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1	"since the patient also had general anesthesia, it should be clairifed to whihc degree analgesics given for the procedure prevented the patient from experienceing severe pain xxxx xx x x x x x x x x x x x x x x x x x x x x x x xx x x x x x xx " Chen KH, Kang MY, Chang YT, Huang SY, Wu YS. Enhancing postoperative pain control by surgically-initiated rectus sheath block in abdominal aortic aneurysm open repair: A case report. World J Clin Cases 2025; 13(6): 100673 [DOI: 10.12998/wjcc.v13.i6.100673]
2	"The novelty of the topic is very important, suitable for fine rather than too broad content. The interpretation of statistical results needs to be rigorous, correlation does not mean causation, and the HR presented may be inaccurate. The discussion needs to be tightly focused on the results and not extend to other unwarranted conclusions." Chen DQ, Wu YX, Zhang YX, Yang HL, Huang HH, Lv JY, Xiao Q. Sarcopenia-associated factors and their bone mineral density levels in middle-aged and elderly male type 2 diabetes patients. World J Diabetes 2024; 15(12): 2285-2292 [DOI: 10.4239/wjd.v15.i12.2285]
3	"I would like to commend the authors for their comprehensive analysis of the complex interplay between gut microbiota, mesenteric adipose tissue (MAT), and creeping fat (CF) in the context of Crohn’s disease (CD). The manuscript provides a valuable contribution to the field. The article meticulously elucidates the profound clinical significance of the interplay between the gut microbiota and MAT/CF. The authors have not only reviewed the current body of knowledge but have also contributed novel insights into the role of MAT and CF in shaping CD phenotypes and treatment strategies.The structure of the letter is well-organized, making it easy to follow the authors' line of reasoning. The abstract succinctly captures the essence of the study, and the core tip effectively highlights the main takeaways for the reader.The exploration of fecal microbiota transplantation (FMT) as a therapeutic strategy is both timely and relevant. The authors have successfully linked the current understanding of microbial imbalances to potential clinical applications, which could influence future treatment protocols for CD. In conclusion, Hasnaoui et al. have provided a thought-provoking analysis of the role of gut microbiota and MAT/CF in CD. Their work not only advances our understanding of the disease but also offers promising avenues for therapeutic intervention." Hasnaoui A, Trigui R, Giuffrida M. Gut microbiota and mesenteric adipose tissue interactions in shaping phenotypes and treatment strategies for Crohn’s disease. World J Gastroenterol 2024; 30(46): 4969-4976 [DOI: 10.3748/wjg.v30.i46.4969]
4	"The author suggests to use in all diabetic patients an interesting technique, the” body surface gastric mapping” (BSGM), to detect the onset of gastric dysmotility precursor of gastroparesis, instead of invasive procedures, as gastroscopy, manometry, emptying of radiopaque markers or radioactive bolus and breath tests . The idea is interesting , but there are some observations to make. First of all the author forgot a simple, not invasive, physiologic and reliable method to measure gastric emptying, that is real-time ultrasonography, which allows the use of a normal solid–liquid meal and gives an immediate result (1). Furthermore the author did not take into account the fact that, as indicated in figure 1 of ref. 4, the cause of delayed gastric emptying in gastroparesis may be also due, not only to antral dysmotility detectable with BSGM, but also to impaired pyloric relaxation upon arrival of antral peristalsis (pylorospasm) and, sometimes, to dysmotility of duodenum, which does not accept the bolus coming from the stomach. The pylorospasm, which was observed in 14 of 24 diabetics, by Mearin et al (2) forms part of the widespread disruption of gut motility that affects some patients with diabetes. Unfortunately these pyloric and duodenal motor abnormalities are not detected by the technique of BSGM, which could find a normal antral motility, giving the impression that everything is OK, while the gastric emptying is already delayed. Therefore I would suggest to monitor the diabetic patients with the real-time ultrasonography, which is able to detect also a minimal delay in gastric emptying harbinger of gastroparesis, and, if the gastric emptying is delayed, then perform the BSGM, to see if the cause of the slowing is due to antral dysmotility. If the latter examination is negative, then the cause of delayed gastric emptying shoul be pylorospasm or duodenal dysmotility. REFERENCES 1) Bolondi L, Bortolotti M, Santi V, Calletti T, Gaiani S, Labò G. Measurement of gastric emptying time by real-time ultrasonography. Gastroenterology. 1985 Oct; 89(4):752-9.PMID:3896910. 2) Mearin F, Camilleri M, Malagelada JR. Pyloric dysfunction in diabetics with recurrent nausea and vomiting. Gastroenterology. 1986 Jun;90(6):1919-25. doi: 10.1016/0016-5085(86)90262-3. PMID: 3699409 " Mori H. Early detection and intervention in diabetic gastroparesis: Role of body surface gastric mapping. World J Gastroenterol 2024; 30(45): 4836-4838 [DOI: 10.3748/wjg.v30.i45.4836]
5	"This article presents a case report of air embolism occurring during endoscopic retrograde cholangiopancreatography (ERCP), emphasizing the necessity for gastroenterologists to maintain a high level of vigilance regarding this potential complication during such procedures. While ERCP is a widely used and effective diagnostic and therapeutic technique, air embolism represents a serious complication that can significantly jeopardize patient health. Consequently, this article not only reviews pertinent cases and analyzes the mechanisms, clinical manifestations, and countermeasures associated with air embolism but also underscores the importance of preventive measures that medical staff should implement to minimize the incidence of such complications during ERCP. The aim of this article is to provide a comprehensive overview of relevant knowledge, thereby enabling medical professionals to better understand and address this issue, ultimately enhancing the safety and effectiveness of clinical operations." Li JH, Luo ZK, Zhang Y, Lu TT, Deng Y, Shu RT, Yu H. Systemic air embolism associated with endoscopic retrograde cholangiopancreatography: A case report. World J Gastrointest Endosc 2024; 16(11): 617-622 [PMID: 39600553 DOI: 10.4253/wjge.v16.i11.617]
6	"Exercise during pregnancy improve organ development in offspring with gestational diabetes mellitus Shengju Chen, Hangming Fan, Yu Chen Abstract In this commentary, we discuss the study by Tang et al., “Effect of exercise during pregnancy on offspring development through ameliorating high glucose and hypoxia in gestational diabetes mellitus”. Gestational diabetes mellitus (GDM), defined as ‘glucose intolerance with onset or first recognition during pregnancy’, impacts millions of women worldwide and poses significant health risks. Exercise during pregnancy has been shown to improve offspring health outcomes in obese mothers, potentially reducing epigenetic changes associated with maternal high-fat diets and minimizing abnormalities in lipid and glucose metabolism. However, while prenatal exercise’s impact on metabolic disorders in GDM offspring has been explored, its effects on organ growth remain insufficiently understood. Tang et al. identified GLUT1 and HIF1 as key regulators influencing the development of the heart, liver, and kidney in GDM offspring. Their study demonstrates that exercise during pregnancy supports organ development by inhibiting placental GLUT1 and HIF1 expression in GDM. This work contributes to understanding the role of GLUT1 and HIF1 in moderating the effects of prenatal exercise on organ development in GDM-affected offspring, supporting the idea that maternal exercise is an important intervention for improving offspring outcomes in GDM pregnancies and warrants further investigation in future epigenetic research. Introduction Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications, affecting approximately 20.9 million pregnant women and their newborns worldwide as of 2020. GDM is associated with a range of adverse pregnancy outcomes, including preeclampsia, polyhydramnios, and fetal organomegaly (Pettitt et al., 1980). Additionally, GDM poses several short-term risks to offspring, such as neonatal respiratory distress, metabolic complications (Ferrara et al., 2007), and increased perinatal mortality rates. The GDM quintet management model recommends five core interventions to mitigate these risks, exercise, dietary regulation, maternal education, pharmacological treatment, and fetal health evaluation (Association, 2003). Pathophysiologically, GDM is characterized by hyperglycemia, glucose intolerance, and insulin resistance, typically manifesting in the late second to early third trimester of pregnancy (Buchanan et al., 2012, Jovanovic and Pettitt, 2001, Pereira et al., 2015). Several mechanisms have been proposed to explain these outcomes, including chronic fetal hyperinsulinemia, impaired oxygenation due to elevated metabolic rates, and metabolic acidosis (Freinkel, 1980). In this commentary, we discuss the article by Tang et al., recently published in the recent issue of the World Journal of Diabetes, which explores the impact of maternal exercise during pregnancy on organ development in offspring of mothers with GDM. Risks and complications associated with GDM In a healthy pregnancy, insulin sensitivity decreases to allow more glucose availability for the fetus; however, normoglycemia is typically maintained through increased insulin production by pancreatic β-cells. In cases of GDM, the pancreas may fail to produce sufficient insulin, resulting in elevated blood glucose levels and the onset of GDM (Freinkel, 1980). GDM pregnancies can lead to additional complications that negatively impact maternal and fetal health (Poston et al., 2011). Immediate complications in offspring of overweight women with GDM include macrosomia, the most severe of which is shoulder dystocia; other neonatal complications such as hypoglycemia and hyperbilirubinemia have also been reported (Kaaja and Rönnemaa, 2008, Lecomte et al., 2017). Long-term exposure to GDM increases the risk of obesity, type 2 diabetes, and cardiovascular diseases (CVD) as offspring age (Capobianco et al., 2016). Epigenetic studies indicate that the intrauterine environment significantly influences offspring organ development, and exposure to elevated maternal blood levels can impair fetal health. Maintaining a healthy uterine environment is thus essential to promoting favorable health outcomes in offspring. Exercise, as a non-pharmacological intervention without side effects, is widely used in diabetes prevention and management. Given that pregnancy is a period when non-pharmacological interventions are especially favored by medical staff and patients, exercise is particularly promising for managing GDM. Benefits of exercise during pregnancy Eight national guidelines on exercise during pregnancy recommend 60-150 minutes of aerobic exercise per week for healthy pregnant women (Savvaki et al., 2018). The benefits of exercise for pregnant women include improved overall health, better weight management, reduced risk of GDM and gestational hypertension (Davenport et al., 2018, Yu et al., 2018). For women with GDM, moderate aerobic or combined exercise has been shown to enhance postprandial blood glucose control (Walter and Klaus, 2014), although the optimal duration and intensity remain unclear. Moderate exercise during pregnancy can improve maternal insulin sensitivity, reduce placental lipid accumulation in both male and female fetuses, and alleviate hypoxia, positively influencing the intrauterine environment and fetal growth (Laker et al., 2014). Exercise during pregnancy also promotes healthier liver glucose production, helps maintain liver triglycerides levels, and prevents the expression of liver enzymes and genes in offspring caused by maternal high-fat diet, thereby improving the offspring’s metabolic profile. These findings suggest that maternal exercise can mitigate modifications linked to a high-fat diet, protecting offspring from future metabolic diseases. Regulation of GLUT1 by maternal exercise and offspring health outcomes in GDM The placenta is responsible for transporting essential nutrients and oxygen from maternal to fetal circulation, as fetal gluconeogenesis is minimal (Kalhan and Parimi, 2000). GDM disrupts