu HP, Zheng RL, Wei JX, Sun QH, Zhong Y, Ma JZ. Musculoskeletal and bone health characteristics in young men: A comparison of low and high bone mineral density. World J Orthop 2026; In press
2026-03-23 | Browse: 6 | Download: 0
20
Tolan DA, Ebrahim NAA, AlAli NS, Ahmed HA, Alharshan GA, Arafat AMA. Stem cell-derived immune cells in pediatric cancer therapy: From bench to bedside. World J Stem Cells 2026; In press
2026-03-23 | Browse: 3 | Download: 0
1204 items  Read more >>
Author Reviews
1
"I am satisfied with the peer review process, but it has been three months since the paper was accepted. Compared to other journals, ..."  [Read more]
"I am satisfied with the peer review process, but it has been three months since the paper was accepted. Compared to other journals, this seems to be taking a bit longer. While I understand that the number of submissions has been increasing recently, given that the journal is primarily online, I hope that measures such as increasing the number of papers accepted will lead to more timely publication. "  [Collapse]
Teragawa H, Hashimoto Y, Tsuchiya A, Nomura S. Prognostic significance of vascular endothelial dysfunction in patients with vasospastic angina. World J Cardiol 2026; 18(3): 116661
2
"To long time for publication and the process is so complicated. The rank of the journal is not reaching science citation index ..."  [Read more]
"To long time for publication and the process is so complicated. The rank of the journal is not reaching science citation index expanded. In my university, this type of journal is not calculated as distinguished journal. I hope you will work on this point to improve the ranking of the journal. best wishes "  [Collapse]
Alghamdi TH. When to operate pancreatic intraductal papillary mucinous neoplasm: Literature review. World J Clin Oncol 2026; 17(3): 114990
3
"I am way more satisfied with the good quality of service provided by the journal and publishing team.I am grateful to the editors ..."  [Read more]
"I am way more satisfied with the good quality of service provided by the journal and publishing team.I am grateful to the editors and reviewers for their kind support throughout. Everything was so sorted and clear that I found it way more easier to do everything on my end. Thank you for giving us a chance of publishing our work in one of the leading journals amongst the readers. "  [Collapse]
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
4
"We are delighted to see this work published, and we would like to express our sincere gratitude to the editorial team. Their ..."  [Read more]
"We are delighted to see this work published, and we would like to express our sincere gratitude to the editorial team. Their professionalism, careful attention to detail and efficient management of the review process were outstanding. From initial submission to final publication, their clear guidance and timely communication ensured a smooth and constructive experience, from which we benefited greatly. "  [Collapse]
Chen M, Chen ZG. Endothelial metabolic reprogramming influences tumor immune microenvironment. World J Clin Oncol 2026; 17(3): 113326
5
"Thank you very much for reviewing and publishing our review article. I believe that there were no issues at all with the review process ..."  [Read more]
"Thank you very much for reviewing and publishing our review article. I believe that there were no issues at all with the review process on this occasion. We would like to continue submitting case reports, review articles, and original research papers to your journal in the future. We would greatly appreciate your continued support. Thank you very much. "  [Collapse]
Usuda D, Furukawa D, Imaizumi R, Ono R, Kaneoka Y, Nakajima E, Kato M, Sugawara Y, Shimizu R, Inami T, Sakurai R, 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. Sodium glucose transporter 2 inhibitors for heart failure. World J Cardiol 2026; 18(3): 118227
6
"Am sincerely grateful to the entire publishing team for their exceptional professionalism and dedication throughout this journey. ..."  [Read more]
"Am sincerely grateful to the entire publishing team for their exceptional professionalism and dedication throughout this journey. The editorial guidance was insightful, the communication was prompt and transparent, and the production quality exceeded my expectations. I particularly appreciate the meticulous attention to detail in formatting, proofreading, and design. The team's collaborative spirit made the process smooth and rewarding. I highly recommend this publisher to fellow authors and look forward to future collaborations. Thank you for bringing my manuscript to life with such care and expertise. "  [Collapse]
Hawanga GD, Li ZX, Li MX, Zhang XL, Qian DH. Lactylation in pancreatic cancer: From molecular mechanisms to therapeutic perspectives. World J Clin Oncol 2026; 17(3): 115882
7
"The entire process for publishing the article was excellent. They were always in communication to answer any questions. We went through ..."  [Read more]
"The entire process for publishing the article was excellent. They were always in communication to answer any questions. We went through a period when the journal was unavailable and things were on hold, but after that, everything went smoothly and was quite fast. They use a checklist for uploading the article, which is very helpful for avoiding forgetting anything or making any mistakes during the upload process. "  [Collapse]
Jaimez Alvarado S, Flores Enciso MF, Amedei A, Aguirre García MM. Gut microbiota-derived metabolite trimethylamine N-oxide in major adverse cardiovascular events: Mechanisms, risk assessment, and therapeutic strategies. World J Cardiol 2026; 18(3): 116780
8
"This research has served as an invaluable scholarly undertaking for our team. We extend our sincere gratitude to the Baishideng ..."  [Read more]
"This research has served as an invaluable scholarly undertaking for our team. We extend our sincere gratitude to the Baishideng Publishing Group for facilitating the exploration of this underexplored facet of cardiology. We trust this contribution will offer substantial merit to the broader general medicine and clinical communities. Finally, we thank all the members of the editorial team for their sincere efforts. "  [Collapse]
Mondal S, Raja DP, Muslim NA, Prabhu MA. Electrocardiographic artifacts in clinical practice: A logical approach to recognition and prevention. World J Cardiol 2026; 18(3): 116299
9
"I am sorry for the delay in the evaluation survey for this author. We had a great experience publishing our research article in this ..."  [Read more]
"I am sorry for the delay in the evaluation survey for this author. We had a great experience publishing our research article in this journal. The peer reviewers' reports greatly helped us to improve our article. The editorial staff was very communicative. They contact with us in timely manner. Thanks for them. "  [Collapse]
