JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-023-02748-w (2023)

Title: A novel immune checkpoint score system for prognostic evaluation in pancreatic
adenocarcinoma
Version: 6 Date: 28 Mar 2023
Reviewer's report:
"PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Yes - current version is technically sound
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: All points raised in previous review have been addressed adequately.
ADDITIONAL REQUESTS/SUGGESTIONS:
Thank you for addressing all the previous points; one error on my behalf relating to the HGVS/
HUGO gene names - apologies - I meant capitalised and italicised, not bold."
Review for 10.1186/s12876-023-02745-z (2023)

Title: Preliminary clinical observation of double C-arm digital subtraction angiography
guidance during transjugular intrahepatic portosystemic shunt placement
Version: 0 Date: 09 Dec 2022
Reviewer's report:
Overall, this study, while well-edited, contains no truly novel information about TIPS placement
or its effects. As there are an abundance of studies performing TIPS even without a double C-
arm and consequently, with lower radiation exposure at identical success and low complication
rates, the advantages seem significantly less clear than indicated.
Specific aspects of the study appeared rather unnaturally designed:
- if experienced personnel is performing an ultrasound-guided puncture of the right portal vein,
why not perform the entire procedure with ultrasound?
- discussing CO2 and its advantages as contrast medium when it wasn't used in this study, appears
like filling material to bulk up the discussion text; rather than contrast media, maybe discuss the
different techniques published to enhance TIPS guidance. Rouabah et al. described a guidance
technique based on a 3D volume rendering of the portal vein generated from a contrast-enhanced
MDCT Angiography (MDCTA) of the portal trunk acquired shortly before the TIPS [Rouabah
K, Varoquaux A, Caporossi JM, et al (2016) Image fusion-guided portal vein puncture during
transjugular intrahepatic portosystemic shunt placement. Diagn Interv Imaging 97:1095–1102.
https://doi.org/10.1016/j.diii.2016.06.015], Luo et al. introduced a guidance technique relying
on intra-procedural acquisition of a CE-CACT with contrast injection in the superior mesenteric
artery to obtain an indirect portomesentericography serving as an overlay [Luo X, Wang X,
Yu J, et al (2018) Transjugular intrahepatic portosystemic shunt creation: three-dimensional
roadmap versus CO2 wedged hepatic venography. Eur Radiol 28:3215–3220.], and Meine et
al. used a 3D/2D image registration of hepatic and portal veins segmented on a previously
acquired CE-MDCT with two fluoroscopic images for guidance of the portal vein puncture,
focused on low-experienced interventionalists [Meine, T.C., Dewald, C.L.A., Becker, L.S. et al.
Transjugular intrahepatic portosystemic shunt placement: portal vein puncture guided by 3D/2D
image registration of contrast-enhanced multi-detector computed tomography and fluoroscopy.
Abdom Radiol 45, 3934–3943 (2020). https://doi.org/10.1007/s00261-020-02589-1]
- not a "new method" (See conclusion)
- a blinded, randomised comparison between patients receiving TIPS with the double C-arm +
US vs. the "standard method", especially concerning potentially flow-optimised positioning of
the TIPS tract  would be of interest; is there any data on the rate of shunt dysfunctions?
Review for 10.1186/s12876-023-02745-z (2023)

Title: Preliminary clinical observation of double C-arm digital subtraction angiography
guidance during transjugular intrahepatic portosystemic shunt placement
Version: 0 Date: 20 Feb 2023
Reviewer's report:
Well written manuscript on the use of double C-arm DSA-assisted portal vein punture. The
authors describe an interesting technique for guiding of the punture of the portal vein during
TIPS placement. This manuscript enumerates the main points and summarizes the technology.
1. The quality for the figures and the structure of the tables is appropriate. Table 1 TIPS
indications: Replace" Esophagogastric varices " with "variceal bleeding", it is more appropriate.
2. The references are recent and relevant for the field.
3. Obeservation indicators and criteria:How is the technical success rate defined? Preoperative
and postoperative complications can be enumerated.
4. Add some pictures of the double C-arm DSA operating table.
5. Discussion:Page 10 "shortening the patient’s recovery time" can be illustrated by adding data.
Review for 10.1186/s12876-023-02745-z (2023)

Title: Preliminary clinical observation of double C-arm digital subtraction angiography
guidance during transjugular intrahepatic portosystemic shunt placement
Version: 1 Date: 01 Mar 2023
Reviewer's report:
Comments were largely adopted in the review.
However, the new passages (marked red) in the text need to undergo spelling and grammar
correction as there are several unnecessary  mistakes, of which I quote examples:
- Wedged hepatic "vein portal graphy"
- In the study of Meine et al., the advantages of fusion technology for "low-expericenced"
interventionalists
- the fused images due to patient "posistion"
Review for 10.1186/s12876-023-02745-z (2023)