placental function, leading to various morphological (Treesh and Khair, 2015) and vascular changes (Aldahmash et al., 2022, El Sawy et al., 2018) and including fetal vascular changes and DNA methylation (Song et al., 2022). Placental transport proteins, such as glucose transporters, facilitate nutrient transfer from the mother to the fetus. Glucose is the primary energy source for both placental and fetal growth (Stanirowski et al., 2017), with GLUT1 and GLUT3 serving as the main placental glucose transport proteins in humans. GLUT1 is expressed in syncytiotrophoblast microvilli and the basal membrane, as well as in vascular endothelium and cell layers (Brown et al., 2011, Jansson et al., 1993). Research on GDM in humans and mice shows increased placental GLUT1 expression, likely due to increased glucose availability in maternal circulation, which enhances placental glucose consumption (Muralimanoharan et al., 2016). This increase in GLUT1 may contribute to the higher rates of macrosomia observed in GDM pregnancies (Stanirowski et al., 2022). Moreover, GDM leads to placental hypoxia, elevated hypoxia-inducible (HIF) levels, and glial cell missing 1 degradation, inhibiting trophoblast migration and invasion. Exercise during pregnancy can significantly reduce placental GLUT1 expression and alleviate hypoxia. Silencing GLUT1 can partially counteract the reduced trophoblast migration caused by hyperglycemia and hypoxia. Beyond energy metabolism, GLUT1 is also related to the development of the heart, liver, and kidneys. Zhang et al. investigated the relationship between GLUT1 expression in these organs and their structural and pathological changes, examining how exercise influences growth and development in offspring with GDM. In a neonatal GLUT1 transgenic heart model, increased glucose metabolism can stimulate hyperplastic growth after cardiac injury (Fajardo et al., 2021). Maternal exercise during pregnancy has been shown to lower hepatic GLUT1 expression, reduce inflammatory infiltration, and decrease the risk of liver disease in adult offspring (Baker and Friedman, 2018). In the kidney, GLUT1 functions vary by cell type; elevated GLUT1 in mesangial cells can impair kidney structure, while in podocytes, it may reduce mesangial expansion and fibronectin accumulation (Chen et al., 2024). Future research is recommended to clarify the specific mechanisms by which exercise benefits renal structure and function in GDM offspring. Directions for future studies The specific mechanisms by which maternal exercise during pregnancy improves health outcomes in diabetic offspring remain under investigation, with multiple synergistic pathways likely involved. Given its role in glucose metabolism, GLUT1 is of particular interest as a regulatory factor in mitigating adverse outcomes in offspring of mothers with GDM through exercise. This underscores the significant influence of exercise on glucose metabolism, which enhances the intrauterine environment and supports offspring health. Improved placental GLUT1 expression appears to regulate the GLUT1 levels in offspring organs, positively impacting organ development. These findings extend our understanding of exercise-related epigenetics modifications, yet further research is essential to clarify the pathways through which maternal exercise regulates placental GLUT1, thereby promoting healthy organ development in offspring and underscoring the benefits of prenatal exercise. Conclusion GDM can lead to adverse outcomes for both the mother and their offspring. Maternal exercise during pregnancy improves the intrauterine environment and enhances offspring health. Elevated maternal blood glucose can cause fetal hyperinsulinemia, hypoxia, and metabolic acidosis. Exercise enhances glucose metabolism, reduces high blood sugar levels, and supports a healthier intrauterine environment, thereby decreasing the risk of metabolic diseases in offspring. The study by Tang et al. confirms the association between elevated placental GLUT1 expression in GDM and abnormal offspring organ development related to hypoxia. Their research demonstrates that exercise during pregnancy can improve placental glucose transport and reduce hypoxia, mitigating adverse developmental outcomes in offspring organs at various stages. These findings validate, across human, animal, and cellular models, the molecular mechanisms through which maternal exercise enhances organ development in offspring affected by GDM. This contributes to clinical application and emphasizes the role of epigenetics in promoting offspring health. As research in epigenetic progresses, the pathways through exercise benefits GDM-affected offspring will become clearer, with GLUT1 as a central regulator of glucose metabolism. Further investigation into these mechanisms will advance our understanding of how maternal exercise supports healthier outcomes for GDM offspring. Aldahmash, W.M., Alwasel, S.H., Aljerian, K., 2022. Gestational diabetes mellitus induces placental vasculopathies. Environ Sci Pollut Res Int 29 (13), 19860-19868. Association, A.D., 2003. Gestational diabetes mellitus. Diabetes Care 26 Suppl 1, S103-105. Baker, P.R., 2nd, Friedman, J.E., 2018. Mitochondrial role in the neonatal predisposition to developing nonalcoholic fatty liver disease. J Clin Invest 128 (9), 3692-3703. Brown, K., Heller, D.S., Zamudio, S., Illsley, N.P., 2011. Glucose transporter 3 (GLUT3) protein expression in human placenta across gestation. Placenta 32 (12), 1041-1049. Buchanan, T.A., Xiang, A.H., Page, K.A., 2012. Gestational diabetes mellitus: risks and management during and after pregnancy. Nat Rev Endocrinol 8 (11), 639-649. Capobianco, E., Fornes, D., Linenberg, I., Powell, T.L., Jansson, T., Jawerbaum, A., 2016. A novel rat model of gestational diabetes induced by intrauterine programming is associated with alterations in placental signaling and fetal overgrowth. Mol Cell Endocrinol 422, 221-232. Chen, Y., Bai, X., Chen, J., Huang, M., Hong, Q., Ouyang, Q., Sun, X., Zhang, Y., Liu, J., Wang, X., Wu, L., Chen, X., 2024. Pyruvate kinase M2 regulates kidney fibrosis through pericyte glycolysis during the progression from acute kidney injury to chronic kidney disease. Cell Prolif 57 (2), e13548. Davenport, M.H., Ruchat, S.M., Poitras, V.J., Jaramillo Garcia, A., Gray, C.E., Barrowman, N., Skow, R.J., Meah, V.L., Riske, L., Sobierajski, F., James, M., Kathol, A.J., Nuspl, M., Marchand, A.A., Nagpal, T.S., Slater, L.G., Weeks, A., Adamo, K.B., Davies, G.A., Barakat, R., Mottola, M.F., 2018. Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis. Br J Sports Med 52 (21), 1367-1375. El Sawy, N.A., Iqbal, M.S., Alkushi, A.G., EL Sawy, N., Iqbal, M., Alkushi, A., 2018. Histomorphological study of placenta in gestational diabetes mellitus. Int. J. Morphol 36 (2), 687-692. Fajardo, V.M., Feng, I., Chen, B.Y., Perez-Ramirez, C.A., Shi, B., Clark, P., Tian, R., Lien, C.L., Pellegrini, M., Christofk, H., Nakano, H., Nakano, A., 2021. GLUT1 overexpression enhances glucose metabolism and promotes neonatal heart regeneration. Sci Rep 11 (1), 8669. Ferrara, A., Weiss, N.S., Hedderson, M.M., Quesenberry, C.P., Jr., Selby, J.V., Ergas, I.J., Peng, T., Escobar, G.J., Pettitt, D.J., Sacks, D.A., 2007. Pregnancy plasma glucose levels exceeding the American Diabetes Association thresholds, but below the National Diabetes Data Group thresholds for gestational diabetes mellitus, are related to the risk of neonatal macrosomia, hypoglycaemia and hyperbilirubinaemia. Diabetologia 50 (2), 298-306. Freinkel, N., 1980. Banting Lecture 1980. Of pregnancy and progeny. Diabetes 29 (12), 1023-1035. Jansson, T., Wennergren, M., Illsley, N.P., 1993. Glucose transporter protein expression in human placenta throughout gestation and in intrauterine growth retardation. J Clin Endocrinol Metab 77 (6), 1554-1562. Jovanovic, L., Pettitt, D.J., 2001. Gestational diabetes mellitus. Jama 286 (20), 2516-2518. Kaaja, R., Rönnemaa, T., 2008. Gestational diabetes: pathogenesis and consequences to mother and offspring. Rev Diabet Stud 5 (4), 194-202. Kalhan, S., Parimi, P., 2000. Gluconeogenesis in the fetus and neonate. Semin Perinatol 24 (2), 94-106. Laker, R.C., Lillard, T.S., Okutsu, M., Zhang, M., Hoehn, K.L., Connelly, J.J., Yan, Z., 2014. Exercise prevents maternal high-fat diet-induced hypermethylation of the Pgc-1α gene and age-dependent metabolic dysfunction in the offspring. Diabetes 63 (5), 1605-1611. Lecomte, V., Maloney, C.A., Wang, K.W., Morris, M.J., 2017. Effects of paternal obesity on growth and adiposity of male rat offspring. Am J Physiol Endocrinol Metab 312 (2), E117-e125. Muralimanoharan, S., Maloyan, A., Myatt, L., 2016. Mitochondrial function and glucose metabolism in the placenta with gestational diabetes mellitus: role of miR-143. Clin Sci (Lond) 130 (11), 931-941. Pereira, T.J., Moyce, B.L., Kereliuk, S.M., Dolinsky, V.W., 2015. Influence of maternal overnutrition and gestational diabetes on the programming of metabolic health outcomes in the offspring: experimental evidence. Biochem Cell Biol 93 (5), 438-451. Pettitt, D.J., Knowler, W.C., Baird, H.R., Bennett, P.H., 1980. Gestational diabetes: infant and maternal complications of pregnancy in relation to third-trimester glucose tolerance in the Pima Indians. Diabetes Care 3 (3), 458-464. Poston, L., Harthoorn, L.F., Van Der Beek, E.M., 2011. Obesity in pregnancy: implications for the mother and lifelong health of the child. A consensus statement. Pediatr Res 69 (2), 175-180. Savvaki, D., Taousani, E., Goulis, D.G., Tsirou, E., Voziki, E., Douda, H., Nikolettos, N., Tokmakidis, S.P., 2018. Guidelines for exercise during normal pregnancy and gestational diabetes: a review of international recommendations. Hormones (Athens) 17 (4), 521-529. Song, J.Y., Lee, K.E., Byeon, E.J., Choi, J., Kim, S.J., Shin, J.E., 2022. Maternal Gestational Diabetes Influences DNA Methylation in the Serotonin System in the Human Placenta. Life (Basel) 12 (11). Stanirowski, P.J., Szukiewicz, D., Majewska, A., Wątroba, M., Pyzlak, M., Bomba-Opoń, D., Wielgoś, M., 2022. Placental expression of glucose transporters GLUT-1, GLUT-3, GLUT-8 and GLUT-12 in pregnancies complicated by gestational and type 1 diabetes mellitus. J Diabetes Investig 13 (3), 560-570. Stanirowski, P.J., Szukiewicz, D., Pyzlak, M., Abdalla, N., Sawicki, W., Cendrowski, K., 2017. Impact of pre-gestational and gestational diabetes mellitus on the expression of glucose transporters GLUT-1, GLUT-4 and GLUT-9 in human term placenta. Endocrine 55 (3), 799-808. Treesh, S.A., Khair, N.S.B., 2015. Histological Changes of the Human Placenta in Pregnancies Complicated with Diabetes. Journal of Cytology and Histology 6, 1-7. Walter, I., Klaus, S., 2014. Maternal high-fat diet consumption impairs exercise performance in offspring. J Nutr Sci 3, e61. Yu, Y., Xie, R., Shen, C., Shu, L., 2018. Effect of exercise during pregnancy to prevent gestational diabetes mellitus: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 31 (12), 1632-1637. " Tang YB, Wang LS, Wu YH, Zhang LX, Hu LY, Wu Q, Zhou ML, Liang ZX. Effect of exercise during pregnancy on offspring development through ameliorating high glucose and hypoxia in gestational diabetes mellitus. World J Diabetes 2024; 15(11): 2203-2219 [PMID: 39582571 DOI: 10.4239/wjd.v15.i11.2203]
7	"I would love to congratulate the authors for writing this excellent editorial about malignant gastric outlet obstruction. The authors have given an overview of the changing spectrum of therapeutic modalities from surgery to endoscopic stenting to the latest EUS-guided interventions. There was an enlightening discussion about the potential benefit of stomach-partitioning gastrojejunostomy to reduce the rate of delayed gastric emptying. The authors have rightly advocated the need for a holistic approach to treat patients with malignant gastric outlet obstructions, keeping in mind their nutritional and clinical status. " Jiang L, Chen XP. Treatment of choice for malignant gastric outlet obstruction: More than clearing the road. World J Gastrointest Endosc 2024; 16(11): 587-594 [PMID: 39600555 DOI: 10.4253/wjge.v16.i11.587]
8	"I would like to congratulate the authors for reporting a rare but potentially treatable complication of ERCP. The authors have clearly stated the scenarios when air embolism should be suspected in a patient undergoing ERCP. The authors have beautifully shown the relevant images showing air embolism. They have also discussed in detail about the timing and efficacy of hyperbaric oxygen therapy for such patients. As GI endoscopists doing regular ERCP, we should be aware of all the potential complications of ERCP, their manifestations, how to diagnose them early and the readily available treatment modalities and availability. " Li JH, Luo ZK, Zhang Y, Lu TT, Deng Y, Shu RT, Yu H. Systemic air embolism associated with endoscopic retrograde cholangiopancreatography: A case report. World J Gastrointest Endosc 2024; 16(11): 617-622 [PMID: 39600553 DOI: 10.4253/wjge.v16.i11.617]