Gao CC, Ding FF, Jiang X. RRM2 attenuates the renal tubular ferroptosis in diabetic kidney disease through PI3K/Akt/Nrf2 pathway. World J Diabetes 2025; 16(11): 111223
10
"Thanks for publishing this important research study that is practice changing. I hope, every clinician and policy makers know the ..."  [Read more]
"Thanks for publishing this important research study that is practice changing. I hope, every clinician and policy makers know the Coronavirus disease 2019 seasonality is not uniformly winter-driven but shaped by behavioural adaptation to climate and host. Severe acute respiratory syndrome coronavirus 2 exhibits a seasonal pattern, being predominantly summer-predominant in tropical regions and winter-predominant in temperate ones, due to its virological resilience and broad host adaptability. Recognizing this behaviourally modulated seasonality is essential for designing climate- and region-specific surveillance, vaccination timing, and ventilation strategies. Thanks again. "  [Collapse]
Panda PK, Garg R. Rethinking COVID-19 seasonality: A summer respiratory virus in the tropics, contrast to influenza. World J Virol 2026; 15(1): 116492
11
"The submission and publication experience with this journal was smooth and well-organized. The manuscript handling process was timely, ..."  [Read more]
"The submission and publication experience with this journal was smooth and well-organized. The manuscript handling process was timely, and the editorial team maintained clear and consistent communication throughout. The peer review feedback was insightful, balanced, and contributed meaningfully to strengthening our work. We also found the formatting, presentation, and overall quality of the published article to be of a high standard. The guidelines were clear and easy to follow, and the turnaround time was satisfactory. Overall, the process was professional and efficient, reflecting a well-structured and reliable journal system. "  [Collapse]
Ahsan M, Ahmed S, Shaik RA, Ahmad MS, Nurani KM, A P. Efficacy of hyperbaric oxygen therapy in the treatment of depression. World J Psychiatry 2026; 16(3): 113572
12
"The entire editorial and peer review process was highly efficient, transparent, and well-coordinated. The online submission system ..."  [Read more]
"The entire editorial and peer review process was highly efficient, transparent, and well-coordinated. The online submission system was user-friendly, and communication from the editorial team was prompt and professional at every stage. The peer review reports were constructive, objective, and significantly improved the quality of our manuscript. We particularly appreciated the clarity of the editorial guidelines, the timely publication process, and the high standard of formatting and presentation in both the PDF and online versions. Overall, the experience was excellent and reflects a credible and well-managed journal. "  [Collapse]
Bavaria S, Chana A, Nurani KM, Kimang’a J. Recurrent hypoglycemia in a young female with nesidioblastosis: A case report and review of literature. World J Diabetes 2026; 17(3): 116660
13
"Overall, a great experience in publishing with a World group of journals. The overall process was relatively prompt, and the manuscript ..."  [Read more]
"Overall, a great experience in publishing with a World group of journals. The overall process was relatively prompt, and the manuscript preparation is great. A further reduction in overall provessing time would further enhance the experience however I could be related to delayed respomse from reviewers, which is beyond the scope of the journal Thanks "  [Collapse]
Qasim A, Zacharia GS, Veena F, Kandhi SD, Patel H. From esophagus to colon: A narrative review of eosinophilic gastrointestinal disorders. World J Gastrointest Pathophysiol 2026; 17(1): 115307
14
"The entire process was satisfactory and attractive to publish with the journal again. I suggest the assessment of the quality of the ..."  [Read more]
"The entire process was satisfactory and attractive to publish with the journal again. I suggest the assessment of the quality of the article should reflect the final published article rather than the initial evaluation at manuscript submission as evaluated by the first reviewer. The accepted and finally published article has significantly improved quality by the additional inputs from the authors, reviewers and the journal editors. The readers should see the quality reassessed at the final part, to be attracted to the manuscript. "  [Collapse]
Roro GM, Roro EM, Abebe DM. Addressing gastrointestinal disorders in rural Ethiopia: Success of a weekend outreach colonoscopy service. World J Gastrointest Endosc 2025; 17(9): 110476
15
"The Authors would like to thank all the editorial board for Your commitment and the overall quality of the service. We look forward ..."  [Read more]
"The Authors would like to thank all the editorial board for Your commitment and the overall quality of the service. We look forward to further collaboration with all the editorial board. Editing service and online systems are clear and easy to use. Some improvements can be made making the communication with the editorial board more easy, but it was satisfactory even as it is right now. Thank you. "  [Collapse]
De Meo D, Accinni T, Staccini D, Petrucci F, Martini P, Candela V, Zoccali C, Gumina S. Psychological burden of bone and joint infections: Systematic review on mental health and quality of life implications. World J Orthop 2026; 17(3): 112040
16
"I am happy with the evaluation system. It could be a bit quicker, but all around it is OK. The peer review is really helpful and the ..."  [Read more]
"I am happy with the evaluation system. It could be a bit quicker, but all around it is OK. The peer review is really helpful and the need for a certain length made the review more interesting and less simple. As such it becomes an important tool in upgrading the manuscript "  [Collapse]
Gafton B, Morărașu Ş, Dimofte GM. Nomograms in the era of personalized oncologic surgery. World J Gastrointest Oncol 2026; 18(3): 115824
17
"I appreciate the opportunity to evaluate the entire process. I would like to emphasise that they should work to reduce turnaround ..."  [Read more]
"I appreciate the opportunity to evaluate the entire process. I would like to emphasise that they should work to reduce turnaround times and improve internal communication. On the other hand, I commend the editors' work and appreciate their invitation to publish. This allows authors without publication funding to disseminate relevant views to the entire scientific system. "  [Collapse]
