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"In this manuscript, the authors performed a meta-analysis of 30 randomized controlled trials involving 16,977 patients to assess whether rectal administration of indomethacin prevents post–endoscopic retrograde cholangiopancreatography pancreatitis (PEP).
The results show no statistically significant difference in the risk of PEP between patients who received indomethacin and those who did not. Nevertheless, in the Discussion and Conclusion, the authors present their findings in a way that implies a beneficial effect of rectal indomethacin for PEP prevention.
This clear discrepancy between the reported results and the authors’ interpretation renders the manuscript confusing and undermines the validity of its conclusions."
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Tian F, Huang ZC, Khizar H, Qiu K. Efficacy of indomethacin for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: A comprehensive meta-analysis of randomized controlled trials. World J Gastroenterol 2026; 32(1): 113232 [DOI: 10.3748/wjg.v32.i1.113232]
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"The review clearly articulated why smoking cessation is particularly critical in diabetes, linking smoking to increased complications and mortality. Authors emphasized routine integration into diabetes care is a major practical strength. Physiological (weight gain, insulin sensitivity changes) and psychological barriers were appropriately highlighted, and the need for tailored approaches is reinforced. This framing helps justify why standard cessation models may be insufficient for this population. The identification of varenicline as the agent with the strongest evidence in people with diabetes is appropriate and clinically useful. The cautious tone regarding nicotine replacement therapy and bupropion was justified because of limited diabetes-specific data. Inclusion of harm reduction strategies, GLP-1 receptor agonists, and digital tools reflects contemporary practice and emerging research directions. The call for pragmatic trials and long-term strategies is well aligned with current gaps in evidence.
However, the role of GLP-1 receptor agonists is interesting but somewhat speculative. Explicitly acknowledging that evidence for a direct effect on smoking cessation is indirect or preliminary would improve scientific rigor.
"
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Russo C, Walicka M, Cohen G, Bellanca CM, Geraci G, Caponnetto P, Noviello DE, Chianetta R, George J, Sammut R, Franek E, Polosa R. Addressing the dual challenge: Managing smoking cessation in patients with diabetes. World J Diabetes 2025; 16(12): 105241 [PMID: 41480599 DOI: 10.4239/wjd.v16.i12.105241]
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"Dear colleagues!
I read with interest your manuscript Artificial intelligence in functional gastrointestinal disorders: From precision diagnosis to preventive healthcare, published in Artif Intell Gastroenterol 2026; 7(1): 112357. The topic is really actual and in your paper, you addressed important aspects of implementation of artificial intelligence to this specific field.
For sure, FGIDs have common pathogenetic features; however, the overlap in the underling mechanisms between each of the disorders relatively low. This makes development of the integrative algorithms for diagnosis, differentiation and treatment (especially personalized) difficult. And this highlights the complexity of your task - to cover all these aspects in one mini-review. I hope that you will continue your work. Given the complexity of integrative coverage of all aspects of AI application in functional diseases of the gastrointestinal tract, perhaps you can prepare separate, more specific materials for each of the diseases. I believe that such material would also be of interest to the readers."
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Yan YN, Zeng JQ, Ding X. Artificial intelligence in functional gastrointestinal disorders: From precision diagnosis to preventive healthcare. Artif Intell Gastroenterol 2026; 7(1): 112357 [DOI: 10.35712/aig.v7.i1.112357]
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"• Pringle is an important technique in lap liver surgery, but if a patient has previously undergone gallbladder removal or gastric surgery, strong adhesions can make it difficult to reach the hepatoduodenal ligament. However, the authors' method of using the ligamentum teres hepatis seems to be a good technique. It has been mentioned that there have been cases where the IVC or right renal vein has been damaged when the technique was inexperienced. Please explain this. Also, please explain what efforts are being made to prevent intestinal adhesions to the hepatoduodenal ligament in the future.
•
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Kawano Y, Murokawa T, Aoki Y, Hamaguchi A, Ono T, Haruna T, Yoshimori D, Irie T, Ueda J, Shimizu T, Matsushita A, Kawashima M, Ga R, Furuki H, Kanda T, Oshiro Y, Minamimura K, Yoshioka M, Taniai N, Nakamura Y, Yoshida H. Utility of liver surface-guided encirclement of hepatoduodenal ligament for the Pringle maneuver in minimally invasive repeat liver resection. World J Gastroenterol 2026; 32(1): 113470 [DOI: 10.3748/wjg.v32.i1.113470]
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"Congratulations on the publication of your paper. I read it promptly and found it extremely interesting. The quality of the manuscript is very high, and it incorporates novel findings, making it a highly valuable contribution. For these reasons, I would like to award it first prize without any reservation. It has been a long time since I last encountered such an outstanding paper. It is truly impressive that you have produced so many publications to date. I sincerely encourage you to continue your efforts in writing papers for the advancement of medicine, and I wish you continued success in your career. Thank you very much."
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Usuda D, Furukawa D, Imaizumi R, Ono R, Kaneoka Y, Nakajima E, Kato M, Sugawara Y, Shimizu R, Inami T, Kawai K, Matsubara S, Tanaka R, Suzuki M, Shimozawa S, Hotchi Y, Osugi I, Katou R, Ito S, Mishima K, Kondo A, Mizuno K, Takami H, Komatsu T, Nomura T, Sugita M. Spontaneous bacterial peritonitis due to Edwardsiella tarda in an immuno-compromised dialysis patient: A case report and review of literature. World J Clin Cases 2026; 14(1): 115102 [DOI: 10.12998/wjcc.v14.i1.115102]
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"This meta-analysis found that rectal indomethacin did not differ significantly from placebo in PEP incidence. However, the pharmacological safety profile was very satisfactory with no significant increase in adverse events compared with the control group. The evidence was more substantial in high-risk patients. It is known that, given this satisfactory safety profile, many centers administer NSAIDs rectally. The authors conclude with the recommendation that “Rectal indomethacin appears to be safe and may offer benefit in selected high-risk patients, though findings should be interpreted with caution due to high heterogeneity”.
The meta-analysis's obvious conclusion is that the drug is ineffective when administered before ERCP. However, in an attempt to mitigate the effects, the authors agree to “accept the results with caution.”
PEP is known to be the most common serious complication of ERCP, occurring in approximately 3.5% to 15% of cases, and up to 25% in high-risk groups. According to the latest clinical guidelines (including ASGE 2023 and IAP 2025 updates), a multi-modal approach is the standard of care. Prevention strategies are divided into patient selection, pharmacological prophylaxis, and procedural techniques. The Summary Protocol for 2026 recommends the following: For Universal Prophylaxis, Rectal Indomethacin 100 mg for all patients + moderate hydration, and for High-Risk Prophylaxis: Rectal NSAIDs + Aggressive Lactated Ringer's + Prophylactic PD Stent.