9	"Re-evaluating the clinical impact of functional regulatory variants Ying Ming, Yun-Ling Du, Meng-Na Zhang Ying Ming, Molecular Diagnosis Center,The Affiliated Hospital of Chengde Medical University, Chengde, 067000, China Yun-Ling Du, Molecular Diagnosis Center,The Affiliated Hospital of Chengde Medical University, Chengde, 067000, China Meng-Na Zhang, Molecular Diagnosis Center,The Affiliated Hospital of Chengde Medical University, Chengde, 067000, China Meng-Na Zhang, Hebei Key Laboratory of Panvascular Diseases, Chengde, 067000, China ORCID number: Ying Ming (0009-0006-2161-8207) , Yun-Ling Du (0000-0001-7624-3226) , Meng-Na Zhang (0000-0001-7624-3226) Author contributions: Ying Ming contributed to the initial drafting of the work; Yun-Ling Du contributed to the drafting process; Meng-Na Zhang contributed to the initial drafting and provided overall supervision to the drafting process; All authors have read and approved the final version of the manuscript. Conflict-of-interest statement: The authors declare that they have no conflict of interest. Corresponding author: Meng-Na Zhang, Molecular Diagnosis Center,The Affiliated Hospital of Chengde Medical University, Chengde, China zhangmengna2014@sina.com Abstract Serotonin 1A receptor polymorphism (5-HTR1A) C-1019G polymorphism (rs6295) is a functional regulatory variants reported to be related with multiple phenotypes including major depression, suicidal behavior and antidepressant response. However, clinical studies investigating this variant and its potential phenotypes had incongruous findings. Molecular studies on this variant showed it does regulate HTR1A expression but meta-analysis showed it had negative relationship with antidepressant drug response in major depressive disorder (MDD), as reported by Wu et al. in the lasted issue of the World Journal of Psychiatry. This suggested the importance of re-evaluating the clinical impact of functional regulatory variants. Key words: regulatory variants, snp-meta, snp-phenotype association Core Tip: Functional regulatory variants might have negative relationship with putative phenotypes even it do regulate gene expression. Single nucleotide polymorphism (SNP) meta analysis helps to identify a more robust SNP-phenotype relationship. We carefully read the article titled “Association between 5-HTR1A gene C-1019G polymorphism and antidepressant response in patients with major depressive disorder: A meta-analysis” published in the World Journal of Psychiatry by Wu et al.[1]. In this study the authors reviewed 11 clinical studies about serotonin 1A receptor polymorphism (5-HTR1A) C-1019G polymorphism (rs6295) and antidepressant response. Though reported to be related with major depression[2], suicidal behavior[3] and antidepressant response[4], rs6295 did not show significant association with antidepressant drug response in major depressive disorder (MDD) in this meta-analysis. Genome-wide association studies (GWAS) show to be a useful tool to investigate the effect of polymorphism on clinical phenotypes. Most disease-associated variants are non-coding variants. Researchers have developed multiple methods to identify functional regulatory variants from putative regulatory regions and their cis-regulated genes, like massively parallel reporter assays (MPRAs) and expression quantitative trait loci (eQTL)[5,6]. The 5-HTR1A C-1019G polymorphism (rs6295) reviewed by Wu et al. [1] is a functional upstream variant that affects HTR1A expression but not associates with antidepressant response in patients with MDD, though the 5-HT1A receptor is a primary target for most antidepressant drugs. This variant has been reported to influence HTR1A expression in numerous molecular studies. The C-allele of this variant is capable of interacting with transcription factors (TFs) such as Hes1, Hes5, and Deaf1, whereas the G-allele fails to bind these TFs [7]. Although these three TFs are typically regarded as repressors, the activity of Deaf1 at the 5-HT1A promoter exhibits opposing effects in presynaptic versus postsynaptic neuronal cells [7]. In the human prefrontal cortex, the G-allele demonstrates a lower expression level compared to the C-allele; however, this pattern does not hold true for the midbrain and hippocampus [8]. In a humanized mouse model, subjects with GG genotype exhibited higher levels of HTR1A mRNA and protein than those with CC genotype in a line-dependent manner [9]. Furthermore, in 5-HT1A-expressing neuronal cells, the G-allele was found to downregulate 5-HT1A expression [10]. These showed the complexity of regulatory variant function. Clinical researches on rs6295 had incongruous findings, raising the need for a SNP-based meta analysis. A single variant approach is a classical method to ascertain the relationship between a variant and putative phenotypes. Selective serotonin re-uptake Inhibitors (SSRIs) like fluoxetine, paroxetine, sertraline, citalopram, and fluvoxamine were included in this meta analysis, however, the result showed no significant correlation between this variation and antidepressant drug efficacy in MDD in the dominant model (CG vs CC), recessive model (GG vs CC), and combined dominant model (CG+GG vs CC). The 11 clinical studies collected in their meta analysis included multiple populations from over 10 countries with low to moderate heterogeneity and were scored 7-9 according to the Newcastle-Ottawa Scale (NOS), suggesting a result with higher confidence. The negative correlation might due to gene-gene interactions or gene-environment interactions in MDD and its treatment. A genome-wide linkage analysis for MDD showed that association of LHPP SNPs to MDD were depended on HTR1A -1019G allele [11]. Single variant approaches are limited by lower statistical detection power because most phenotypes result from the influence of many genetic variants in many genes and pathways[12]. This limitation is particularly pronounced in pharmacogenetics and multigenic diseases like MDD. Large-scale meta-analysis of GWAS might overcome this disadvantage. However, phenotype analysis involving rs6295 through GWAS is inherently limited due to its ambiguous nature (C/G). It is challenging to distinguish which complementary allele serves as the effect allele. Furthermore, the minor allele frequency (MAF) of rs6295 is G=0.483 in gnomAD and C=0.458 in 1000G, making it impossible to solve the problem by allele frequency. Ambiguous SNPs with allele frequencies close to 0.5 are usually removed in GWAS [13]. Therefore, a SNP meta-analysis remains a viable option for investigating rs6295. The clinical impacts of regulatory variants in monogenic Mendelian diseases have also been noticed. Many bioinformatic tools were developed to predict TF binding of regulatory variants like SNEEP [14]. Many of them use eQTL datasets as training and validation sets. In rs6295’s case, the variant had different functions in different brain regions, and showed negative significance to putative related phenotype. This suggested a limitation of using these tools to predict clinical candidate variants. However, there are few clinical curated regulatory variants databases available. There are only hundreds of regulatory variants in Clinvar database classified as pathogenic/likely pathogenic/benign/likely benign (data not shown). That’s not enough to feed a complex model. Overall, the negative relationship between the functional regulatory variant rs6295 and antidepressant response underscores the importance of re-evaluating the clinical significance of functional regulatory variants. Both positive and negative meta-analyses are essential for establishing robust relationships between polymorphisms and phenotypes. References [1] Wu HN, Zhu SY, Zhang LN, Shen BH, Xu LL. Association between 5-HTR1A gene C-1019G polymorphism and antidepressant response in patients with major depressive disorder: A meta-analysis. World J Psychiatry 2024; 14(10): 1573-1582 [2]Lemonde S, Turecki G, Bakish D, Du L, Hrdina PD, Bown CD, Sequeira A, Kushwaha N, Morris SJ, Basak A, Ou XM, Albert PR. Impaired repression at a 5-hydroxytryptamine 1A receptor gene polymorphism associated with major depression and suicide. J Neurosci. 2003 Sep 24;23(25):8788-99 [3]Hernández-Díaz, Y., Tovilla-Zárate, C. A., Castillo-Avila, R. G., Juárez-Rojop, I. E., Genis-Mendoza, A. D., López-Narváez, M. L., Villar-Juárez, G. E., & González-Castro, T. B. (2023). Association between the HTR1A rs6295 gene polymorphism and suicidal behavior: an updated meta-analysis. European archives of psychiatry and clinical neuroscience, 273(1), 5–14 [4]Lemonde S, Du L, Bakish D, Hrdina P, Albert PR. Association of the C(-1019)G 5-HT1A functional promoter polymorphism with antidepressant response. Int J Neuropsychopharmacol. 2004 Dec;7(4):501-6 [5]Abell NS, DeGorter MK, Gloudemans MJ, Greenwald E, Smith KS, He Z, Montgomery SB. Multiple causal variants underlie genetic associations in humans. Science. 2022 Mar 18;375(6586):1247-1254 [6]Umans BD, Battle A, Gilad Y. Where Are the Disease-Associated eQTLs? Trends Genet. 2021 Feb;37(2):109-124 [7]Czesak M, Lemonde S, Peterson EA, Rogaeva A, Albert PR. Cell-specific repressor or enhancer activities of Deaf-1 at a serotonin 1A receptor gene polymorphism. J Neurosci. 2006 Feb 8;26(6):1864-71 [8]Donaldson ZR, le Francois B, Santos TL, Almli LM, Boldrini M, Champagne FA, Arango V, Mann JJ, Stockmeier CA, Galfalvy H, Albert PR, Ressler KJ, Hen R. The functional serotonin 1a receptor promoter polymorphism, rs6295, is associated with psychiatric illness and differences in transcription. Transl Psychiatry. 2016 Mar 1;6(3):e746 [9]Cunningham AM, Santos TL, Gutzeit VA, Hamilton H, Hen R, Donaldson ZR. Functional Interrogation of a Depression-Related Serotonergic Single Nucleotide Polymorphism, rs6295, Using a Humanized Mouse Model. ACS Chem Neurosci. 2019 Jul 17;10(7):3197-3206 [10]Czesak M, Lemonde S, Peterson EA, Rogaeva A, Albert PR. Cell-specific repressor or enhancer activities of Deaf-1 at a serotonin 1A receptor gene polymorphism. J Neurosci. 2006 Feb 8;26(6):1864-71 [11]Neff CD, Abkevich V, Packer JC, Chen Y, Potter J, Riley R, Davenport C, DeGrado Warren J, Jammulapati S, Bhathena A, Choi WS, Kroeger PE, Metzger RE, Gutin A, Skolnick MH, Shattuck D, Katz DA. Evidence for HTR1A and LHPP as interacting genetic risk factors in major depression. Mol Psychiatry. 2009 Jun;14(6):621-30 [12]Defo J, Awany D, Ramesar R. From SNP to pathway-based GWAS meta-analysis: do current meta-analysis approaches resolve power and replication in genetic association studies? Brief Bioinform. 2023 Jan 19;24(1):bbac600 [13]Ndong Sima, C.A.A., Step, K., Swart, Y. et al. Methodologies underpinning polygenic risk scores estimation: a comprehensive overview. Hum. Genet. 143, 1265–1280 (2024) [14]Baumgarten N, Rumpf L, Kessler T, Schulz MH. A statistical approach for identifying single nucleotide variants that affect transcription factor binding. iScience. 2024 Apr 18;27(5):109765" Wu HN, Zhu SY, Zhang LN, Shen BH, Xu LL. Association between 5-HTR1A gene C-1019G polymorphism and antidepressant response in patients with major depressive disorder: A meta-analysis. World J Psychiatry 2024; 14(10): 1573-1582 [PMID: 39474388 DOI: 10.5498/wjp.v14.i10.1573]