García Menéndez S, Inserra F, de Cavanagh EM, Ferder L, Manucha W. Renin-angiotensin system blockade attenuates brain mitochondrial dysfunction, oxidative stress, and neuroinflammation associated with hypertension, metabolic disorders, and aging. World J Exp Med 2026; 16(1): 113259
18
"The degree of satisfaction with the manuscript editing and publishing process is good. The peer review with fair, helpful, improved ..."  [Read more]
"The degree of satisfaction with the manuscript editing and publishing process is good. The peer review with fair, helpful, improved the manuscript , done in a timely manner . The final print is good quality. Looking forward to more publication with your journal and enhance the filed of orthopedic especially in my subspecialty of spine surgery "  [Collapse]
Elgafy H, Michael R, Jackson C, Burke C. Does the application of intrawound and prolonged systemic antibiotics decrease spine postoperative surgical site infection? World J Orthop 2026; 17(3): 116878
19
"The publication of this article was a particularly lengthy and demanding process, extending over several months. It was marked by ..."  [Read more]
"The publication of this article was a particularly lengthy and demanding process, extending over several months. It was marked by repeated and prolonged periods of inactivity between revisions and editorial communications, which significantly delayed progress and slowed the overall momentum of the work. This situation created frustration and uncertainty, ultimately contributing to a notably time-consuming, inefficient, and somewhat discouraging publication timeline. "  [Collapse]
Demarquoy J. Effects of micro and nano plastics on renal health. World J Nephrol 2026; 15(1): 115039
20
"The journal shows strong potential to become one of the most influential and well-established publications in the medical field. My ..."  [Read more]
"The journal shows strong potential to become one of the most influential and well-established publications in the medical field. My experience throughout the submission and review process was highly positive, reflecting a commendable level of professionalism and organization. The editorial team managed the process efficiently and maintained clear, respectful communication at every stage. In addition, the reviewers provided comprehensive and constructive feedback that significantly enhanced the quality and clarity of my manuscript. This reflects the journal’s genuine commitment to scientific excellence and high editorial standards. "  [Collapse]
Marzoog BA, Chomakhidze P, Gognieva D, Parunova AY, Demchuk SN, Silantyev A, Kuznetsova N, Kostikova A, Podgalo D, Nagornov E, Gadzhiakhmedova A, Kopylov P. Updates in breathomics behavior in ischemic heart disease and heart failure, mass-spectrometry. World J Cardiol 2025; 17(2): 102851
21010 items  Read more >>
Article Quality Tracking-Peer-Review
1
" 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"  [Collapse]
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 ..."  [Read more]
"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 "  [Collapse]
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 ..."  [Read more]
"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."  [Collapse]
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. ..."  [Read more]
"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. "  [Collapse]
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
5
"This is a high-level evaluation of a study or meta-analysis that summarizes its overall quality, reliability, strengths, limitations, ..."  [Read more]
"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. "  [Collapse]
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
6
"Summary: This study presents an exploratory analysis of bilateral upper limb sEMG activity in an experienced endoscopist during ..."  [Read more]
"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. "  [Collapse]
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 ..."  [Read more]
"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."  [Collapse]
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
8
"This study underscores the importance of considering systemic immune modulation in H. pylori infection, particularly in DU patients, ..."  [Read more]
"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."  [Collapse]
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
9
"Review Summary Report Review Notes: • The study addresses an important clinical question and provides practical guidance for ..."  [Read more]
"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. "  [Collapse]
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
10
"The manuscript addresses a highly relevant and timely topic in medical education. The focus on VR-based endoscopy training is ..."  [Read more]
"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. "  [Collapse]
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 ..."  [Read more]
"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."  [Collapse]
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
12
"Post-ERCP pancreatitis (PEP) is comprehensive and clearly outlined both epidemiology and pathophysiology. The discussion appropriately ..."  [Read more]
"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. "  [Collapse]
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 ..."  [Read more]
"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."  [Collapse]
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. "  [Collapse]
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."  [Collapse]
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. "  [Collapse]
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."  [Collapse]
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 ..."  [Read more]
"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."  [Collapse]
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
19
" 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."  [Collapse]
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."  [Collapse]
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
15972 items  Read more >>
Peer-Reviewers and Manuscript Statistics
Editorial board members
2263
Peer-reviewers
36600
Manuscripts received today
31
Manuscript reviews today
73
Unhandled manuscripts today
169
Active peer-reviewers today
3227
Reviewer acceptance today
92
Reviewer refusals today
106
Total accepted manuscripts
40797
Total rejected manuscripts
45045
Total peer-reviewers
4740995
Total submissions
38479
Baishideng Publishing Group (BPG) publishes 47 peer-reviewed, open-access journals covering a broad range of topics in clinical medicine, as well as several topics in biochemistry and molecular biology, relevant to human health today.
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All Journal Articles
1