I think that such vital clinical issues are best resolved through international consensus, which will provide clear, universally accepted guidelines."
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Tian F, Huang ZC, Khizar H, Qiu K. Efficacy of indomethacin for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: A comprehensive meta-analysis of randomized controlled trials. World J Gastroenterol 2026; 32(1): 113232 [DOI: 10.3748/wjg.v32.i1.113232]
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"I would like to commend the authors for an exceptionally comprehensive and timely review on strategies to optimize mesenchymal stem cell (MSC) therapy for tendon-bone healing. I found the sections on MSC-derived extracellular vesicles (EVs)/exosomes particularly insightful. The manuscript effectively highlights the advantages of EV-based, cell-free therapies, including lower immunogenicity, reduced tumorigenic risk, and the ability to mediate paracrine effects similar to parent MSCs, positioning them as a promising modality for tendon-bone regeneration.
The discussion of strategies to enhance EV efficacy, such as preconditioning of parent MSCs (hypoxia, LIPUS, magnetic stimulation, and pharmacological agents) and engineering delivery platforms (endogenous/exogenous loading, surface modifications for targeted delivery), is highly relevant for translational applications. I especially appreciated the emphasis on exosome-mediated modulation of macrophage polarization, promotion of angiogenesis, and enhancement of osteogenic and chondrogenic differentiation, which highlights their mechanistic versatility.
While the manuscript provides excellent mechanistic insight and preclinical evidence, a brief discussion on challenges in EV translation—such as scalable production, stability, standardization of dosing, and regulatory considerations—could further strengthen the practical relevance. Nonetheless, this focused review of MSC-derived EVs significantly contributes to the field by showcasing both the potential and current hurdles of cell-free therapies for tendon-bone healing."
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Li H, Li ZP, Zhu MT, Lan CH, Wang YX, Liao P, Chen Z, Wang P, Sun JK, Shi Z, Lu PY, Lou C, Xu GH. Optimizing mesenchymal stem cell therapy for tendon-bone healing: Multifaceted approaches and future directions. World J Stem Cells 2025; 17(12): 114076 [PMID: 41480394 DOI: 10.4252/wjsc.v17.i12.114076]
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"The ethical approval provided by the author meet the requirements.
This report provided a rare case report, with educational significance.
Of “It is a safe and reliable approach for OT treatment, which
offers the advantages of minimal trauma, mild postoperative pain, and rapid recovery for stylistic precision”. It’s not adequate in this section.
Of “Abdominal contrast-enhanced CT plays a crucial role in diagnosing OT, and laparoscopic surgery is a safe and effective diagnostic and therapeutic approach” in the conclusion. It’s not adequate to address “and laparoscopic surgery is a safe and effective diagnostic and therapeutic approach” in the “Conclusion”.
Structure of relative description was not adequate. Discussion needs not involve much about other aspects of omental torsion other than imaging diagnosis, it should focus on imaging diagnosis and differential diagnosis, especially contrast-enhanced CT and contrast-enhanced ultrasound. Compared to CT, contrast-enhanced CT has higher sensitivity and specificity in the visualization of the omental vascular running and contrast perfusion, and has better ability to determine whether there is ischemia and associate secondary change.
“whirlpool sign” is unique for the diagnosis of omental torsion.
Duplex ultrasound can find “whirlpool sign” and loss of color signal of vascualrity in some cases of omental torsion. It should be addressed that color Doppler flow imaging is usually not able to detect blood vessels in the great omentum. Contrast-enhanced ultrasound can find defect of vascular perfusion in the region of the great omentum with necrosis, while there was discussion on this technique.
It should be addressed that “whirlpool sign” can only be detected in part cases of omental torsion.
Ovary torsion has “whirlpool sign” and abdominal emergency, and differential diagnosis is required.
The report was written in English awkwardly, not meeting native English and standardized professional expression.
Of Figure 1. There were no arrows to indicate “whirlpool sign” of omental torsion.
Of “(hematoxylin and eosin, × 50)” in Figure 4. “× 50” does not follow routine practice, and it may be mistaken.
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Li YL, Fan JX, Yang Y, Yao MQ, Jiang YP. Omental torsion diagnosed by abdominal contrast-enhanced computed tomography: A case report. World J Radiol 2025; 17(12): 114398 [PMID: 41480291 DOI: 10.4329/wjr.v17.i12.114398]
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"This is very interesting paper about the relationship between IBD and Alzheimer’s. Recent studies suggest that patients with IBD ( UC and chronic ) have a significantly higher about 2.5 times risk of developing dementia,including Alzheimer’s disease and are diagnosed at a younger age. This association may be due to the intestinal inflammation caused by IBD, disruption of intestinal flora and dysfunction of the gut-brain axis sharing a common pathway with the underlying mechanisms of Alzheimer’s disease (such as amyloid beta accumulation),and it is possible that improving the intestinal environment may lead to the prevention of dementia."
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Durairajan SSK, Singh AK, Sulaiman SM, Patnaik S, Krishnamoorthi S, Iyaswamy A, Vellingiri B, Yang CB, Williams LL. Molecular links between inflammatory bowel disease and Alzheimer’s disease through immune signaling and inflammatory pathways. World J Gastroenterol 2025; 31(48): 111301 [PMID: 41480321 DOI: 10.3748/wjg.v31.i48.111301]
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"Bouveret syndrome is a rare form of gallstone ileus, presenting as gastric outlet obstruction due to a large gallstone that has migrated through a biliogastric or bilioduodenal fistula.This manuscript is a well-written and presented rarely case report.Bouveret Syndrome primarily affects elderly patients. The authors point out that it may also occur in young individuals. I think that this manuscript is worth to publication."
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Hu YC, Chen XY, Cao MK, Fan Z. Bouveret syndrome in a young patient: A case report and review of literature. World J Gastrointest Surg 2025; 17(12): 113532 [PMID: 41479725 DOI: 10.4240/wjgs.v17.i12.113532]
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"This study clearly highlights the importance and contribution of AI in the diagnosis of rectal neuroendocrine tumors in daily clinical practice. It is known that rectal endocrine tumors present significant diagnostic difficulties because they are often considered as hyperplastic polyps and are either not removed and therefore not subjected to histological evaluation, or are removed as normal polyps. The consequence is that diagnosis is delayed or requires subsequent complementary imaging and/or endoscopic examination.
The authors developed an image analysis and detection model for rectal neuroendocrine tumors using the YOLOv7 algorithm. This algorithm demonstrated significant diagnostic accuracy, exceeding that of most endoscopes with which it was compared.