10	"This study provides valuable insights into the treatment of Helicobacter pylori infection. The comparison between low - dose and standard - dose tetracycline in combination with amoxicillin quadruple therapy is well - designed and the results are significant.The research is comprehensive, considering factors such as eradication rates and adverse events. It offers a potential alternative treatment option with better safety profiles, which is beneficial for patients. Also, there still exist some questions to be considered. 1. Regarding the article structure • When introducing the research background, various antibiotic resistance rates against Helicobacter pylori are listed in detail. However, could this part be presented more concisely and focused more on the resistance situations of tetracycline and amoxicillin directly related to this study? • In the research methods section, could the description of the patient inclusion and exclusion criteria be more focused on the key points and avoid being interfered by too many irrelevant details? For example, the emphasis could be placed on those factors that may have a crucial impact on the research results. • In the results presentation part, could the comparison results of different groups be shown in a clearer structure? For example, the main results of all groups could be presented first, and then the situations of each subgroup (such as the primary treatment group and the rescue treatment group) could be elaborated in detail respectively, which would make it easier for readers to grasp the overall logic. 2. Regarding the article content • When discussing the advantages of low - dose tetracycline, besides comparing the eradication rates and adverse events with the standard - dose tetracycline, could the possible mechanism of action be further explored? This would help readers understand the research results more in - depth. • Some factors affecting the Helicobacter pylori eradication rate are mentioned in the article, such as patient compliance, smoking history, etc. However, could a more in - depth analysis of the interactions between these factors be carried out? For example, does smoking affect the eradication rate by influencing compliance? • Regarding the content of the gut microbiota, although it is mentioned in the limitations that the impact of the low - dose tetracycline regimen on the gut microbiota has not been studied, could the future research directions be more specifically elaborated on how to design relevant studies to explore this issue? 3. Regarding the charts • There is a lot of data in the tables in the article, and some abbreviations in the tables may confuse readers. Could more detailed explanations be given below the tables or where the abbreviations first appear? • Could the titles of the charts more clearly reflect the core content of the charts? For example, some chart titles only simply describe the variables involved in the charts without highlighting the main conclusions or trends. • Could some more charts be considered to present the key information in the research more intuitively? For example, charts could be used to show the occurrence trends of adverse events in different tetracycline dose groups during the treatment process, or to present the relative magnitudes of the impacts of different factors on the eradication rate. 4.Further study • It would be interesting to see if the results hold true in different populations and geographical regions. • The study could have included a more detailed analysis of the long - term effectiveness and potential recurrence of H. pylori infection after treatment. " Zhao YR, Wang XJ, Zhu MJ, Chen AL, Zhang D, Du Q, Kim JJ, Hu WL. Efficacy and safety of low-dose tetracycline, amoxicillin quadruple therapy in Helicobacter pylori infection: A retrospective single center study. World J Gastroenterol 2024; 30(39): 4295-4304 [PMID: 39492823 DOI: 10.3748/wjg.v30.i39.4295]
11	"This paper conducts an in-depth study on the effects of invigorating-spleen and anticancer prescription (ISAP) in a mice model of colon cancer, providing valuable experimental data and analysis. Here are some of my comments on the paper: 1. Clear research background: The paper begins with a detailed introduction to the epidemiological data of colon cancer, emphasizing the severity of the disease and the limitations of existing treatment methods, providing a good background for the necessity of the study. 2. Reasonable experimental design: The study established a mice model of colon cancer and divided it into several experimental groups (including a control group and groups with different doses of ISAP), a design that effectively compares the effects of different doses of ISAP on tumor suppression. 3. Detailed data analysis: The paper provides detailed data on the measurement of mice weight, tumor inhibition rate, and related protein expression levels, with clear and understandable results. These data provide empirical support for the anti-tumor mechanism of ISAP. 4. In-depth mechanism exploration: By analyzing key proteins in the ERK/MAPK signaling pathway, the paper explores the potential mechanism of action of ISAP, providing new ideas for subsequent research. 5. Clinical significance: Although the study has achieved positive results in the mice model, the effectiveness and safety of ISAP still need to be verified in clinical trials. This point can be further emphasized in the discussion section. 6. Language and structure: The language of the paper is relatively fluent, with a clear structure, making it easy for readers to understand. However, the explanation of some professional terms could be more detailed, for the understanding of non-professional readers. Overall, this paper provides strong support for the potential of ISAP in the treatment of colon cancer, looking forward to seeing more clinical research results in the future." Wang W, Wang J, Ren XX, Yue HL, Li Z. Effects of invigorating-spleen and anticancer prescription on extracellular signal-regulated kinase/mitogen-activated protein kinase signaling pathway in colon cancer mice model. World J Gastrointest Oncol 2024; 16(11): 4468-4476 [PMID: 39554742 DOI: 10.4251/wjgo.v16.i11.4468]
12	"The original article by Wang FD et al., "Gamma-aminobutyric acid enhances miR-21-5p loading into adipose-derived stem cell extracellular vesicles to alleviate myocardial ischaemia-reperfusion injury via TXNIP regulation," is very good. GABA-induced miR-21-5p-loaded EVs utilise a unique mechanism to lessen myocardial ischaemia-reperfusion injury (MIRI) and present a novel method for managing MIRI through oxidative stress modulation. The study reported that miR-21-5p exerts its effects through a direct interaction with TXNIP in cardiomyocytes, thereby triggering oxidative stress and elucidating related molecular mechanisms. Furthermore, this work systematically employs in vivo, in vitro, and a variety of imaging methods with gene knockout models to provide comprehensive methodological proofs. Considering myocardial ischaemia is a common clinical condition, this study has high translational relevance. But there are few queries: The experiment only evaluates its EV source in inguinal ADSCs and could miss other potential beneficial configurations of EV. It is still unclear whether these short-term therapeutic effects are sustainable or if they interfere with repeated dosing against MIRI, despite the study's lack of a long-term assessment. The process of producing, standardizing, and ensuring the safety of EVs for human use could potentially complicate the clinical translation of the latter strategy." Wang FD, Ding Y, Zhou JH, Zhou E, Zhang TT, Fan YQ, He Q, Zhang ZQ, Mao CY, Zhang JF, Zhou J. Gamma-aminobutyric acid enhances miR-21-5p loading into adipose-derived stem cell extracellular vesicles to alleviate myocardial ischemia-reperfusion injury via TXNIP regulation. World J Stem Cells 2024; 16(10): 873-895 [PMID: 39493825 DOI: 10.4252/wjsc.v16.i10.873]
13	"The theme of this article is very practical and a common problem that troubles elderly women, and the conclusion is very meaningful. It can help alleviate the pain of many women. The abundant scientific data and clear images fully demonstrate the role of exercise therapy, providing methods and ideas for further research.As a reader, I really enjoy this article as it allows me to quickly gain knowledge about this topic." Dai ZQ, Gong XY, Zhang R, Jin MQ, Lu W, Wen W, Chen J, Lu FJ, Yang YF, Wang L, He XJ. Research trends in exercise therapy for the treatment of pain in postmenopausal osteoporosis over the past decade: A bibliometric analysis. World J Orthop 2024; 15(10): 950-964 [PMID: 39473512 DOI: 10.5312/wjo.v15.i10.950]
14	"This article is interesting, but does not provide any novelties nor scientific approaches in diagnostics of IBD, it is based on "defending" physicians and minorizing their role in detecting Crohn's disease. I could agree with main conclusion of this article, that providing a diagnose of Crohn's disease is multifactorial, and it depends not only on physicians but on patients itself, time frame, diagnostic abilities. " Zeng Y, Zhang JW, Yang J. Physician-dependent diagnosis delay in Crohn's disease: A pseudo-proposition or not? World J Gastroenterol 2024; 30(38): 4242-4245 [PMID: 39493331 DOI: 10.3748/wjg.v30.i38.4242]
15	"1. This study lacks an ethics statement. It is advisable to include an ethics statement within the methods section. 2. The ROC curve presented in the results suggests that the sample size may be relatively insufficient. It is recommended that researchers increase the sample size in further studies and conduct prospective investigations to validate these findings." Lin BS, Liu ZG, Chen DR, Yang YL, Yang DZ, Yan JH, Zeng LY, Yang XB, Xu W. Relationship between hemoglobin glycation index and risk of hypoglycemia in type 2 diabetes with time-in-range in target. World J Diabetes 2024; 15(10): 2058-2069 [PMID: 39493564 DOI: 10.4239/wjd.v15.i10.2058]
16	"Title: A Study on the Deterioration of Intracranial Epidermoid Cysts through Whole Exome Sequencing Dear Editors and Authors, First and foremost, I would like to congratulate the authors on the publication of this high-quality case report on the malignant transformation of intracranial epidermoid cysts (IEC) into squamous cell carcinoma (SCC) in the "World Journal of Clinical Oncology." This study not only provides valuable insights into the molecular mechanisms underlying the transformation of IEC to SCC but also reveals two potential disease-related gene mutations: GJB2 (c.257C>T) and TLR2 (c.1039A>G) through whole exome sequencing (WES). Comment Content: Innovation and Importance of the Study: The innovation of this study lies in providing the first clinical evidence for the potential role of GJB2 and TLR2 in the development and treatment of IEC. This is significant for guiding future research directions and potential therapeutic targets. Rigorous Study Design: The authors have employed WES technology, which is efficient and cost-effective for processing large amounts of data quickly. This method is highly applicable for screening genetic variants related to rare and complex diseases, demonstrating the rigor and forward-thinking of the study design. Detailed Case Report: The article provides a very detailed description of the case, including the patient's clinical symptoms, medical history, laboratory test results, and imaging examination results. These details help readers to fully understand the case and provide valuable data for future research. In-Depth Analysis of Genetic Variants: The authors not only identified two risk variants but also conducted an in-depth analysis of their impact on protein structure and function. This in-depth analysis helps to understand how these variants affect the occurrence and development of the disease. Comprehensive Treatment and Follow-Up: The article describes the patient's treatment process and follow-up results in detail, providing valuable references for clinical doctors and demonstrating the effectiveness of comprehensive treatment in controlling the condition. Suggestions for Improvement: Increase the Sample Size: Although this is a report on a rare case, increasing the sample size will help to verify the association between these gene mutations and the deterioration of IEC and improve the generalizability and reliability of the study's results. Functional Validation Experiments: The authors mentioned plans for functional validation experiments in future studies. These experiments will help further confirm the role of GJB2 and TLR2 in the development of IEC and how these mutations affect protein function. Long-Term Follow-Up Data: Long-term follow-up data will help assess the long-term effects of treatment and the patient's quality of life, which is crucial for evaluating treatment outcomes and formulating treatment guidelines. Conclusion: This article is an important contribution to the study of the mechanisms underlying the malignant transformation of IEC. It not only enhances our understanding of the genetic basis of this rare disease but also provides new ideas for future treatments. The authors' work is commendable, and I look forward to their future research bringing more breakthrough" Song ZN, Cheng Y, Wang DD, Li MJ, Zhao XR, Li FW, Liu Z, Zhu XR, Jia XD, Wang YF, Liang FF. Whole exome sequencing identifies risk variants associated with intracranial epidermoid cyst deterioration: A case report. World J Clin Oncol 2024; 15(11): 1428-1434 [PMID: 39582614 DOI: 10.5306/wjco.v15.i11.1428]