Title: Preliminary clinical observation of double C-arm digital subtraction angiography
guidance during transjugular intrahepatic portosystemic shunt placement
Version: 1 Date: 16 Mar 2023
Reviewer's report:
The response letter and manuscript reviewed that the paper have been revised according to
criteria the manuscript  for publication.
Review for 10.1186/s12876-023-02701-x (2023)

Title: Comparison of endoscopic retrograde cholangiopancreatography outcomes between cap-
fitted forward and side viewing endoscopes in patients with Billroth II anastomosis
Version: 3 Date: 08 Nov 2022
Reviewer's report:
This is a single-center retrospective observational study to compare ERCP outcomes between
CE group and SE group. This study is interesting. However, there are several concerns to be
mentioned in this manuscript.
Major comment:
1) Factors associated with ERCP-related complications including diameter of bile duct, usage
of antithrombotics and antibiotics should be included in Table1. Furthermore, the rate of
successful selective biliary cannulation, selective cannulation time, cannulation technique such
as guidewire-assisted cannulation, unintended pancreatic injection and pancreatic guidewire
insertion, and precut sphincterotomy should be included in Table2.
2) Comparison of ERCP outcomes between CE group and SE group in this form is unfair because
the several patient backgrounds such as EST only and EPBD are different between CE group
and SE group. Therefore, the authors should compare the ERCP outcomes between CE group
and SE group after matching patient backgrounds between the CE group and SE group.
3) Aggressive hydration is an effective for prophylaxis of PEP. The authors should describe
this point.
4) How did the authors decide to use cap-fitted forward viewing scope or side viewing scope?
The author’s strategy for selection of endoscope should be clarified in this study.
5) Although clinical ERCP outcomes between CE group and SE group were not significantly
different in this study because of small sample size of SE group, clinical ERCP outcomes seemed
to be better in SE group than in CE group. Therefore, if side-viewing scope can be inserted safely,
performing ERCP using side-viewing scope may be better in patients with B-2 anastomosis.
Side-viewing scope insertion through a large-diameter overtube after the placement of a large-
diameter overtube designed for colonoscopy into the afferent loop may help the side-viewing
insertion in patients with B-2 anastomosis. Tips of side-viewing insertion in patients with B-2
anastomosis should be discussed.
Minor comments:
1) Did the authors perform EPLBD for large or multiple stones?
2) The rates of inability to reach the major duodenal papilla in CE group and SE group should
be clarified.
3) Why did the authors exclude patients with Braun anastomosis?
4) Detail of forward-viewing and side-viewing endoscope should be described. (GIF-Q260J?
TJF-260V?)
5) Please add the tips of biliary cannulation using forward-viewing endoscope in patients with
B-2 anastomosis to be more practical.
Review for 10.1186/s12876-023-02701-x (2023)

Title: Comparison of endoscopic retrograde cholangiopancreatography outcomes between cap-
fitted forward and side viewing endoscopes in patients with Billroth II anastomosis
Version: 3 Date: 16 Nov 2022
Reviewer's report:
I did agree with author discussion about  limitations of your study.
Precut sphincterotomy or fistulotomy in CE group increase  risk of post ERCP pancreatitis.
Please comment: The reason that they prefer to use this technique rather than standard
cannulation with EST or EPBD.  It may be the reason that CE group had more pancreatitis.
Please mention about  SE technique, rate of intubation failure, change from SE to CE?
Review for 10.1186/s12876-023-02701-x (2023)

Title: Comparison of endoscopic retrograde cholangiopancreatography outcomes between cap-
fitted forward and side viewing endoscopes in patients with Billroth II anastomosis
Version: 3 Date: 18 Nov 2022
Reviewer's report:
I enjoyed reading this study entitled “Comparison of endoscopic retrograde
cholangiopancreatography outcomes between cap-fitted forward and side viewing endoscopes
in patients with Billroth II anastomosis”.
This study is interesting to show the difference of between the SE and CE groups for patients
with Bil-II anatomy.
However, there are some concerns about this study. The following comments should be
addressed.
Review for 10.1186/s12876-023-02701-x (2023)

Title: Comparison of endoscopic retrograde cholangiopancreatography outcomes between cap-
fitted forward and side viewing endoscopes in patients with Billroth II anastomosis
Version: 6 Date: 16 Jan 2023
Reviewer's report:
I enjoyed reading this study entitled “Comparison of endoscopic retrograde
cholangiopancreatography outcomes between cap-fitted forward and side viewing endoscopes
in patients with Billroth II anastomosis”.
#Comment#
I think that the analysis of procedure time is needed for “Clinical outcomes of ERCP”.
Review for 10.1186/s12876-023-02701-x (2023)

Title: Comparison of endoscopic retrograde cholangiopancreatography outcomes between cap-
fitted forward and side viewing endoscopes in patients with Billroth II anastomosis
Version: 6 Date: 21 Jan 2023
Reviewer's report:
Thank you for your revision. This manuscript is well revised.
There are one point to be revised. Although the authors presented "Final success rate of selective
bile duct cannulation was not significantly different between the SE and CE groups (94.5% vs.
95.6%, p = 0.0.308)" in abstract section,  P=0.308 seems to be correct.
Review for 10.1186/s12876-023-02701-x (2023)