It has been repeatedly emphasized that AI is expected to revolutionize the diagnosis of many gastrointestinal diseases, including rectal endocrine tumors. We experience this to a large extent in daily clinical practice. However, it should be emphasized that the effectiveness of this system in detecting neuroendocrine rectal tumors should be investigated and evaluated in future large, multicenter studies."
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Liu K, Wang ZY, Yi LZ, Li F, He SH, Zhang XG, Lai CX, Li ZJ, Qiu L, Zhang RY, Wu W, Lin Y, Yang H, Liu GM, Guan QS, Zhao ZF, Cheng LM, Dai J, Bai Y, Xie F, Zhang MN, Chen SZ, Zhong XF. Artificial intelligence-assisted diagnosis of rectal neuroendocrine tumors during white-light endoscopy. World J Gastroenterol 2025; 31(48): 112683 [PMID: 41480324 DOI: 10.3748/wjg.v31.i48.112683]
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"1. The authors have projected the cardiotoxicity as a sequel of chemotherapy relevant to LMIC in perspective, documenting the follow up timings
2. The importance of the follow up and its necessity is also well brought out in the light of current literature
3. The relevance of cardiotoxicity lies in the drug / regime and the dosage. Especially if the patient was administered more than the expected maximal dosage. This can be included for better understanding. "
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Ali W, Mehmood A, Surani S. Chemotherapy-related cardiotoxicity: Bridging the gap between evidence and practice. World J Clin Cases 2025; 13(36): 114228 [PMID: 41480053 DOI: 10.12998/wjcc.v13.i36.114228]
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"1. The difference of a squamous cell ca in a viscera, in comparison to that in the superficial skin site can be brought out in terms of presentation, prognosis / management / tumor behaviour, etc
2. When to suspect a similar lesion can be highlighted for the benefit of readers
3. The conclusion section can avoid summary of the manuscript, rather can include a crisp take home message on the index case."
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Li QQ, Wei J, Fang LY, Zhou JL, Zhao HF. Primary ileal squamous cell carcinoma: A case report and review of literature. World J Clin Cases 2025; 13(36): 111835 [PMID: 41480057 DOI: 10.12998/wjcc.v13.i36.111835]
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"The article entitled Evolving trends in hepatitis A epidemiology: Shifting patterns, emerging risks, and future strategies is well written article but some comments to be considered:
- Most of the studies included in the review article depend on seroprevalence of the disease that is mean it depend on detection of antibodies which of course of low speceficity as diagnosis of HAV infection must depend on isolation of the virus by real time PCR especially in endemic areas to avoid false positive results.
- There is some redunduncy and reptition of the data (e.g Endemicity in the era of vaccination and improving living standards -- Changing epidemiology of hepatitis A
"
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Majeed AA, Sarfraz M, Butt AS. Evolving trends in hepatitis A epidemiology: Shifting patterns, emerging risks, and future strategies. World J Virol 2025; 14(4): 112590 [PMID: 41479578 DOI: 10.5501/wjv.v14.i4.112590]
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" The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied."
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Huang K. Influence of obesity on the patient’s recovery after laparoscopic surgery. World J Clin Cases 2025; 13(36): 115269 [PMID: 41480056 DOI: 10.12998/wjcc.v13.i36.115269]
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" The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied."
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Taha R, Elsayed G, Mohamed L, Gadour E. Beyond biliary causes, fish bone perforation as a rare etiology of recurrent fever in a post-Whipple patient: A case report. World J Clin Cases 2025; 13(36): 114956 [PMID: 41480059 DOI: 10.12998/wjcc.v13.i36.114956]
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" The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied."
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Li QQ, Wei J, Fang LY, Zhou JL, Zhao HF. Primary ileal squamous cell carcinoma: A case report and review of literature. World J Clin Cases 2025; 13(36): 111835 [PMID: 41480057 DOI: 10.12998/wjcc.v13.i36.111835]
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"In this study, the authors describe a patient with severe ulcerative colitis resistant to treatment and comorbid health problems who responded favorably and without side effects to the combined treatment of an α4β7 integrin antagonist (vedolizumab) and an interleukin 23p19 inhibitor (mirikizumab).
This case reinforces the view, expressed over the last few years, of the need to combine two biological agents in treatment-resistant inflammatory bowel disease and in treatment-resistant patients with extraintestinal manifestations.
Personally, I believe we will be led to adopt the above recommendation in the near future. What remains is the approval and adoption of this recommendation by the pharmaceutical companies manufacturing biological agents, so they can conduct extensive, multicenter studies and avoid being limited to descriptions of individual cases or series from specialized centers with very small patient numbers."
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Guimarães AC, Ferreiro-Iglesias R, Calviño-Suarez C, Baston-Rey I, Barreiro-de Acosta M. Dual biologic therapy in patient with refractory ulcerative colitis and comorbidities: A case report. World J Gastroenterol 2025; 31(47): 113381 [PMID: 41479760 DOI: 10.3748/wjg.v31.i47.113381]
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"1 Ethics: Does the ethical approval form provided by the author meet the requirements?
Not applicable.
2 Methods: Is the experimental method effective? Can it be repeated by fellow researchers (according to adequate textual/citation content presented)?
Not applicable.
3 Results: Are the results true and authentic? Is the theory or hypothesis of universal significance validated or partially validated?
Not applicable.
4 Figures and tables: Does the author provide perfect tables, line charts and/or graphs? Or, does the author provide figures and tables that are confusing, poorly constructed and/or not well-annotated?
Yes.
5 Biostatistics: Does the author provide perfect biostatistics data? Or, does the author provide tables and line charts that have mistakes in the data?
Not applicable.
6 References: Does the author scientifically and reasonably cite the latest references which are important in this field and related to the scientific problems and research hypotheses addressed in the study? Or, does the author self-cite, omit, mis-cite and/or over-cite references?
Yes.
7 Language: Does the language in article correctly, clearly and concisely express the information? Or, does the article have multiple grammatical and spelling mistakes?
Yes.
8 Caveats or drawbacks: What are the caveats or drawbacks for the results?
They didn't provide many new ideas."
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Li H, Li ZP, Zhu MT, Lan CH, Wang YX, Liao P, Chen Z, Wang P, Sun JK, Shi Z, Lu PY, Lou C, Xu GH. Optimizing mesenchymal stem cell therapy for tendon-bone healing: Multifaceted approaches and future directions. World J Stem Cells 2025; 17(12): 114076 [PMID: 41480394 DOI: 10.4252/wjsc.v17.i12.114076]
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"These findings illuminate the pivotal role of YY1 in driving the progression of Helicobacter pylori-induced gastric carcinogenesis through the activation of epithelial-mesenchymal transition (EMT). From a molecular vantage point, this study stands as a compelling testament to rigorous scientific inquiry, underpinned by a wealth of robust experimental evidence that substantiates its central claims.