17	"The combination of Astragalus polysaccharide and gimeracil oteracil potassium capsule (S-1) in the treatment of pancreatic cancer can effectively improve the efficacy, reduce side effects, and increase long-term survival rates, which has significant clinical value.In the future, we can further validate its efficacy by conducting prospective, large-scale, multi-center studies and provide more guiding recommendations for clinical practice." Li GY, Jiang J. Recent efficacy and long-term survival of Astragalus polysaccharide combined with gemcitabine and S-1 in pancreatic cancer. World J Clin Oncol 2024; 15(11): 1404-1411 [PMID: 39582615 DOI: 10.5306/wjco.v15.i11.1404]
18	" Commentary: Predictors of survival in autoimmune liver disease overlap syndromes Jian-Guo Zhang,Biao Wen Jian-Guo Zhang,Biao Wen,Department of Gastroenterology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610000, Sichuan Province, China Author contributions:Jian-Guo Zhang wrote the original draft; Biao Wen contributed to conceptualization, writing, reviewing and editing; Jian-Guo Zhang and Biao Wen participated in drafting the manuscript; and all authors have read and approved the final version of the manuscript. ORCID number：0000-0001-5226-5981 Corresponding author:Biao Wen,MD, PhD,Assistant Professor,Department of Gastroenterology, The First Affiliated Hospital of Chengdu Medical College,No. 312, Middle Section of Baoguang Avenue, Xindu District, Chengdu 610000, Sichuan Province, China. 820695761@qq.com We perused the article authored by Jayabalan et al[1]with considerable interest and extend our congratulations to the authors for their commendable endeavor. The authors have reported a prospective investigation into the predictors of survival in patients with autoimmune liver disease overlap syndromes (AILDOS)[1]. The study's conclusion suggests that the LOS holds potential as a predictive tool for liver-related mortality in individuals with autoimmune hepatitis and primary biliary cholangitis overlap (AIH-PBC)[1]. However, several aspects of this study merit further scrutiny and discussion. Firstly, a critical exclusion criterion for the study was the prior performance of a liver transplant prior to enrollment[1]. Upon consideration, we postulated the possibility that a portion of the enrolled patients might harbor coexisting liver pathology stemming from disparate causes (including, but not limited to, alcoholic liver disease or viral hepatitis), which could introduce bias and complicate the interpretation of our results. Therefore, we advised the authors to implement rigorous exclusion criteria for such patients to uphold the accuracy and reliability of our findings. Secondly, the diagnoses of autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC) were established in accordance with the criteria stipulated by the International Autoimmune Hepatitis Group, the European Association for the Study of the Liver Clinical Practice Guidelines, and the American College of Gastroenterology Clinical Guidelines, respectively[1-4]. It is noteworthy that these diagnostic criteria originate from disparate geographical regions, and the progression of research concerning each disease varies across these regions. Consequently, such variability may potentially impact the precision of the study's findings. In light of this, we propose that the authors consider adopting diagnostic criteria from a uniform geographical region. Therefore, we recommend the uniform application of diagnostic guidelines or consensus recommendations established by reputable institutions in the United States for the purposes of disease ascertainment. Such standardization is poised to substantially elevate the reliability and validity of the research findings, thereby reinforcing the scientific rigor and credibility of the conducted studies.[4-6]. Thirdly, the authors confined their analysis solely to the occurrence or absence of liver-related mortality, while neglecting to account for the medical interventions undergone by the patients during the follow-up period[1]. It is imperative to elucidate the potential impact of these interventions on the study's findings. A comprehensive assessment of the medical interventions received by the patients is crucial for ensuring the accuracy and robustness of the study's conclusions. Ultimately, as highlighted by the authors, the primary limitation of this study is the relatively modest sample size[1]. Consequently, it is imperative that future research endeavors incorporate larger sample populations and adopt a multicenter design to validate the findings of the present study and further elucidate the pertinence to patients with AIH-PSC. Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported. REFERENCES 1 Jayabalan D, Huang Y, Calzadilla-Bertot L, Janjua M, de Boer B, Joseph J, Cheng W, Hazeldine S, Smith BW, MacQuillan GC, Wallace MC, Garas G, Adams LA, Jeffrey GP. Predictors of survival in autoimmune liver disease overlap syndromes. World J Hepatol 2024; 16: 1269-1277. [PMID:39351512 DOI: 10.4254/wjh.v16.i9.1269] 2 European Association for the Study of the Liver. EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis. J Hepatol 2017; 67: 145-172. [PMID: 28427765 DOI: 10.1016/j.jhep.2017.03.022] 3 Czaja AJ. Diagnosis and Management of Autoimmune Hepatitis: Current Status and Future Directions. Gut Liver 2016; 10: 177-203. [PMID:26934884 DOI: 10.5009/gnl15352] 4 Lindor KD, Kowdley KV, Harrison ME. ACG Clinical Guideline: Primary Sclerosing Cholangitis. Am J Gastroenterol 2015; 110: 646-659, 660. [PMID: 25869391 DOI: 10.1038/ajg.2015.112] 5 Mack CL, Adams D, Assis DN, Kerkar N, Manns MP, Mayo MJ, Vierling JM, Alsawas M, Murad MH, Czaja AJ. Diagnosis and Management of Autoimmune Hepatitis in Adults and Children: 2019 Practice Guidance and Guidelines From the American Association for the Study of Liver Diseases. Hepatology 2020; 72: 671-722. [PMID: 31863477 DOI: 10.1002/hep.31065] 6 Lindor KD, Bowlus CL, Boyer J, Levy C, Mayo M. Primary Biliary Cholangitis: 2018 Practice Guidance from the American Association for the Study of Liver Diseases. Hepatology 2019; 69: 394-419. [PMID:30070375 DOI: 10.1002/hep.30145]" Jayabalan D, Huang Y, Calzadilla-Bertot L, Janjua M, de Boer B, Joseph J, Cheng W, Hazeldine S, Smith BW, MacQuillan GC, Wallace MC, Garas G, Adams LA, Jeffrey GP. Predictors of survival in autoimmune liver disease overlap syndromes. World J Hepatol 2024; 16(9): 1269-1277 [PMID: 39351512 DOI: 10.4254/wjh.v16.i9.1269]
19	"Comment on “Mesenchymal stem cells in wound healing: A bibliometric analysis as a powerful research tool” Shuang Wu, Hong Cai* Corresponding author: Hong Cai, Department of Dermatology, Air Force Medical Center, PLA, Beijing, 100142, P. R. China. ch1031@163.com Affiliation: Department of Dermatology, Department of Dermatology, Air Force Medical Center, PLA. No.30 of Fucheng Road. Beijing 100142, China. Key Words: Bibliometric analysis; Mesenchymal stem cells; Wound healing; To the Editor: We read the editorial by Vera et al [1]with great interest. In this editorial, the author conducted a keyword comparison and analysis of basic research published in BPG from 2023 to 2024, utilizing the bibliometric analysis approach of Shi et al[2]. This emphasizes the effectiveness of bibliometric analysis as a research tool. Additionally, the author examined several other articles on BPG, excluding WJSC, that were not included in Shi et al.'s bibliometric analysis. The findings indicate that although the application of bibliometric analysis in basic research remains limited, it can help identify key research directions and challenges in the field, advance the application of MSCs in the treatment of chronic wounds, and facilitate comprehensive analysis of related literature to better understand the current state of research and future development potential. First, the author conducted a keyword analysis of basic research on diabetic foot published in BPG, utilizing the bibliometric analysis by Shi et al. to highlight the value of bibliometric analysis in this field, which can provide clear directions for research hotspots. However, while Shi et al. used the Web of Science Core Collection database, the author of this article relied solely on the database affiliated with BPG for keyword comparisons. This discrepancy might introduce potential biases in the analysis results due to differences in research directions and acceptance criteria between journals[3,4]. Second, the author also pointed out limitations in Shi et al.'s bibliometric analysis: the analysis primarily focused on journals related to diabetic foot, while literature from other relevant fields was excluded from the search. This implies that some articles pertaining to stem cell therapy for diabetic foot may not have been incorporated, underscoring the necessity of expanding the search scope in future bibliometric analyses. Third, the author specifically analyzed literature on stem cell therapy for diabetic foot published in BPG during 2023-2024, while Shi et al.'s bibliometric analysis covered related literature from 2000 to 2023, thereby including a broader time span and a more extensive range of keywords. As basic research evolves, there may be past hotspot keywords that are now rarely used, or new research hotspots published in BPG that were not included in Shi et al.'s bibliometric analysis[5]. In summary, this is an editorial that employs bibliometric analysis to conduct a keyword analysis of relevant papers published in BPG from 2023 to 2024, elucidating the role of bibliometric analysis in basic research. If the analysis were to consider the acceptance criteria of different journals and the issue of timeliness more extensively, the conclusions could potentially be more compelling. References 1 Voinova VV, Vasina DV, Bonartsev AP. Mesenchymal stem cells in wound healing: A bibliometric analysis as a powerful research tool. World J Stem Cells 2024; 16: 827–831. [PMID: 39351262 DOI: 10.4252/wjsc.v16.i9.827] 2 Shi H-S, Yuan X, Wu F-F, Li X-Y, Fan W-J, Yang X, Hu X-M, Liu G-B. Research progress and challenges in stem cell therapy for diabetic foot: Bibliometric analysis and perspectives. World J Stem Cells 2024; 16: 33–53. [PMID: 38292441 DOI: 10.4252/wjsc.v16.i1.33] 3 Frank E. Authors’ Criteria for Selecting Journals. JAMA 1994; 272: 163–164. [DOI: 10.1001/jama.1994.03520020089026] 4 Garfield E. The History and Meaning of the Journal Impact Factor. JAMA 2006; 295: 90–93. [DOI: 10.1001/jama.295.1.90] 5 Tversky A, Kahneman D. Judgment under Uncertainty: Heuristics and Biases. Science 1974; 185: 1124–1131. [DOI: 10.1126/science.185.4157.1124] " Voinova VV, Vasina DV, Bonartsev AP. Mesenchymal stem cells in wound healing: A bibliometric analysis as a powerful research tool. World J Stem Cells 2024; 16(9): 827-831 [PMID: 39351262 DOI: 10.4252/wjsc.v16.i9.827]
20	"The article by Shen et al. offers important insights into the need for better screening practices for primary nasal tuberculosis (TB) in patients receiving tumor necrosis factor inhibitor (TNFi) therapy. The rarity of primary nasal TB, due to the nasal mucosa's natural defenses, along with the identified risk factors like diabetes, minimally invasive nasal surgery, and HIV, is well highlighted. We completely agree with the authors about the importance of early detection, especially in high-risk individuals. Their suggestion to increase screening frequency using the Interferon Gamma Release Assay (IGRA) makes sense. However, it’s also worth considering how practical this approach is in areas with lower TB prevalence. In regions with fewer resources, a more targeted strategy based on local TB rates and individual patient risk might be more appropriate. Another point to consider is how clinicians can best decide on the timing of these screenings. While IGRA testing is key, decisions on how often to test should also factor in a patient’s specific history, immune status, and any symptoms they might be experiencing. A one-size-fits-all approach may not work, so a more flexible screening schedule, tailored to both the patient’s needs and the region’s TB prevalence, could be even more effective. We look forward to further research in this area which will help shape future guidelines for managing TB risk in this patient group." Shen DX, Wang YW, Lin ZM, Jin D, Ying ZH, Li C. Early screening to identify and diagnose primary nasal tuberculosis in patients with tumor necrosis factor inhibitors. World J Clin Cases 2024; 12(33): 6604-6607 [PMID: 39600487 DOI: 10.12998/wjcc.v12.i33.6604]