Zhang TQ, Zhang L, Yong X, Tian C, Chen BJ, Qin JP, Mu D, Tang SH. Transjugular intrahepatic portosystemic shunt for variceal bleeding due to hereditary hemorrhagic telangiectasia with cirrhosis: A case report. World J Gastroenterol 2026; 32(12): 119002

2026-03-28 | Browse: 175 | Download: 50
2

Chen Q, Li KN, Liu TQ. From clinical efficacy to population health: Implementing vonoprazan-amoxicillin dual therapy for Helicobacter pylori control. World J Gastroenterol 2026; 32(12): 116953

2026-03-28 | Browse: 174 | Download: 57
3

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

2026-03-28 | Browse: 234 | Download: 71
4

Yang YH, Li Y. Reconsidering early-life bile acid amidation defect in environmental enteric dysfunction. World J Gastroenterol 2026; 32(12): 116258

2026-03-28 | Browse: 145 | Download: 44
5

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

2026-03-28 | Browse: 183 | Download: 41
6

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

2026-03-28 | Browse: 194 | Download: 43
7

Corovic IF, Pantic JM, Stanisavljevic IA, Pavlovic SM, Jovanovic IP, Radosavljevic GD, Simovic Markovic BJ. ST2 gene deficiency alleviates acute gastric injury in mice by modulating inflammation and epithelial cell death. World J Gastroenterol 2026; 32(12): 114576

2026-03-28 | Browse: 178 | Download: 54
8

Han X, Chen MY, Xiong QF, Zhong YD, Liu DX, Li J, Yang YF. Role of hepatic sonic hedgehog protein expression in the diagnosis of metabolic dysfunction-associated steatohepatitis. World J Gastroenterol 2026; 32(12): 113939

2026-03-28 | Browse: 201 | Download: 51
9

Dupuis O, Mavromatis S, Mavromatis A, Compas CN, Sabbagh C, Oliveira L, Hassard P. Endocuff Vision-enhanced colonoscopy: Does it improve polyp detection? World J Gastroenterol 2026; 32(12): 113927