Here I only offer a suggestion and reference. In fact, cancer is a complex pathological ecosystem rather than a simple genetic disease. However, the current mainstream research perspective is greatly influenced by the "somatic mutation" theory, often believing that genes and molecules are the ultimate essence of cancer. However, such a linear reductionist view has not brought about fundamental improvements in prognosis in clinical practice, such as in targeted therapy. I believe that in the post-genomic era, we should think more about the occurrence and development of cancer from the perspectives of ecology and evolution rather than being confined to the molecular level. As I pointed out in the "Rethinking Cancer" column for the 110th anniversary of the Chinese Medical Association (https://pubmed.ncbi.nlm.nih.gov/40443342/), the key to understanding such a complex systemic disease as tumors does not lie in the relentless pursuit of genes and molecules. It can be said that the role and function (promoting or inhibiting cancer, driver, passenger or neutral) of a single gene mutation in cancer cells depend on the environment and ecological niche in which they are located. By the way, I kindly recommend the authors and your team explore the book "Rethinking Cancer" (Strauss B. et al., 2021), which is also available in Chinese version (2024, Tsinghua University Press). This book might offer a refreshing and insightful perspective on human cancers, which could help guide future research and practice and better assist in improving patient prognosis."
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Chen JW, Ouyang JJ, Wang ZH, Ma DM, Zhang Z, Teng Q, Yu G, Li XY. Yin Yang 1 activates JAK-STAT3-mediated epithelial-mesenchymal transition in Helicobacter pylori-induced gastric cancer progression. World J Clin Oncol 2025; 16(12): 112626 [PMID: 41480166 DOI: 10.5306/wjco.v16.i12.112626]
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"This is very interesting paper. The authors state that the Bismuth-Corlett classification, hypokalemia, and AST levels were identified as independent risk factors for PBI following ERCP drainage. The Bismuth-Corlett classification and AST levels can be understood as risk factors for drainage infection after ERCP, but please explain why hypokalemia is a risk factor. Please state in numbers how much hypokalemia is and what the AST level is."
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Wang YF, Han K, An N, Sun YN, Gao F, Sun Y, Zhang D, Zhao ZF, Guo Q, Gu JN, Yang Z. Risk prediction of biliary infection after endoscopic drainage for malignant perihilar biliary obstruction: A 10-year multicenter retrospective study. World J Gastroenterol 2025; 31(47): 113156 [PMID: 41479752 DOI: 10.3748/wjg.v31.i47.113156]
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"The study is particularly strong in its development of a multimodal fusion model that integrates clinical data, radiomics, and habitat imaging to achieve markedly superior performance in predicting early recurrence of hepatocellular carcinoma, outperforming traditional single‑modality models in both accuracy and clinical net benefit. It also excels by incorporating SHAP‑based interpretability to clarify how specific imaging and clinical features contribute to predictions, and by validating meaningful correlations between selected radiomic/habitat features and key pathological markers such as MVI, Ki‑67, and GPC‑3, thereby enhancing biological plausibility and clinical relevance."
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Huang LH, Fang YJ, Zheng XJ, Huang C, Li CL, Yu B, Huang MJ, Qin SJ, Huang DY, Lu DW. Application of multimodal fusion technology in early recurrence prediction and pathological analysis of hepatocellular carcinoma. World J Gastrointest Oncol 2025; 17(12): 114037 [PMID: 41480210 DOI: 10.4251/wjgo.v17.i12.114037]
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"The study excels by integrating radiomics and body composition metrics from both pretreatment and follow‑up T12‑level CT scans, demonstrating that combining these imaging biomarkers with clinical data markedly improves the accuracy of survival prediction in esophageal cancer. It also stands out for using automated segmentation tools to eliminate manual variability, rigorously comparing multiple machine‑learning models, and showing that follow‑up imaging adds substantial prognostic value. Overall, the research provides a practical, non‑invasive, and clinically applicable framework that enhances personalized risk stratification when traditional L3‑level imaging is unavailable."
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Liu MC, Cheng YY, Lin SC, Lin CH, Chuang CY, Chen WH, Liao CH, Hsieh CH, Hsieh MF, Liu YJ. Machine learning survival prediction in esophageal cancer using radiomics and body composition from pretreatment and follow-up T12-level computed tomography. World J Gastrointest Oncol 2025; 17(12): 112873 [PMID: 41480227 DOI: 10.4251/wjgo.v17.i12.112873]
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"The study demonstrates several strengths, including the safe and smooth execution of cryoablation without perioperative deaths, the clear improvement in immune function and pain reduction following treatment, and the meaningful clinical benefits such as tumor shrinkage and prolonged overall survival compared with chemotherapy alone; together, these findings highlight cryoablation as an effective, minimally invasive option that enhances quality of life and offers a promising therapeutic alternative for patients with locally advanced pancreatic cancer."
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Kang LM, He XL, Lang L, Wang AY, Wang X, Liu YH, Zhao YH, Xu L, Yu FK, Zhang FW. Safety and efficacy of cryoablation in treating locally advanced pancreatic cancer. World J Gastrointest Oncol 2025; 17(12): 113387 [PMID: 41480225 DOI: 10.4251/wjgo.v17.i12.113387]
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25
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"The study evaluated a WeChat‑based bowel preparation monitoring system for outpatients undergoing colonoscopy and found that, compared with traditional oral and written education, the digital system significantly reduced patients’ anxiety and depression, improved bowel cleanliness, enhanced key colonoscopy quality indicators such as cecal intubation rate and polyp detection rate, increased patient compliance with dietary and medication instructions, and lowered the incidence of adverse reactions, demonstrating that real‑time, interactive, and personalized guidance can meaningfully improve the overall effectiveness and safety of colonoscopy preparation."
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Xi MJ, Gong YP, Tao J, Li F, Xu MY, Gu X, Bao H, Jiang S, Xu B. Exploring the improvement effect of intestinal network monitoring system on intestinal preparation quality of colonoscopy. World J Gastrointest Oncol 2025; 17(12): 111101 [PMID: 41480224 DOI: 10.4251/wjgo.v17.i12.111101]
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"The article provides a rigorous and comprehensive meta‑analysis evaluating the prognostic significance of cancer‑associated fibroblasts in liver cancer using real‑world clinical data. It strengthens its conclusions through well‑structured subgroup analyses across different CAF markers and cancer types, offering a more nuanced understanding of their prognostic value. The study also adheres to PRISMA guidelines and includes only high‑quality research, enhancing the reliability and credibility of its findings."