21	"First, I would like to congratulate the authors for their excellent work that reports precisely the role of ultrasonography as the first step in diagnosing liver echinococcus cyst. The paper is comprehensive and well-written, accompanied by many impressive imaging figures. Echinococcosis or hydatid disease is caused mainly by the dog tapeworm Echinococcus granulosus and occasionally by the fox tapeworm Echinococcus multilocularis (alveolaris). Infection by the former exhibits a rather chronic, benign course. Infection by the latter, seen in north and central Europe, Switzerland, Alaska, Canada, Russia, Japan, and China, resembles carcinoma and without treatment is ultimately fatal; there have been reports mistaking it for hepatic carcinoma. The hydatid disease predominantly affects the liver, and surgical management, despite its difficulties and high recurrence rates, is considered the cornerstone of treatment. The incidence of liver echinococcal cyst has considerably reduced across the world owing to concerted public health hygiene and sanitary measures to disrupt the parasite cycle between the main host (dog,wolf, fox) and the intermediate host (human, sheep, cow, pig), but it remains endemic in some areas.. Diagnosis is established by current imaging techniques (US, CT, MRI-MRCP), aided by serum serology tests for antibodies against hydatid antigens. Specific anti-echinococcal antibodies (IgG, IgM), detected by ELISA (with a sensitivity of 95–97%) is the most widely used serologic test in everyday practice. Modern MRI depicts accurately the details of a hepatic echinococcal cyst as well as the communication with the biliary tree. MRCP showing dilatation of the biliary tract and echinococcal material in it may be valuable. Surgery is the main treatment modality in the management of liver echinococcosis caused by echinococcus granulosus, especially in large solitary cysts. It includes the most demanding radical procedures (total pericystectomy or hepatectomy) and the more conservative procedures (cyst evacuation, partial cystectomy, and drainage or omentoplasty). Complete removal of the cyst ensures permanent cure and should be the treatment of first-choice. In contrast, liver echinococcosis caused by echinococcus multilocularis (alveolaris) is not usually amenable to surgical treatment, except in drug therapy by Albendazole. It is used at a dose of 10 mg/kg/day. One tablet of 400 mg twice daily is the usual therapeutic scheme. A cycle of 28 days is recommended, followed by a washout period of 14 days, and repetition again. " Tao Y, Wang YF, Wang J, Long S, Seyler BC, Zhong XF, Lu Q. Pictorial review of hepatic echinococcosis: Ultrasound imaging and differential diagnosis. World J Gastroenterol 2024; 30(37): 4115-4131 [PMID: 39474399 DOI: 10.3748/wjg.v30.i37.4115]
22	"This retrospective study provide a machine learning method using nomogram to present medical imaging features associated with clinical factors via univariate and multivariate analysis in patients with colon cancer. Maybe the results of CT imaging with 12 characteristics as author stated is interesting for readers in clinic diagnosis as well as these representative images can be shared by your database online. " Hu ZX, Li Y, Yang X, Li YX, He YY, Niu XH, Nie TT, Guo XF, Yuan ZL. Constructing a nomogram to predict overall survival of colon cancer based on computed tomography characteristics and clinicopathological factors. World J Gastrointest Oncol 2024; 16(10): 4104-4114 [PMID: 39473950 DOI: 10.4251/wjgo.v16.i10.4104]
23	"This article has explained the effects of mesenchymal stem cells and their derivatives in the non-alcoholic fatty liver disease and alcohol-associated liver disease using mouse models. Maybe it is meaningful to indicate the application of mesenchymal stem cells in fatty liver in the future. Hope that interaction between mesenchymal stem cells and human hepatic cell lines can be investigated to explore this effective role for further use in the clinic. " Gao FQ, Zhu JQ, Feng XD. Innovative mesenchymal stem cell treatments for fatty liver disease. World J Stem Cells 2024; 16(9): 846-853 [PMID: 39351260 DOI: 10.4252/wjsc.v16.i9.846]
24	"Through this meta-analysis, better guidance has been provided for the treatment of tenosynovitis. USG-guided PRP with percutaneous needle tenotomy gives better outcome in DQT. which provides better pain management and stable improvement in functional outcomes in the long term. Ultrasonography-guided PRP with percutaneous needle tenotomy gives a better outcome. There are minimal side effects associated with PPR injection." Hidajat NN, Magetsari RMSN, Steven G, Budiman J, Prasetiyo GT. Platelet-rich plasma for de Quervain’s tenosynovitis: A systematic review and meta-analysis. World J Orthop 2024; 15(9): 858-869 [PMID: 39318495 DOI: 10.5312/wjo.v15.i9.858]
25	"1. The case in this article needs to be clarified whether thought reaches delusional and its duration. If there is delusion, the diagnosis also needs to differentiate with delusional disorder. Another name is Ekbom syndrome, in which comprises of visual hallucinations and delusional parasitosis. Delusional parasitosis, which is characterized by a fixed and persistent belief of having a pathogenic infection despite objective evidence to the contrary. 2. The authors described the diagnosis of early dementia. However, the article did not mention the clinical course and symptoms of typical dementia in this patient, such as the patient's memory complaints, cognitive function deterioration, instrumental and basic activities of daily livings, and executive functions. The results of cognitive function assessment should be provided. 3. The case history mentioned that the patient had gait problems. The reader may wonder what the patient's neurological examination, especially the evaluation of the limbs and gait. A type of dementia called Lewy body dementia (DLB), and its core symptoms contain parkinsonism. DLB is also considered to be likely to have vivid visual hallucinations. 4. Authors can discuss the pathophysiology of psychotic symptoms in dementia and late life and review associated reports on the use of antipsychotics in such clinical situation. 5. If the patient meets the diagnosis of early dementia, the use of AchEI can be considered and discussed. Compared with antipsychotics, the advantage of using AchEI to treat psychiatric symptoms in dementia patients is that it does not affect cognitive function and has fewer extrapyramidal side effects. 6. Thanks for the author's paper." Xu T, Mei X, Zhao Z, Liu YH, Zheng CY. Effectiveness of anti-psychiatric treatment on visual and haptic perceptual disorder for a patient with Alzheimer’s disease: A case report. World J Psychiatry 2024; 14(9): 1404-1410 [PMID: 39319233 DOI: 10.5498/wjp.v14.i9.1404]
26	" In this manuscript, the method of network pharmacology was used to explore the specific mechanism of Xiaojianzhong decoction treating gastric cancer, and the drug target network and gastric cancer differential genes were creatively used to analyze the potential therapeutic target, providing a new possibility for the treatment of gastric cancer. However, a fly in the ointment is that only GSE118916 is used for the differentially expressed gene related to gastric cancer, which makes its application value relatively insufficient. It should be understood that cancer is a complex disease related to multiple genes and multiple targets, and the use of multiple GEO chips to screen common pathogenic genes will make the study more universal. Using a single chip amplifies potential disease-causing genes and reduces the confidence of drug targets." Chen GQ, Nan Y, Ning N, Huang SC, Bai YT, Zhou ZY, Qian G, Li WQ, Yuan L. Network pharmacology study and in vitro experimental validation of Xiaojianzhong decoction against gastric cancer. World J Gastrointest Oncol 2024; 16(9): 3932-3954 [PMID: 39350988 DOI: 10.4251/wjgo.v16.i9.3932]
27	"The authors' proposed study aims to investigate the association between nutritional and inflammatory markers and the prognosis of patients with CRC-PM. The article argues for the predictive role of NLR with respect to patients' OS, based on blood sampling performed one week before surgery regardless of the treatment the patient receives. It also constructs a nomogram on NLR, Hb and PCI (dividing patients into only two groups PCI > or <20). As highlighted by the authors in the introduction, treatment impacts the OS of patients: the OS of chemo-treated-only patients is 13 months while for those who received a CRS/HIPEC it is up to 41.7 months. In the literature, the following are documented as prognostic factors affecting OS: extent of peritoneal disease in accordance with PCI (there are more than two subgroups, commonly: PCI<7-11; PCI between 11 and 15 ,PCI>15 also, some studies consider a PCI>20 to be outside the chances of benefiting from any treatment), achievement of optimal surgical cytoreduction (CC0-CC1), type of peri-operative chemotherapy received by the patient, and tumor biology. the role played by HIPEC (and the various application protocols) is a matter of debate. The population on which NRL is tested and then the nomogram constructed is heterogeneous in both staging and treatment received. Characteristics of pre-surgical extent of disease are not known. Any chemotherapy treatments received by patients are not known. The authors pool patients who received only palliative treatments and those who received radical therapy into the same population. In summary, despite a large number of papers in the literature advocating the importance of careful evaluation/selection of patients with CRC-PM and the impact of treatments on patients' OS the authors support the selection role of a single inflammatory marker and base the construction of a nomogram on this. There is a risk of providing non-expert clinicians with an inadequate assessment tool that could lead to incorrect treatment choices. " Wu ZJ, Lan B, Luo J, Ameti A, Wang H, Hu QY. Impact of preoperative inflammatory and nutritional markers on the prognosis of patients with peritoneal metastasis of colorectal cancer. World J Gastrointest Oncol 2024; 16(9): 3865-3874 [PMID: 39350999 DOI: 10.4251/wjgo.v16.i9.3865]
28	"This study explores the potential of resveratrol, a natural polyphenol, in targeting pancreatic cancer by depleting senescent tumor-associated fibroblasts (TAFs). Tumor-associated fibroblasts play a key role in the tumor microenvironment, promoting cancer cell proliferation and metastasis. By depleting senescent TAFs, resveratrol disrupts this supportive environment, leading to inhibited cancer growth and spread. The findings suggest that resveratrol could be an effective therapeutic strategy for pancreatic cancer, especially in limiting metastasis. This study highlights the importance of targeting the tumor microenvironment and opens the door to potential combination therapies involving resveratrol in cancer treatment. The limitations of this study include the need for further validation in clinical settings, as the effects of resveratrol were primarily observed in preclinical models, which may not fully replicate human pancreatic cancer biology. The dosage and bioavailability of resveratrol in humans could also differ, potentially limiting its therapeutic efficacy. Additionally, the study focuses on depleting senescent tumor-associated fibroblasts (TAFs) but does not fully explore the long-term consequences of this depletion on the tumor microenvironment or potential side effects. More comprehensive studies are required to determine resveratrol's safety and effectiveness as a standalone or combination therapy." Jiang H, Wang GT, Wang Z, Ma QY, Ma ZH. Resveratrol inhibits pancreatic cancer proliferation and metastasis by depleting senescent tumor-associated fibroblasts. World J Gastrointest Oncol 2024; 16(9): 3980-3993 [PMID: 39350997 DOI: 10.4251/wjgo.v16.i9.3980]