2026-03-28 | Browse: 165 | Download: 55
10

Deng QX, Yang K, He J, Li JF, Li XQ, Zou L, Li YM, Xu SM, Jiang Z, Wu LJ. Autophagy related RHEB-CSF1R complex promotes tumor metastasis via advancing phosphorylation levels of PI3K, AKT, mTOR in pancreatic cancer. World J Gastroenterol 2026; 32(12): 112725

2026-03-28 | Browse: 223 | Download: 65
11

Usuda D, Furukawa D, Imaizumi R, Ono R, Kaneoka Y, Nakajima E, Kato M, Sugawara Y, Shimizu R, Inami T, Sakurai R, 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. Sodium glucose transporter 2 inhibitors for heart failure. World J Cardiol 2026; 18(3): 118227

2026-03-26 | Browse: 52 | Download: 20
12

Li A, Zhu YJ, Ma XX, Jin Y, Yang J, Feng QT. Arrhythmogenic right ventricular cardiomyopathy with atrial tachycardia and sick sinus syndrome: A case report. World J Cardiol 2026; 18(3): 117999

2026-03-26 | Browse: 55 | Download: 20
13

Hu PF, Bai LY, Zhao M, Ma KY, Xuan LY, Qi X. Landiolol modulates sodium 1.5 ion and connexin-43 to reduce sepsis ventricular arrhythmias. World J Cardiol 2026; 18(3): 117821

2026-03-26 | Browse: 52 | Download: 20
14

Ahmed S, Ahmad E, Ashraf H, Ain HU, Ahmad S, Akram U, Basit J, Hassan IN, Ullah I, Ahmed R, Fonarow GC, Cortese B. Nicorandil in ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention: A systematic review and meta-analysis. World J Cardiol 2026; 18(3): 116789

2026-03-26 | Browse: 73 | Download: 33
15

Jaimez Alvarado S, Flores Enciso MF, Amedei A, García MMA. Gut microbiota-derived metabolite trimethylamine N-oxide in major adverse cardiovascular events: Mechanisms, risk assessment, and therapeutic strategies. World J Cardiol 2026; 18(3): 116780

2026-03-26 | Browse: 55 | Download: 18
16

Teragawa H, Hashimoto Y, Tsuchiya A, Nomura S. Prognostic significance of vascular endothelial dysfunction in patients with vasospastic angina. World J Cardiol 2026; 18(3): 116661

2026-03-26 | Browse: 53 | Download: 22
17

Mondal S, Raja DP, Muslim NA, Prabhu MA. Electrocardiographic artifacts in clinical practice: A logical approach to recognition and prevention. World J Cardiol 2026; 18(3): 116299

2026-03-26 | Browse: 157 | Download: 35
18

Karbovskaya AD, Marzoog BA, Stroeva A, Suvorov A, Chomakhidze P, Gognieva D, Kuznetsova N, Syrkin A, Fadeev VV, Ismailova SM, Poluboyarinova IV, Kopylov P. Machine learning-based detection of diabetes mellitus from single-lead electrocardiography: A phenotype-stratified approach. World J Cardiol 2026; 18(3): 116217

2026-03-26 | Browse: 53 | Download: 17
19

Karbovskaya AD, Marzoog BA, Stroeva A, Chomakhidze P, Gognieva D, Kuznetsova N, Syrkin A, Fadeev VV, Poluboyarinova IV, Ismailova SM, Suvorov A, Kopylov P. Discriminating diabetes mellitus from single-lead electrocardiography using machine learning and multinomial regression. World J Cardiol 2026; 18(3): 116115

2026-03-26 | Browse: 50 | Download: 19
20

Tsai TY, Garg S, Serruys PW. Key considerations of a meta-analysis in physiology-guided percutaneous vs surgical revascularization in multivessel coronary artery disease. World J Cardiol 2026; 18(3): 115153

2026-03-26 | Browse: 32 | Download: 16
62642 items  Read more >>
Featured Articles
1

Karbovskaya AD, Marzoog BA, Stroeva A, Chomakhidze P, Gognieva D, Kuznetsova N, Syrkin A, Fadeev VV, Poluboyarinova IV, Ismailova SM, Suvorov A, Kopylov P. Discriminating diabetes mellitus from single-lead electrocardiography using machine learning and multinomial regression. World J Cardiol 2026; 18(3): 116115

2026-03-23 | Browse: 2 | Download: 1
2

Karbovskaya AD, Marzoog BA, Stroeva A, Suvorov A, Chomakhidze P, Gognieva D, Kuznetsova N, Syrkin A, Fadeev VV, Ismailova SM, Poluboyarinova IV, Kopylov P. Machine learning-based detection of diabetes mellitus from single-lead electrocardiography: A phenotype-stratified approach. World J Cardiol 2026; 18(3): 116217