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Wei YH, Jiang WJ, Wang SQ, Cai YL, Ma XL. Cancer-associated fibroblasts, clinicopathological characteristics and prognosis of liver cancer: A systematic review and meta-analysis based on real-world research. World J Gastrointest Oncol 2025; 17(12): 110395 [PMID: 41480218 DOI: 10.4251/wjgo.v17.i12.110395]
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"It was with pleasure that I reviewed the article quality of the following manuscript:
1 Ethics: Not applicable given manuscript type
2 Methods: Not applicable given manuscript type
3 Results: Not applicable given manuscript type
4 Figures and tables: Not applicable - non included
5 Biostatistics: Not applicable given manuscript type
6 References: References are appropriate/up to date
7 Language: Concise/well written manuscript
8 Caveats or drawbacks: None "
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Turan B. Prognostic impact of tumor deposits in colorectal cancer. World J Gastroenterol 2025; 31(47): 114506 [PMID: 41479747 DOI: 10.3748/wjg.v31.i47.114506]
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" The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied"
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Ding YZ, Tang DQ, Zhao XJ. Esophageal fistula after resection of giant mediastinal liposarcoma: A case report. World J Clin Cases 2025; 13(35): 115410 [PMID: 41479741 DOI: 10.12998/wjcc.v13.i35.115410]
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"This is a very interesting paper. I ask some questions for you.When comparing clip-E-CIGARETTES andEUS-C+G, the varicella obliteration rate is 91.7% and 94.4%,respectively and rebleeding is 23.6% and 19.4%,respectively,suggesting that Clip-ECI has a slightly lower success rate.Please also consider Clip-ECI and EUS-C+G from the point of cost and procedure time.How do you deal with rebleeding cases after endoscopic procedure?Also ,please tell us about cases where endoscopic treatment is difficult."
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Giri S, Kumar K. Gastric varices management: Is clip-assisted glue injection a real-world alternative to endoscopic ultrasound-guided therapy? World J Gastroenterol 2025; 31(46): 114149 [PMID: 41479651 DOI: 10.3748/wjg.v31.i46.114149]
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"In recent years, knowledge of the diagnostic and therapeutic roles of stem cells in many digestive system diseases has increased dramatically. Stem cells, with their inherent self-renewal and differentiation capabilities, can expand the therapeutic possibilities of modern gastroenterology across varied diagnostic and therapeutic fields. For example, as the authors of this review report, liver organoids derived from human pluripotent stem cells are used for diverse liver cancer remodeling and drug-sensitivity testing. Furthermore, mesenchymal stem cells/stromal cells are used in clinical/therapeutic studies for a large number of liver diseases. It is known that liver diseases (benign and malignant) result in high morbidity and mortality in all countries of the world. The financial burden on international health systems is becoming increasingly unsustainable in many countries, even in those that are highly developed economically. The implementation of stem cell-based diagnosis and treatment strategies for liver diseases is expected to become a reality in the near future, with visible consequences not only in the successful care of patients but also in improving healthcare economic parameters.
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Wang YX, Ren YN, Zhang SS, Sun S, Xu MY, Wei T, Zhang LS. Application of stem cells in the precise diagnosis and treatment of liver diseases. World J Gastroenterol 2025; 31(46): 114415 [PMID: 41479645 DOI: 10.3748/wjg.v31.i46.114415]
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31
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"1. This review presents a thorough and timely overview of stem cell-based strategies in the diagnosis, modeling and treatment of liver diseases. The authors have gathered an impressive volume of literature and have covered a wide spectrum of topics that range from pluripotent stem cell differentiation to organoid systems and clinical applications. One of the most notable strengths of the manuscript is the inclusion of clinical trial information, which has been organized into clear and informative tables that greatly enhance the translational relevance of the work. Although the content is comprehensive and highly informative, the overall narrative would benefit from more concise expression because certain sections contain repeated explanations and overly detailed descriptions that affect readability.
2. References：The manuscript contains a rich and extensive reference list, which reflects careful and comprehensive literature collection. This is a clear advantage of the review and provides the reader with broad and current coverage of relevant studies.
3. Language：The manuscript generally uses appropriate scientific terminology and conveys complex concepts accurately. However, the writing occasionally becomes verbose and repetitive. Several paragraphs contain long and heavily structured sentences, repeated connective phrases and extensive lists of factors or markers. These patterns interrupt the natural flow of the text and make some sections difficult to read. A more concise presentation of key ideas and smoother transitions between paragraphs would help strengthen the clarity and coherence of the manuscript. Reducing repeated descriptions of differentiation procedures, signaling pathways and mesenchymal stem cell mechanisms would particularly improve the overall fluency.
4. Figures and tables：The figures and tables play a helpful role in supporting the manuscript. The tables summarizing differentiation methods and clinical trials are especially informative and make complex information more accessible to readers. Some figures contain a large amount of condensed information and many abbreviations, which may make them difficult to interpret at a glance. However, the authors have provided all the abbreviations right next to each table, which is very good. In addition, figure 2 that integrates the major mechanisms and introduction of stem cell-based liver organoids is exquisite visually but may require further editing conceptually.
5. Caveats or drawbacks：
Although the review provides extensive information, it relies heavily on descriptive summaries and would benefit from deeper analytical discussion. Several important challenges are mentioned only briefly, such as heterogeneity among stem cell sources, safety considerations in clinical translation, variability of organoid systems and the limited outcomes of early clinical studies. A more thorough examination of these issues would give the review greater authority and balance.
Overall, the manuscript offers a rich collection of information and valuable resources, especially through its comprehensive references and clinical trial summaries. The quality of the paper would be further improved by tightening the language, and reducing redundancy.
I would like to comment a little bit more at the end of this ‘Track article quality’ section. The review appropriately highlights stem cell derived exosomes and extracellular vesicles, which is a valuable component of the manuscript. As far as current knowledge suggests, multiple clinical trials involving exosomes or other extracellular vesicle based therapeutics are actively underway. These vesicle based preparations may offer functional advantages comparable to their parental stem cells, while potentially avoiding several practical and safety related challenges associated with cell based therapies, including difficulties in storage, risks of uncontrolled proliferation, and concerns related to tumorigenesis. Given these advantages, a more extensive discussion of exosomes, extracellular vesicles, and their clinical development would further strengthen the manuscript. This topic may be an excellent focus for the authors to expand upon in their future work. Considering the comprehensive scope and overall quality of this review, I would also recommend it for recognition or award within the journal.