29	"The subject with autologous conditioned serum (ACS) as a therapeutic agent for spine pathology is very interesting and the outcomes from meta-analysis was great. Actually, the ACS method has not been widely used so far, so the kind of analysis could make it the feasibility and safety for spreading its use. However, the article has some minor limitations for the general use. Most of all, the articles used at the meta-analysis were made from duplicated institutes (just 3 different hospitals) and in the meta-analysis some statistical results were lacking, so it is hard to believe that the outcomes can be generalized. Nevertheless, the study has a strong point that only a few article have handled the ACS for confirming clinical effectiveness for spinal disease. Thus, the article can be a cornerstone of ACS use for spine pathology, and further studies regarding the ACS are necessary to greater define the effectiveness and safety." Rajkovic CJ, Merckling ML, Lee AW, Subah G, Malhotra A, Thomas ZD, Zeller SL, Wainwright JV, Kinon MD. Conservative management of spinal pathology with autologous conditioned serum: A systematic review of the literature. World J Orthop 2024; 15(9): 870-881 [PMID: 39318497 DOI: 10.5312/wjo.v15.i9.870]
30	"We recognize the innovation and practical value of this article, which comprehensively summarizes the bone marrow mesenchymal stem cells (BMSCs) biological properties, outlines the role and mechanism of BMSCs in alleviating PNI, and suggests that transplantation of BMSCs for the treatment of PNI has a broad prospect. We are very grateful to the authors for their commitment to the study of BMSCs for alleviating nerve injury, which will help to elucidate the biological mechanisms related to the amelioration of PNI by BMSCs, and provide a solid foundation for basic and clinical research. 1.The article is a bit thin in terms of pictures and tables, and it would be more beautiful if we could add a table and a picture in moderation. Because pictures can illustrate specific things at a glance and are more vivid than words. 2.Bioengineering and nanotechnology have been hot directions for MSCs in recent years, with broad application potentials and a crucial role in PNI recovery, but the study has been depicted somewhat, but not in great depth. 3.The clinical trials section is poorly discussed and lacks in-depth exploration of their progress and potential. If there are few, then at least clinical trials for neurologically related diseases or other similar diseases should be added to elucidate the current progress of clinical research on MSCs, such as routes of administration, dosage of administration, and safety. 4.The biology of BMSCs (in terms of structure, origin, homing, targeting, etc.) is poorly characterized, and these are critical for the cells to perform their physiological functions for the treatment of PNI. 5.The multidirectional differentiation characteristics, immunomodulatory effects and simplicity of in vitro isolation, culture and expansion of BMSCs have laid the foundation for their clinical application. However, in the process of specific clinical application, the safety and effectiveness of BMSCs must be affirmed, based on which attention should be paid to the standardization of cell culture, the survival of implanted cells, and the inherent differentiation characteristics of the cells as well as immune rejection, etc.; the prospects and challenges of the clinical trials in this study have not yet been elucidated in depth. 6.In addition, the bibliography of the article is somewhat outdated, and it would have been better if more than 70 per cent of the bibliography had been from the last three years, so that at least the currency of the article could have been ensured." Zou XF, Zhang BZ, Qian WW, Cheng FM. Bone marrow mesenchymal stem cells in treatment of peripheral nerve injury. World J Stem Cells 2024; 16(8): 799-810 [PMID: 39219723 DOI: 10.4252/wjsc.v16.i8.799]
31	"The most significant contribution of this editorial is the clear establishment of sarcopenia and myosteatosis as independent prognostic factors that significantly impact the outcomes of gastric cancer patients treated with immune checkpoint inhibitors (ICIs). While the authors reference studies that confirm these associations, the editorial falls short in providing sufficient details on the mechanisms and implications of sarcopenia and myosteatosis. Expanding on these aspects would enhance understanding and underscore the importance of addressing these conditions in clinical practice." Yang YN, Wang LS, Dang YQ, Ji G. Evaluating the efficacy of immunotherapy in gastric cancer: Insights from immune checkpoint inhibitors. World J Gastroenterol 2024; 30(32): 3726-3729 [PMID: 39221068 DOI: 10.3748/wjg.v30.i32.3726]
32	"In their meta-analysis, the authors demonstrated that the clinical outcomes except mortality consistently showed a worsening trend in patients with NAFLD and concomitant COVID-19, although further research in conducting prospective longitudinal studies is essential for a more powerful conclusion. The results are not unexpected given the numerous sources for COVID-19 detrimental development in patients with chronic liver and other concomitant diseases. As a slight limitation I consider the results section in the abstract, it could be more efficiently presented. " Moeed A, Larik MO, Fahim MAA, Rahman HAU, Najmi L, Changez MIK, Javed MM, Hasibuzzaman MA. Impact of non-alcoholic fatty liver disease on coronavirus disease 2019: A systematic review. World J Hepatol 2024; 16(8): 1185-1198 [PMID: 39221098 DOI: 10.4254/wjh.v16.i8.1185]
33	"Dear Editor, We would like to submit the enclosed manuscript entitled “Microvesicles derived from mesenchymal stem cells: a promising therapeutic strategy for acute respiratory distress syndrome-related pulmonary fibrosis?”, which we wish to be considered for publication in World Journal of Stem cells. This is an invited manuscript and my ID is 07415442. It is submitted to be considered for publication as a EDITORIAL in your journal. This paper is new. Neither the entire paper nor any part of its content has been published or has been accepted elsewhere. It is not being submitted to any other journal. Pulmonary fibrosis is a significant predictor of poor outcomes in patients with acute respiratory distress syndrome (ARDS). Currently, there is a lack of effective therapeutic options for pulmonary fibrosis in clinical practice. Therefore, there is an urgent need to identify safe and effective treatment strategies. This article provides a concise overview of the role of mesenchymal stem cells (MSCs), microvesicles (MVs), and hepatocyte growth factor (HGF) in pulmonary fibrosis, with a focus on their implications in both basic research and clinical practice. Furthermore, it examines the potential applications and challenges associated with the use of MSC-MVs as a novel therapeutic approach. Because your journal welcomes manuscripts in stem cells, we feel that this work is of general interest and is suitable for publication in World Journal of Stem cells. Thank you very much for considering our manuscript for potential publication. We are looking forward to hearing from you soon." Chen QH, Zhang Y, Gu X, Yang PL, Yuan J, Yu LN, Chen JM. Microvesicles derived from mesenchymal stem cells inhibit acute respiratory distress syndrome-related pulmonary fibrosis in mouse partly through hepatocyte growth factor. World J Stem Cells 2024; 16(8): 811-823 [PMID: 39219725 DOI: 10.4252/wjsc.v16.i8.811]
34	"The paper offers valuable insights into lymphocyte phenotypes in patients with liver cirrhosis, contributing significantly to our understanding of immune alterations in this condition. However, a mild critique lies in the abstract, which, unfortunately, does not adequately reflect the depth and specificity of the results presented. This omission may inadvertently limit the paper's reach and impact by not fully engaging potential readers. Despite this, the study is commendable for its rigorous and well-detailed methodology, which ensures the validity of its findings. The results are not only statistically significant but also hold considerable practical relevance for clinical applications and further research in the field." Li Y, Quan X, Tai Y, Wu YT, Wei B, Wu H. Causal association between 731 immunocyte phenotypes and liver cirrhosis: A bidirectional two-sample mendelian randomization analysis. World J Hepatol 2024; 16(8): 1156-1166 [PMID: 39221101 DOI: 10.4254/wjh.v16.i8.1156]
35	"The title of "Retrospective study evaluating association of colorectal tumors and hepatitis C virus" paper seems meaningful in the clinical analysis of both outcomes of HCV and pathogenic factors of colorectal tumors. Maybe author can discuss the effects of viral pathogens such as HBV, HIV besides HCV in the development of colorectal tumors. " Gogtay M, Yadukumar L, Singh Y, Suresh MG, Soni A, Yekula A, Bullappa A, Abraham GM. Retrospective study evaluating association of colorectal tumors and hepatitis C virus. World J Virol 2024; 13(3): 92647 [PMID: 39323450 DOI: 10.5501/wjv.v13.i3.92647]
36	"There are some methodological concerns that we would highlight. In their exclusion criteria, we note that the authors excluded patients with serious underlying disease, The extent of severity of comorbidities to warrant exclusion was not defined. Furthermore, patients with immediate postoperative complications were also excluded from final analysis. These exclusions may introduce an element of selection bias into the analysis, as only the fittest patients who had an uneventful postoperative course were included in the final analysis. It is also concerning that there is no mention of provision of neoadjuvant or perioperative systemic therapy for these gastric cancer patients, as is the standard of care in locally advanced gastric cancer throughout the world. It would have been interesting to know if there was an association between receiving perioperative chemotherapy, such as FLOT, and survival outcomes, or with the presence of vascular tumour thrombosis. There would have been a subset of patients with early gastric cancer that would have had upfront surgery as well, which would have opened the door to a subgroup analysis of patients that received neoadjuvant therapy vs. those that didn’t. The completeness of this study would have benefited from reporting mean or median follow up durations, as well completeness of follow up. There was no discussion regarding recurrence or disease-free intervals. Ultimately, this study adds to an already sizeable pool of knowledge that suggests that the presence of microvascular invasion in gastric cancer is associated with poorer survival outcomes. " Chen GY, Ren P, Gao Z, Yang HM, Jiao Y. Analysis of vascular thrombus and clinicopathological factors in prognosis of gastric cancer: A retrospective cohort study. World J Gastrointest Oncol 2024; 16(8): 3436-3444 [PMID: 39171182 DOI: 10.4251/wjgo.v16.i8.3436]
37	"Good, informative. Same Keywords are repeated. Kindly check" Fernandez CJ, Shetty S, Pappachan JM. Diabetic cardiomyopathy: Emerging therapeutic options. World J Diabetes 2024; 15(8): 1677-1682 [PMID: 39192854 DOI: 10.4239/wjd.v15.i8.1677]
38	"Osteoarthritis (OA) is the most prevalent degenerative disorder of synovial joints and leads to chronic disability due to pain and associated joint dysfunction. Microarray analysis found 53 markedly downregulated miRNAs and 17 evidently upregulated miRNAs in the OA cartilages tissues, which revealed the role of miRNAs in the progression of OA. Therefore, supplementing the downregulated miRNAs may delay the progression of OA. In addition, exosome from bone marrow mesenchymal stem cells (BMSCs) have great potential in the treatment of OA. On this basis, Yang et al revealed engineered BMSCs exosome loaded with miR-29a could exert anti-inflammatory effects, maintain extracellular matrix stability, protect articular cartilage and slow the progression of OA, and its therapeutic effect was better than that in the normal exosome group. We suggest that on the basis of this research, experiments on the effects of engineered BMSCs exosome loaded with miR-29a on the proliferation, migration, and extracellular matrix synthesis of chondrocyte can be added, as well as exploration of the signaling pathway regulated by miR-29a. Some studies have confirmed that miR-26b-5p, miR-17, and miR-29b-5p can effectively treat OA. We speculate if exosomes derived from stem cells are combined with these miRNAs, better therapeutic effects may be achieved. In the future, there may be more engineered exosomes that can be used to treat OA." Pei H, Zhang Y, Wang C, He BJ. Additional comments on extracellular vesicles derived from mesenchymal stem cells mediate extracellular matrix remodeling in osteoarthritis. World J Stem Cells 2024; 16(7): 739-741 [PMID: 39086559 DOI: 10.4252/wjsc.v16.i7.739]