2026-03-23 | Browse: 2 | Download: 1
3

Teragawa H, Hashimoto Y, Tsuchiya A, Nomura S. Prognostic significance of vascular endothelial dysfunction in patients with vasospastic angina. World J Cardiol 2026; 18(3): 116661

2026-03-23 | Browse: 2 | Download: 1
4

Mondal S, Raja DP, Muslim NA, Prabhu MA. Electrocardiographic artifacts in clinical practice: A logical approach to recognition and prevention. World J Cardiol 2026; 18(3): 116299

2026-03-23 | Browse: 2 | Download: 1
5

Usuda D, Furukawa D, Imaizumi R, Ono R, Kaneoka Y, Nakajima E, Kato M, Sugawara Y, Shimizu R, Inami T, Sakurai R, 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. Sodium glucose transporter 2 inhibitors for heart failure. World J Cardiol 2026; 18(3): 118227

2026-03-23 | Browse: 2 | Download: 1
6

Mera A, Sancho G, Garin O, Pont À, Pardo Y, Macias V, Hervas A, Cabrera P, Ferrer F, Roselló À, Samper Ots P, García ME, Jové-Teixidó J, Ferrer M, TMSGOCLPC. Patient-reported outcome measures for technology assessment: A comparison between three-dimensional conformal and intensity-modulated radiotherapy in prostate cancer. World J Clin Oncol 2026; 17(3): 115774

2026-03-23 | Browse: 4 | Download: 17
7

Yang YH, Li Y. Deep learning radiomic analysis in the prediction of MYCN status and survival outcome in children with neuroblastoma. World J Clin Oncol 2026; 17(3): 114744

2026-03-23 | Browse: 4 | Download: 17
8

Hawanga GD, Li ZX, Li MX, Zhang XL, Qian DH. Lactylation in pancreatic cancer: From molecular mechanisms to therapeutic perspectives. World J Clin Oncol 2026; 17(3): 115882

2026-03-23 | Browse: 3 | Download: 13
9

Chen M, Chen ZG. Endothelial metabolic reprogramming influences tumor immune microenvironment. World J Clin Oncol 2026; 17(3): 113326

2026-03-23 | Browse: 4 | Download: 15
10

Almashni SY, Fayek FB, Javens DC, Boulis MT, Makary MS. Evolving and novel applications of artificial intelligence in interventional oncology. World J Clin Oncol 2026; 17(3): 113226

2026-03-23 | Browse: 4 | Download: 11
11

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

2026-03-20 | Browse: 26 | Download: 47
12

Khan RTY, Ahsam S, Kumar SK, Khan K, Kakar MT, Hyder A, Malik W, Mubarak M, Luck NH. Hypoalbuminemia as a predictor of mortality in patients with acute cholangitis: A systematic review and meta-analysis. World J Gastrointest Pathophysiol 2026; 17(1): 113373

2026-03-20 | Browse: 17 | Download: 51
13

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

2026-03-20 | Browse: 21 | Download: 55
14

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

2026-03-20 | Browse: 23 | Download: 32
15

Qasim A, Zacharia GS, Veena F, Kandhi SD, Patel H. From esophagus to colon: A narrative review of eosinophilic gastrointestinal disorders. World J Gastrointest Pathophysiol 2026; 17(1): 115307

2026-03-20 | Browse: 22 | Download: 36
16

Dupuis O, Mavromatis S, Mavromatis A, Compas CN, Sabbagh C, Oliveira L, Hassard P. Endocuff Vision-enhanced colonoscopy: Does it improve polyp detection? World J Gastroenterol 2026; 32(12): 113927

2026-03-19 | Browse: 41 | Download: 24
17

Han X, Chen MY, Xiong QF, Zhong YD, Liu DX, Li J, Yang YF. Role of hepatic sonic hedgehog protein expression in the diagnosis of metabolic dysfunction-associated steatohepatitis. World J Gastroenterol 2026; 32(12): 113939

2026-03-19 | Browse: 39 | Download: 26
18

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

2026-03-19 | Browse: 34 | Download: 64
19

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

2026-03-19 | Browse: 27 | Download: 31
20

Chen Q, Li KN, Liu TQ. From clinical efficacy to population health: Implementing vonoprazan-amoxicillin dual therapy for Helicobacter pylori control. World J Gastroenterol 2026; 32(12): 116953