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Wang YX, Ren YN, Zhang SS, Sun S, Xu MY, Wei T, Zhang LS. Application of stem cells in the precise diagnosis and treatment of liver diseases. World J Gastroenterol 2025; 31(46): 114415 [PMID: 41479645 DOI: 10.3748/wjg.v31.i46.114415]
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"The authors express concern about the lack of detailed analysis of the depth of analysis, i.e., tumor miss rates, machine learning model complexity, and dataset quality. They also discuss future directions for the potential of AI in endoscopy training to facilitate skill development and improve the overall proficiency of endoscopists, a crucial area for the future adoption of AI in clinical practice. For AI endoscopy to further develop, we need to work on updating image data and deep learning."
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Fogas CR, Balassone V. Artificial intelligence in gastrointestinal endoscopy: Focus on analytical depth and endoscopist training. Artif Intell Gastrointest Endosc 2025; 6(4): 115140 [DOI: 10.37126/aige.v6.i4.115140]
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33
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"The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied."
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Wu PE, Chen PJ, Su WC, Chang TK, Chen YC. Perforated sigmoid colon diverticulitis initially presenting with pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum: A case report. World J Clin Cases 2025; 13(34): 112593 [PMID: 41377680 DOI: 10.12998/wjcc.v13.i34.112593]
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34
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"The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied."
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Deng X, Lv LY, Jiang SX, Huang JX, Chen XY, Zhang MF, Qi J, Yang M. Low-grade appendiceal mucinous neoplasm: A case report. World J Clin Cases 2025; 13(34): 111668 [PMID: 41377681 DOI: 10.12998/wjcc.v13.i34.111668]
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35
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"With all due respect, this case shouldn't have been accepted for publication. I lacks complete originality and shows lots of contradictions. That is, the title contradicts the case itself. Initially presenting with Pneumoperitoneum and the cases report indicates that the patient had "three (3) days" with lower abdominal pain. Irregardless of that, whatever clinical presentation, this case shows nothing new that has previously been reported. In conclusion this case report lacks complete originality."
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Wu PE, Chen PJ, Su WC, Chang TK, Chen YC. Perforated sigmoid colon diverticulitis initially presenting with pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum: A case report. World J Clin Cases 2025; 13(34): 112593 [PMID: 41377680 DOI: 10.12998/wjcc.v13.i34.112593]
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36
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"First of all, congratulations on the publication of your paper. I have read it carefully, and I found it to be extremely well written, highly educational, and truly informative for readers. For these reasons, I would like to award this paper the first prize. I hope you will continue to produce such valuable work in the future. Thank you very much."
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Usuda D, Furukawa D, Imaizumi R, Ono R, Kaneoka Y, Nakajima E, Kato M, Sugawara Y, Shimizu R, Inami T, Kawai K, Matsubara S, Tanaka R, Suzuki M, Shimozawa S, Hotchi Y, Osugi I, Katou R, Ito S, Mishima K, Kondo A, Mizuno K, Takami H, Komatsu T, Nomura T, Sugita M. Recurrence of acyclovir-resistant herpes encephalitis in an immunocompromised patient: A case report. World J Clin Cases 2025; 13(34): 111438 [PMID: 41377679 DOI: 10.12998/wjcc.v13.i34.111438]
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37
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"At the Baveno VII consensus workshop has defined the concept of recompensation of decompensated liver cirrhosis. It implies that after elimination of the etiological factor, there is at least a partial regression of structural and functional disorders in the liver, reduction of portal pressure with a positive effect on portal hypertension related complications. Many studies have shown the efficacy of direct acting antivirals (DAAs) in achieving recompensation of HCV-related decompensated liver cirrhosis. The authors confirmed these data in Egyptian patients."
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Abdel Hafez RS, Semeya AA, Elgamal R, Othman AA. Direct-acting antiviral therapy reduces variceal rebleeding and improves liver function in hepatitis C virus-related cirrhosis: A multicenter retrospective cohort study. World J Hepatol 2025; 17(11): 110638 [PMID: 41368107 DOI: 10.4254/wjh.v17.i11.110638]
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38
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"This is a comprehensive and well-structured review that effectively synthesizes the complex landscape of MASLD in Egypt. The authors have articulated the convergence of risk factors, diagnostic challenges, and management gaps, positioning MASLD as a critical public health priority. The article's strength lies in its contextualization of the problem within Egypt's unique epidemiological and socioeconomic backdrop, particularly the interplay with the legacy of HCV and nutritional transitions. The inclusion of figures illustrating the multifactorial risks enhances the manuscript's clarity and impact.
There are several inherent challenges remain unresolved. The review points out that studies evaluating the prevalence of MASLD in Egypt are scarce and often include small numbers, and the prevalence and impact of key genetic variants (e.g., PNPLA3, TM6SF2) in the Egyptian population remain underexplored. The natural history and progression rates of MASLD specifically within the Egyptian population are not well-defined due to the absence of longitudinal cohort studies.
The authors have already laid out a roadmap for future research. They intend to advocate for and potentially lead large-scale, population-based epidemiological studies. The appropriate methodology like a stratified cluster sampling design, and the non-invasive diagnostics like FibroScan, could ensure the accuracy to assess the prevalence and fibrosis stages.
The review by Abdelhamed et al. is a powerful call to action, raising interest in non-communicable disease like MASLD in Egypt, and providing an evidence-based argument for a public health-oriented approach to a complex disease. "
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Abdelhamed W, Amin M, Waked I, El-Kassas M. Metabolic dysfunction-associated steatotic liver disease in Egypt: Epidemiology, risk factors and management challenges. World J Gastroenterol 2025; 31(45): 111643 [PMID: 41378328 DOI: 10.3748/wjg.v31.i45.111643]
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39
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"This manuscript showed the cellular mechanisms of pentadecanoic acid as an odd-number fatty acid. The presented figures are interesting and include valuable information, especially Figure 2, which shows the relation between pentadecanoic acid and cell signaling. In this figure, Mek/ERk and JAK/STAT pathways were shown as the pathways in which pentadecanoic acid was engaged."
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Mercola J. Molecular and cellular mechanisms of pentadecanoic acid. World J Biol Chem 2025; 16(4): 111258 [PMID: 41378251 DOI: 10.4331/wjbc.v16.i4.111258]
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40
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"This manuscript showed biomarkers for Gestational diabetes mellitus, which is an important metabolic disorder in pregnancy. The authors have shown the biochemical parameters of the healthy and diabetic participants. This is a good point. The authors also showed a good agarose electrophoresis of PCR products. In addition, the gene expression of gene variants was studied and proved as biomarkers of
Gestational diabetes mellitus.
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Shamsad A, Gautam T, Singh R, Banerjee M. CD36 fatty-acid-transporter gene variants-CD36 G/A (rs1761667) and CD36 C/T (rs75326924) as biomarkers for risk-prediction in gestational diabetes mellitus. World J Biol Chem 2025; 16(4): 111104 [PMID: 41378247 DOI: 10.4331/wjbc.v16.i4.111104]
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41
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"Laparoscopic hepatectomy is a minimally invasive surgical procedure to remove part of the liver in cases of benign and/or malignant tumors of the organ. Patients benefit from all the advantages of laparoscopic surgery, such as faster recovery, minimal pain, and smaller surgical wounds, compared to open surgery.