39	" Gata3 is very know involve in heart development，immune regulation，blood development，kidney development, sensorineural deafness, and renal anomalies (HDR) syndrome, the pathogenic mode was haplodose insufficiency. Here Li-Juan Ma et al., report the boy carried a de novo hemizygous variant, c.704C>T (p.Pro235 Leu) exhibited growth retardation, early-onset nephrotic syndrome, microscopic hematuria, sensorineural deafness, T-cell immunodeficiency and congenital heart disease. This phenotypes are consistent with GATA3 gene functions and make sence. This case report has very high guiding significance for the early diagnosis of HDR syndrome caused by Gata3." Ma LJ, Yang W, Zhang HW. HDR syndrome presented with nephrotic syndrome in a Chinese boy: A case report. World J Clin Cases 2024; 12(27): 6111-6116 [PMID: 39328859 DOI: 10.12998/wjcc.v12.i27.6111]
40	"This paper uses network pharmacology to explore the molecular mechanisms underlying the therapeutic effects of the Jianpi Huatan Quyu recipe on chronic heart failure with spleen Qi deficiency syndrome. However, there are several shortcomings. Firstly, the background is unclear; the chosen prescription is not a common treatment for heart failure, and the rationale for selecting this recipe is not explained. Additionally, the methods section is overly simplistic, lacking detailed descriptions of procedures and experimental conditions. Although the paper predicts multiple potential active ingredients and targets through network pharmacology, it lacks experimental validation, compromising the reliability and applicability of the conclusions. The results section misses further necessary analyses, such as core cluster analysis post-PPI and molecular docking following target identification. The discussion is not detailed, failing to connect the findings to clinical practice or previous research comprehensively. The authors rely on previous studies to support their findings, but the number of citations is insufficient, and the discussion lacks depth. Overall, the study suggests that the selected prescription may act on certain pathways to treat heart failure, but this is insufficient to provide robust clinical evidence. Further experimental validation and detailed analysis are needed to enhance the scientific rigor and practical relevance of the research." Li SQ, Min DY, Jiang JW, Li XY, Yang XN, Gu WB, Jiang JH, Chen LH, Nan H, Chen ZY. Network pharmacology-based exploration of molecular mechanisms underlying therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure with spleen Qi deficiency syndrome. World J Cardiol 2024; 16(7): 422-435 [PMID: 39086892 DOI: 10.4330/wjc.v16.i7.422]
41	"Enhancing Participation Rates: The Necessity of Optimizing Colorectal Cancer Screening Strategies Introduction Magie Tamraz et al.'s article in the World Journal of Gastroenterology delves into the critical issue of optimizing colorectal cancer (CRC) screening strategies. Despite the proven mortality benefits of screening, adherence to CRC screening guidelines remains low in many regions worldwide. This comment highlights the key points of the article and its significant contributions to CRC screening strategies. Identifying High-Risk Groups The article emphasizes the importance of identifying high-risk groups for screening, given the limited financial and human resources. This perspective is highly pragmatic as nationwide screening is not feasible in many countries. By focusing on screening high-risk individuals, resources can be utilized more effectively to minimize the burden of CRC. Considering Population Variations Implementing screening procedures requires consideration of variations within each population. This argument underscores the necessity of avoiding a "one-size-fits-all" approach in developing and implementing screening strategies. Each population has specific barriers and challenges, and addressing these is crucial for improving screening adherence. The authors suggest tackling these barriers in a targeted manner to enhance overall screening effectiveness. Encouraging Patients with Comorbidities to Undergo Screening The article points out that patients with comorbidities who regularly visit the hospital are often diagnosed with CRC at an early stage, similar to those undergoing periodic screening. This finding highlights the importance of encouraging patients with comorbidities who do not attend routine visits to undergo screening. This recommendation is significant for reducing the burden of late-stage CRC diagnosis, emphasizing the critical role of regular screening in early cancer detection. Conclusion Tamraz et al.'s article provides valuable insights into optimizing CRC screening strategies. Identifying high-risk individuals, considering population variations, and encouraging patients with comorbidities to undergo screening are key steps in improving screening adherence and reducing the burden of CRC. Implementing these optimized strategies can significantly enhance the efficiency and effectiveness of CRC screening, ultimately improving overall patient outcomes." Tamraz M, Al Ghossaini N, Temraz S. Optimization of colorectal cancer screening strategies: New insights. World J Gastroenterol 2024; 30(28): 3361-3366 [PMID: 39091719 DOI: 10.3748/wjg.v30.i28.3361]
42	"Managing PFCD requires a comprehensive, multidisciplinary approach. While conventional therapies have limitations, emerging treatments, particularly MSC therapy, offer hope for improved outcomes. Establishing effective surveillance programmes for anal cancer in perianal CD patients is crucial for early detection and better prognosis. Future research should focus on optimizing treatment protocols and validating new therapeutic strategies." Pacheco T, Monteiro S, Barros L, Silva J. Perianal disease in inflammatory bowel disease: Broadening treatment and surveillance strategies for anal cancer. World J Gastroenterol 2024; 30(28): 3373-3385 [PMID: 39091713 DOI: 10.3748/wjg.v30.i28.3373]
43	"The editorial is valuable by the conclusion that made, although CRC screening is a highly recommended strategy to detect the disease in its initial stages in individuals without signs or symptoms, this strategy is underused by the Japanese population, particularly for those who appear healthy, and generally do not use the available health services. " Pérez-Holanda S. Non-participation of asymptomatic candidates in screening protocols reduces early diagnosis and worsens prognosis of colorectal cancer. World J Gastroenterol 2024; 30(26): 3198-3200 [PMID: 39086635 DOI: 10.3748/wjg.v30.i26.3198]
44	"The editorial comment on the multifaceted problem that includes not only HBV reactivation, but also participation of the virus in pathogenesis of autoimmune disorders and cancer. " Morozov S, Batskikh S. Reactivation of hepatitis B virus infection – an important aspect of multifaceted problem. World J Gastroenterol 2024; 30(26): 3193-3197 [PMID: 39086636 DOI: 10.3748/wjg.v30.i26.3193]
45	"The editorial is highly relevant to gather and comprehensively present a summary of digesting gluten with oral endopeptidases to improve the management of celiac disease. " Durham K, Ince MN. Digesting gluten with oral endopeptidases to improve the management of celiac disease. World J Gastroenterol 2024; 30(26): 3201-3205 [PMID: 39086640 DOI: 10.3748/wjg.v30.i26.3201]
46	" After the development of “NOTES” technology many years ago, there has been a significant boost in the improvement and development of technology for closing gastric and colonic iatrogenic perforations. The authors of the editorial provide sufficient and extensive commentary on this topic. I have also read the original article by Wang et al., which I believe helps endoscopists manage the safe closure of gastric wall defects after full-thickness resection of SELs. However, the comments in the editorial do not fully achieve this. In fact, I miss editorial comments comparing the Double-nylon purse-string suture technique with more sophisticated and challenging methods such as through-the-scope suturing (TTSS) and OTSC, which are difficult to implement and learn and are scarce in many endoscopy units. Additionally, the editorial does not discuss the applicability and ease of implementation of these techniques in the typical workflow of an endoscopy unit in clinical practice, nor do they address the potential for their use in other areas, such as the rectum, colon, and duodenum. " Walia A, Trasolini RP, Shahidi N. Double-nylon purse-string suture technique: Another addition to the endoscopist's toolbox for full-thickness defect closure. World J Gastroenterol 2024; 30(25): 3152-3154 [PMID: 39006385 DOI: 10.3748/wjg.v30.i25.3152]
47	"The manuscript by Xie et al. presented a standard genetic analysis of a case with juvenile hemochromatosis caused by pathogenic variants in hemojuvelin (HJV). The author provided a detailed description of clinical phenotypes and genetic variations, and summarized the previously published literature. However, authors shoule better discuss the relationship between HJV mutant and liver fibrosis, diabetes, hypogonadotropic hypogonadism, hypophysis hypothyroidism, and skin hyperpigmentation. After all, these symptoms appeared in the same patient with a mutation in the HJV gene. Do the authors feel these symptoms may be part of the HJV-related phenotype or is it just a coincidence? " Xie LD, Kong XM, Shen JX, Wang TL, Ma J, Zhang YF, Chen XP. Novel compound heterozygous mutations in the hemojuvelin gene in a juvenile hemochromatosis patient: A case report. World J Clin Cases 2024; 12(19): 3961-3970 [PMID: 38994316 DOI: 10.12998/wjcc.v12.i19.3961]
48	"Congratulations to the authors for their significant contribution in developing a comprehensive algorithm for managing post-POEM (per-oral endoscopic myotomy) gastroesophageal reflux (GER). This article is highly important as it provides a detailed and structured approach for diagnosing and treating post-POEM GER. The identification of various predictive factors for GER after POEM highlights the complexity of the procedure and suggests that personalized approaches based on these factors could be crucial in minimizing complications and improving patient outcomes. This underscores the importance of ongoing research and tailored surgical techniques in enhancing the effectiveness of POEM. Nevertheless, one critique is that the article mainly depends on data from small-scale studies and single-center experiences, which might limit the broader applicability of the findings and recommendations. Future research should focus on larger, multicenter trials to validate the proposed algorithm, refine endoscopic techniques like POEM with fundoplication, and address technical challenges to ensure better clinical practice and patient care." Tawheed A, Bahcecioglu IH, Yalniz M, El-Kassas M. Gastroesophageal reflux after per-oral endoscopic myotomy: Management literature. World J Gastroenterol 2024; 30(23): 2947-2953 [PMID: 38946871 DOI: 10.3748/wjg.v30.i23.2947]
49	"Clear cell sarcoma of the pancreas, whether primary or metastatic, represents a rare and challenging subset of cancers. Primary pancreatic sarcomas, such as clear cell sarcoma, are notably uncommon compared to the predominant epithelial adenocarcinomas and neurogenic malignancies of the pancreas. They require careful differentiation from gastrointestinal and retroperitoneal sarcomas that may involve the pancreas secondarily. The incidence of clear cell sarcoma across various databases ranges from 0.01 to 0.29 cases per 100,000 individuals annually, underscoring its rarity. This rarity poses diagnostic and therapeutic dilemmas, necessitating a nuanced approach in clinical practice. Metastatic clear cell sarcoma of the pancreas, originating typically from distant sites like soft tissues or bones, further complicates management strategies. Treatment involves tailored systemic therapies aimed at the tumor's molecular profile, reflecting advancements in precision medicine. In conclusion, clear cell sarcoma of the pancreas exemplifies a rare cancer phenotype, demanding heightened awareness among clinicians and researchers. Enhanced understanding of its distinctive characteristics is pivotal for accurate diagnosis and effective treatment strategies, ensuring optimal patient outcomes in this challenging oncological landscape." Cheng CY, Hao WR, Cheng TH. Unveiling significant risk factors for intensive care unit-acquired weakness: Advancing preventive care. World J Clin Cases 2024; 12(18): 3288-3290 [PMID: 38983419 DOI: 10.12998/wjcc.v12.i18.3288]
50	"A well written short description of pancreatic inflammation and it's relationship to malignancy. " Vescio F, Ammendola M, Currò G, Curcio S. Relationship between mast cell, angiogenesis and pancreatic cancer: Our experience. World J Gastroenterol 2024; 30(23): 2927-2930 [PMID: 38946872 DOI: 10.3748/wjg.v30.i23.2927]