2026-03-19 | Browse: 28 | Download: 21
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67732 items  Read more >>
Reader Comments
1
"Sheriefet al. [1]demonstrated dual parametric evaluation to assess diagnostic performance for Hepatocellular carcinoma (HCC), ..."  [Read more]
"Sheriefet al. [1]demonstrated dual parametric evaluation to assess diagnostic performance for Hepatocellular carcinoma (HCC), discriminating from Hepatitis C-related liver Cirrhosis and Healthy control cohorts via plasma in a single centred Egyptian population.This study [1] revealed two leading biomarkers with exceptional accuracy (AUC >0.99); hsa-miR-21-5p (Sensitivity and Specificity of 98.6% and 96.7%, respectively) and Leukocyte-associated immunoglobulin-like receptor-1(LAIR-1) mean fluorescence intensity (MFI) (Sensitivity and Specificity of 100 % and 98.3%, respectively). Sherief et al. [1]aims to address one of the clinically challenging issues i.e. lack of sensitive, specific circulatory biomarker/s for early diagnosis of Hepatocellular Carcinoma (HCC).Commentary noted several strengths of the study by Sherief et al. [1],such as; looks technicallymoderatein study design, methodology and innovation level i.e. prospective study, minimally invasive sample collection, exploration of dual parameters: tumour derived circulatory micro-RNA and immune related marker. Additionally, study employed rigorous statistical analysis for diagnostic performance assessment including ROC curve analysis, comparative Sensitivity/Specificity,revealed promising findings that may pave for future research towards biomarkers validation and discovery. However,present commentary observed several concerns for the study by Sherief et al. [1]; (i) Lack of mechanistic cascade exploration including causal pathway/s.(ii) Median age of HCC cohort is significantly higher than Hepatitis C-related liver Cirrhosis and Healthy control, may be a biasing factor in expression pattern. (iii) Since study did not include follow up subjects that limits for probing of prognostic markers. (iv) Paucity of multi-centric involvement for diversified population, may limit the findings for generalized conception. (v) Validation of findings through blinded samples may demonstrate a better decision regarding applicability. (vi) Authors used word ‘noninvasive’, for plasma-based markers investigation(vii) Global Cancer statistics 2022,wasalready published in 2024[2], still authors used GLOBOCON 2020 [3] reference in epidemiological outline in the manuscript [1], latest reference can provide contemporary status. The article by Sherief et al. [1], demonstrated balanced and structured scientific contents along with logical explanations. However, addition of graphical abstract to present the study in nutshell may improve the visibility for readers. A large sample sized, multi-centered,longitudinal study, involving diversified geographical and ethnic population of HCC, Hepatitis C-related liver Cirrhosis, Healthy control cohorts, and mechanistically relevant subgroups, using common protocol, validation through blinded samples, may provide potential edge for HCCdiagnosticsto achieve common consensus and identification of prognostic biomarkers. Integrated nomogram ofhsa-miR-21-5p with LAIR-1 MFI, may be explored for possible better diagnosticsetup. Application of Artificial Intelligence (AI) may be explored for diagnostic performance as well as high throughput outcomes. References: 1. Sherief DE, Shehata HH, Nosair N, Othman AAA, Sadaka E, Elgamal R. Dual-parameter liquid biopsy using plasma miR-21-5p and T cell LAIR-1 mean fluorescence intensity for hepatocellular carcinoma diagnosis in a high-risk Egyptian cohort. World J Gastrointest Oncol 2026 March 15a; 18(3): 116567. 2. Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, Jemal A. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for36 cancers in185 countries. CA Cancer J Clin. 2024; 74:229–263 3. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021; 71: 209-249 "  [Collapse]
Sherief DE, Shehata HH, Nosair N, Othman AAA, Sadaka E, Elgamal R. Dual-parameter liquid biopsy using plasma miR-21-5p and T cell LAIR-1 mean fluorescence intensity for hepatocellular carcinoma diagnosis in a high-risk Egyptian cohort. World J Gastrointest Oncol 2026; 18(3): 116567
2
"I read with ken interest about the following article. As a reader I have few comments/ suggestions also. Alok Bharadwaj, Manas Taneja, ..."  [Read more]
"I read with ken interest about the following article. As a reader I have few comments/ suggestions also. Alok Bharadwaj, Manas Taneja, Sneha Dubey, Aditya Saxena. Very low-density lipoprotein and the human health. World J Exp Med 2026;16(1): 117024 [DOI: 10.5493/wjem.v16.i1.117024] Abstract Apo B100, TGL and cholesterol are present in LDL in addition to VLDL. But the ratio of TGL: cholesterol may vary. PATHOLOGICAL ROLE OF VLDL: Metabolism-associated fatty liver disease and liver disease: Distinction between NAFLD, MAFLD and MASLD may be provided Following the classification of metabolic dysfunction-associated fatty liver disease (MAFLD), non-alcoholic fatty liver disease (NAFLD) has recently been redefined again as metabolic dysfunction-associated steatotic liver disease (MASLD). Both MASLD and MALFD were linked to higher all-cause mortality risk, but MASLD identified a greater number of individuals compared to MAFLD. (Song R, Li Z, Zhang Y, Tan J, Chen Z. Comparison of NAFLD, MAFLD and MASLD characteristics and mortality outcomes in United States adults. Liver Int. 2024;44:1051-1060. doi:10.1111/liv.15856) Metabolic-associated fatty liver disease (MAFLD) exhibits a raised VLDL secretion rate attributed to increased intrahepatic TGs hydrolysis. They apparent the absence of immediate VLDL secretion reduction yet maintained a consistent apo B100 secretion rate, as informed by previous studies/ I would like to reframe this sentence: in the presence of elevated