Lei ZL et al. in their study entitled “Comparison of the efficacy of laparoscopic hepatectomy and radiofrequency ablation for small hepatocellular carcinoma: A retrospective study. World J Gastroenterol 2025; 31(45): 111540 demonstrated that, in patients with small hepatocellular carcinoma, laparoscopic hepatectomy significantly prolongs survival compared with tumor destruction. The findings suggest that laparoscopic hepatectomy should be preferred in these patients, provided liver function is adequate. Nevertheless, radiofrequency tumor destruction remains a valuable weapon in our pharmaceutical arsenal, especially in patients at high surgical risk. It is understandable, however, that these surgical procedures must be performed in specialized centers by surgeons with extensive experience in laparoscopic surgery, particularly in liver surgery."
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Lei ZL, Tan ZL, Luo YH, Yang M, Wang JL, Qin Z, Liu YY. Comparison of the efficacy of laparoscopic hepatectomy and radiofrequency ablation for small hepatocellular carcinoma: A retrospective study. World J Gastroenterol 2025; 31(45): 111540 [PMID: 41378322 DOI: 10.3748/wjg.v31.i45.111540]
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42
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"This mechanism showed an understanding of mechanisms. As a review article, it includes important information about obesity. Figures 1 and 2 were well designed. The therapeutic strategies in Table 1 also included important information. The authors are urged to perform research work on the subject area of this manuscript, especially the concept of the therapeutic strategy.
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Chen KR, Chen ZY, Liu FY, Xie CY, Hu J, Wang SY, Xu B, Xu TC. Macrophage-mediated metabolic dysregulation in the pancreas: Insights from obesity. World J Biol Chem 2025; 16(4): 109509 [PMID: 41378249 DOI: 10.4331/wjbc.v16.i4.109509]
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43
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"This study analyzes RSPO3 rearrangements in advanced colorectal cancer (aCRC) and their clinical implications. Among 73 patients with stage pT4a‑b tumors, RSPO3 fusions were detected in 8% of cases, predominantly in right‑sided or transverse colon cancers. These rearrangements were associated with smaller tumor size, normal carcinoembryonic antigen levels, microsatellite stability, and significantly poorer overall survival. The authors also confirmed through in silico analyses that elevated RSPO3 expression correlates with worse recurrence‑free and overall survival in independent CRC cohorts. Strengths of the work include comprehensive next‑generation sequencing of 50 cancer‑related genes, detailed clonal evolution analysis, and integration of clinical, pathological, and molecular data. Overall, the study highlights RSPO3 fusions as a potential prognostic biomarker and therapeutic target in advanced colorectal cancer."
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Tur R, Abad M, Filipovich E, Rivas MB, Rodriguez M, Montero JC, Sayagués JM. RSPO3 rearrangements in advanced colorectal cancer patients and their relationship with disease characteristics. World J Gastrointest Oncol 2025; 17(11): 112838 [PMID: 41281482 DOI: 10.4251/wjgo.v17.i11.112838]
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44
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"This retrospective study develops and validates a novel nomogram model to predict survival outcomes in advanced HER‑2 negative gastric cancer patients treated with immunochemotherapy. Using data from 200 patients who received sintilimab plus chemotherapy, the authors identified PD‑L1 expression, microsatellite status, TNM stage, tumor differentiation, neutrophil‑to‑lymphocyte ratio, and the C‑reactive protein–albumin–lymphocyte (CALLY) index as independent prognostic factors. The resulting models demonstrated strong discrimination (C‑index 0.78–0.82) and calibration, with high accuracy for progression‑free and overall survival across multiple time points. Strengths of the work include integration of molecular, clinical, and inflammatory markers into a single predictive tool, rigorous statistical validation, and clear demonstration of clinical applicability. Overall, the study provides a robust framework for individualized risk assessment and treatment planning in HER‑2 negative advanced gastric cancer."
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Yao ZY, Bao G, Li GC, Hao QL, Ma LJ, Rao YX, Xu K, Ma X, Han ZX. Survival prognosis in advanced HER-2 negative gastric cancer treated with immunochemotherapy: A novel model. World J Gastrointest Oncol 2025; 17(11): 112981 [PMID: 41281500 DOI: 10.4251/wjgo.v17.i11.112981]
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45
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"This meta‑analysis evaluates the efficacy of neoadjuvant immunotherapy combined with radiotherapy and chemotherapy in locally advanced rectal cancer (LARC). Across 15 studies involving 796 patients, the addition of immunotherapy significantly improved major pathological response, pathological complete response, and clinical complete response, particularly in patients with proficient mismatch repair (pMMR) and microsatellite stability. Rates of R0 resection and sphincter‑preserving surgery were also higher, while adverse events such as hematologic toxicity and liver dysfunction remained within acceptable limits. Strengths of the study include comprehensive literature retrieval, rigorous subgroup and sensitivity analyses, and clear reporting of heterogeneity and publication bias. Overall, the findings suggest that integrating immunotherapy into neoadjuvant chemoradiotherapy regimens enhances remission and organ preservation without substantially increasing complications, supporting its consideration as a first‑line strategy for LARC."
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Yan WX, Yuan HQ, Xiong ZY, Qin LJ, Wu J, He J, Mu J, Li J, Li N. Meta-analysis of the efficacy of neoadjuvant immunotherapy combined with radiotherapy and chemotherapy for locally advanced rectal cancer. World J Gastrointest Oncol 2025; 17(11): 113048 [PMID: 41281473 DOI: 10.4251/wjgo.v17.i11.113048]
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46
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"This study investigates folate receptor–positive circulating tumor cells (FR+ CTCs) as potential biomarkers for hepatocellular carcinoma (HCC). In a retrospective cohort of 128 patients, FR+ CTC counts demonstrated superior diagnostic accuracy compared to alpha‑fetoprotein (AFP), with sensitivity of 90% and specificity of 77%. Elevated FR+ CTC levels correlated with adverse pathological features such as larger tumor size, multiple lesions, macrovascular invasion, and extrahepatic metastasis. Importantly, higher baseline FR+ CTC counts predicted shorter disease‑free survival after hepatectomy, with a cutoff of 12.9 FU/3 mL distinguishing high‑risk patients. Strengths of the work include rigorous methodology using ligand‑target PCR, clear statistical validation with ROC and Cox regression analyses, and demonstration that FR+ CTCs may serve both diagnostic and prognostic roles independent of AFP. These findings provide promising evidence that FR+ CTC quantification could enhance patient stratification, guide treatment evaluation, and improve recurrence prediction in HCC."
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Zhang ZY, Zhou M, Liu JJ, Zhang W. Folate receptor-positive circulating tumor cells might function as potential biomarkers for hepatocellular carcinoma. World J Gastrointest Oncol 2025; 17(11): 113431 [PMID: 41281492 DOI: 10.4251/wjgo.v17.i11.113431]
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47
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"This article presents two rare case reports of gastrointestinal stromal tumors (GISTs) driven by novel FGFR2 fusions, expanding the molecular spectrum beyond the well‑known KIT and PDGFRA mutations. Both patients underwent successful surgical resection followed by adjuvant imatinib therapy, achieving sustained remission over more than two years. The study is well executed in several respects: it highlights the importance of comprehensive genomic profiling with next‑generation sequencing to uncover actionable mutations, demonstrates that even non‑canonical alterations may respond to standard tyrosine kinase inhibitors, and underscores the potential of FGFR‑targeted therapies for imatinib‑resistant or advanced disease. By carefully documenting clinical, pathological, and molecular features, the authors provide valuable preliminary evidence that FGFR2 fusions may define a distinct, therapeutically relevant GIST subtype."
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Hong YY, Shou CH, Yang WL, Wang XD, Zhang Q, Liu XS, Yu JR. FGFR2 fusions as novel oncogenic drivers in gastrointestinal stromal tumors: Two case reports and review of literature. World J Gastrointest Oncol 2025; 17(11): 113262 [PMID: 41281483 DOI: 10.4251/wjgo.v17.i11.113262]
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48
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"I read with interest of this article. In spite of there are many similar studies in literature, the findings of this study is still informative. Shear wave elastography (SWE) is a non-invasive ultrasound (US) technique that can quantify tissue stiffness, which can used for assistance of diagnosing focal and diffusive diseases. Establishing reference values in normal tissues or organs in healthy individuals is crucial, since abnormal stiffness is associated with clinically relevant conditions such as tumors, liver fibrosis, and pancreatic disease. In the literature, normal values of stiffness for liver, spleen, and pancreas in healthy individuals are various, and they have not been well established. In this study, the investigators measured the stiffness of the liver, spleen, and pancreas in 50 healthy subjects with p-QElaXto and 2D-QElaXto on Esaote MyLab 9 ultrasound system, compared with 2D-SWE on the SuperSonic Imagine Aixplorer (SSI). Values of measurements of stiffness ranges were analyzed for relationship with clinical and technical factors, and inter-operator variability across the different SWE modalities were studied. The results demonstrated that the liver and spleen stiffness assessment was feasible in > 98% of patients, while pancreas stiffness was measurable in 84%-88% depending on the SWE technique. Mean liver stiffness ranged between 3.9-4.7 kPa across techniques, spleen stiffness ranged from 19.4-23.0 kPa, and pancreas stiffness from 5.2-7.6 kPa. Inter-operator agreement was excellent for liver and good to moderate for spleen and pancreas. Bland-Altman analysis confirmed good correlation but also systematic differences among devices, especially in pancreas measurements. The investigators concluded that the values of stiffness of the liver and spleen matched existing guidelines, and pancreas SWE showed more variability and reduced reproducibility. Stiffness measurements of the pancreatic using shear wave elastography is less reliable than that for liver and spleen.
There were some potential limitations of this study, as had been addressed in the article, especially the relatively small sample size compromises the soundness and robust of the results.
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Viceconti N, Paratore M, Del Zompo F, Zocco MA, Ainora ME, Esposto G, Gasbarrini A, Pompili M, Riccardi L, Garcovich M. Shear wave elastography in healthy patients: Pancreatic stiffness is less reliable than liver and spleen measurements. World J Radiol 2025; 17(11): 111651 [PMID: 41356758 DOI: 10.4329/wjr.v17.i11.111651]
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"This review was well written. The subject was meaningful. The objective of this study was to analyse the utility of point-of-care ultrasound-measured optic nerve sheath diameter for early identification of raised intracranial pressure in non-traumatic headache patients, aiming to guide clinicians in integrating this technique into early headache evaluation for better patient outcomes. Point-of-care ultrasound measurement of optic nerve sheath diameter is a convenient, non-invasive method with high sensitivity and specificity for detecting elevated intracranial pressure. Its use can expedite diagnosis, guide urgent management, and reduce unnecessary imaging, especially in outpatient and resource-limited settings. To ensure reliability and accuracy of measurement, comprehensive training programs and standardized protocols for ultrasound operator are required.
Emerging artificial intelligence(AI)-assisted measurement promises to enhance its reliability by reducing operator-dependent variability, and this will broaden its clinical impact. AI-assisted interpretation and automated measurement tools will be the future direction.
One thing must mention, the word “decline” in the sentence that “A good example of the potential value of POCUS is a patient with an acute neurological decline” should be “deficit”."
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Tlaiss Y, Tarchichi A, Atallah K, Al Mashtoub E, Zalzali I, Chokor Z, Fassih I, Harb N, Kassas J, Hamze H. Point-of-care ultrasonography for detecting raised intracranial pressure through optic nerve sheath diameter in non-traumatic headache patients. World J Radiol 2025; 17(11): 113012 [PMID: 41356762 DOI: 10.4329/wjr.v17.i11.113012]
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"In patients with troponin elevation at ER, distinguishing ACS is crucial, but troponin often rises for reasons other than ACS. PSVT is one such cause, but diagnosis is difficult if the episode has already terminated by the time the ER ECG is taken. This is because troponin is only positive in 30-50% of PSVT cases. Even if sinus rhythm is present at presentation, troponin may still be positive after PSVT has stopped.
For example, in patients who experienced palpitations. Therefore, I would also like to see criteria indicating in which PSVT cases troponin will be positive.
Elevated troponin due to paroxysmal supraventricular tachycardia (PSVT) does not merely indicate the presence of ischemic heart disease. It is associated with a high heart rate, prolonged duration, chest pain, and in many cases, causes mild to moderate transient troponin elevation. Conversely, in the absence of obvious organic heart disease, it does not directly correlate with worsened clinical prognosis. The degree of troponin elevation is primarily associated with the heart rate during the episode (risk increases at 165 bpm or higher) and the duration of the episode. Particularly in clinically stable cases, there appears to be limited justification for invasive evaluation based solely on troponin elevation. Further validation through large-scale prospective studies is desired in the future.
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Özlek B, Tanık VO, Barutçu S. Troponin elevation in supraventricular tachycardia: A narrative review. World J Cardiol 2025; 17(11): 113411 [PMID: 41356591 DOI: 10.4330/wjc.v17.i11.113411]
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