counter-regulatory hormones, lipolysis takes place in the adipose tissue releasing free fatty acids into circulation. Majority of these fatty acids are take up liver and converted into triglycerides. If VLDL secretion from liver is not proportionate to the level of fatty acid entry into liver, fatty acids may get accumulated in the liver causing different forms of fatty liver. In individuals with insulin resistance and higher body weight, there is an elevation in apo C-III levels within VLDL. Apo CIII is an inhibitor of lipoprotein lipase, thus inhibiting lipolysis of TGL in VLDL, thus increasing VLDL concentration in blood. Insulin resistance and MetS Insulin-hampered VLDL production, along with insulin resistance, leads to increased and decreased production of VLDL, often associated with hypertriglyceridemia Does VLDL increase or decrease with insulin resistance Hepatic VLDL production is decreased by glucagon Mechanism behind this Alterations of VLDL in various disorders have been explained well. All the mechanistic pathways have been adequately addressed "  [Collapse]
Bharadwaj A, Taneja M, Dubey S, Saxena A. Very low-density lipoprotein and the human health. World J Exp Med 2026; 16(1): 117024
3
"This letter to the Editor notes the potential significance of clinical situation in patients who suffer from emphysematous ..."  [Read more]
"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. "  [Collapse]
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
4
"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. "  [Collapse]
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
5
"Reader’s code: 00106360 Commentary on the Article Impact of metabolic dysfunction-associated steatotic liver disease on liver ..."  [Read more]
"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. "  [Collapse]
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
6
"Esophageal variceal bleeding is one of the most severe complications of cirrhotic portal hypertension, associated with high rates ..."  [Read more]
"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. "  [Collapse]
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
7
"This systematic review of 8 randomized trials (1758 participants) rigorously evaluates adjunctive pharmacotherapies for diuretic ..."  [Read more]
"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. "  [Collapse]
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
8
"The article raises critical issues regarding healthcare expenditure and the anesthesiologist’s responsibility in cost containment. ..."  [Read more]
"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. "  [Collapse]
Karim HMR. Healthcare delivery cost and anesthesiologists: Time to have a greater role and responsibility. World J Anesthesiol 2019; 8(3): 19-24
9
"I read with great interest the study by Khalifa et al. published in the World Journal of Orthopedics, evaluating the impact of surgeon ..."  [Read more]
"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. "  [Collapse]
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
10
"I would like to congratulate the authors on this clinically relevant study. The authors provided a conclusion that differs from ..."  [Read more]
"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. "  [Collapse]
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
11
"I congratulate the authors on this relevant study on this study. As the authors pointed out, Klebsiella is the leading cause of liver ..."  [Read more]
"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 "  [Collapse]
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
12
"Wang and Pan present an editorial that meaningfully extends the discussion of ERAS in elderly gastric cancer patients beyond ..."  [Read more]
"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. "  [Collapse]
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
13
"This Editorial thoroughly explores the field of AI use in diagnostic radiology. It provides a complete overview of the potential and ..."  [Read more]
"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. "  [Collapse]
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
14
"This study demonstrates that presenilin-1 (PS-1) is significantly associated with β-catenin activation, PTEN phosphorylation, advanced ..."  [Read more]
"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. "  [Collapse]
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
15
"In this paper, the tumor indicators of patients with gastric cancer after operation were detected and analyzed. It was found that ..."  [Read more]
"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. "  [Collapse]
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
16
"Dear Editor, I am writing in response to your invitation to comment on the prospective study by Güneş et al., entitled “Diagnostic ..."  [Read more]
"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 "  [Collapse]
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
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"Systemic antifungal therapy is the backbone of treatment for invasive fungal infections, but it carries an under-recognized burden ..."  [Read more]
"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. "  [Collapse]
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 ..."  [Read more]
"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. "  [Collapse]
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
19
"This minireview provides a timely and balanced synthesis of the evolving role of endoscopic ultrasound-guided radiofrequency ablation ..."  [Read more]
"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. "  [Collapse]
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 ..."  [Read more]
"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] "  [Collapse]
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
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