Title: Comparison of endoscopic retrograde cholangiopancreatography outcomes between cap-
fitted forward and side viewing endoscopes in patients with Billroth II anastomosis
Version: 6 Date: 26 Jan 2023
Reviewer's report:
I am OK with the revised manuscript.
For the revised table, I think they are too many parameters and informations. If you prefer to
use matched cohort for analysis, it is enough to show only  red columns. You can mention the
black columns in your result.
Your result is different from the meta-analysis due to center experiences and Endoscopist
preference.
Review for 10.1186/s12876-023-02724-4 (2023)

Title: CHFR promotes metastasis of human gastric carcinoma by activating AKT and ERK via
NRF2- ROS axis
Version: 2 Date: 30 Jan 2023
Reviewer:  Xiaojing Chang
Reviewer's report:
The authors constructing CHFR stably expressed cell lines to analyzed and evaluated its role and
its correlation with ROS, AKT and ERK pathway. Results showed that CHFR over-expression
inhibited the cell proliferation rate of SGC-7901 and AGS cells, while significantly enhanced
the potential of cell migration and invasion, and exerted a significantly higher lung metastasis
ability in nude mice models, CHFR might take part in gastric cancer progression by activating
AKT and ERK via NRF2- ROS axis.
The data and figures showed here are interesting and meaningful. But, there are many
orthographic errors through the manuscript.
1. In Fig 2, authors should add the caption, which ones from SGC-7901 or AGS cells.
2. In discussion, Authors should give detail explanation and discussion for these results
that CHFR over-expression inhibited the cell proliferation but enhanced the potential of cell
migration and invasion. While, authors should also give detail discussion for result data
compared with published papers, not just again state the results.
Review for 10.1186/s12876-023-02726-2 (2023)

Title: The burden of nonalcoholic steatohepatitis (NASH) in the United States
Version: 2 Date: 14 May 2022
Reviewer's report:
The authors have compared altered lifestyle features and doctor visits of NASH, type 2 DM, and
general population using population data and self reported diagnoses.
The findings indicate the hindrance posed by NASH compared to the other studied groups.
I am wondering whether it would be possible to include an obesity group that does not possess
T2DM or NASH to analyze.  It is possible that obesity contributes largely to their impairment.
Review for 10.1186/s12876-023-02726-2 (2023)

Title: The burden of nonalcoholic steatohepatitis (NASH) in the United States
Version: 2 Date: 17 Jul 2022
Reviewer's report:
The aim of this work was to assess the burden of NASH on quality of life, productivity, and use
of healthcare resources in the United States . People diagnosed with NASH were compared on
these outcomes with the general population and people with type 2 diabetes.
Overall, the work is interesting and well written, however NASH and type 2 diabetes are
intimately related diseases, and the prevalence of NASH is high in patients with T2D.
Furthermore, NASH that has not yet evolved into cirrhosis is usually an asymptomatic condition.
This likely means that a high percentage of NASH may not have been identified among diabetics,
and the negative impact on the lives of people with NASH is likely highly conditioned by
comorbidities, including diabetes. For these reasons, a realistic comparison between the burden
of diabetes and that of NASH would seem difficult and uncertain to interpret for me.
Since it is difficult to quantify the true burden specifically related to the presence of NASH, at
most the authors can derive information on the burden of diagnosing NASH, but as the authors
themselves point out, the consequences of the diagnosis of NASH can also differ depending on
where the people receive such diagnosis.
The authors, in addition to the comparison with the general population, may consider comparing
the impact of NASH with that of diseases less intimately related to this condition and which
are known to have a negative effect on quality of life and productivity (e.g., chronic obstructive
pulmonary disease, asthma, migraine, psoriasis, etc.).
Review for 10.1186/s12876-023-02726-2 (2023)

Title: The burden of nonalcoholic steatohepatitis (NASH) in the United States
Version: 4 Date: 10 Oct 2022
Reviewer's report:
Since last review, there has not been any alteration to the initial manuscript leading me to have
the following comments.
1.  The authors use general population and then diabetes as separate comparison groups to  NASH
patients.  Why?  Why isn't this a  3 way comparison with post hoc comparisons  particularly since
a general population is included?  The way that the statistical analysis is performed presently
appears  suboptimal.
2.  The discussion should include the role of obesity in all the categories they are looking at due
to its contribution.  There is little mention in the discussion to this point and it appears largely
passed over.
Review for 10.1186/s12876-023-02726-2 (2023)

Title: The burden of nonalcoholic steatohepatitis (NASH) in the United States
Version: 10 Date: 23 Jan 2023
Reviewer's report:
The comments that I provided initially should be addressed in the manuscript discussion
including why the data analysis was performed in the way that it was done.    Also, there needs
to be a discussion in the manuscript of the role of obesity in T2DM and NAFLD even if it was
not directly included in the analysis.
Review for 10.1186/s12876-023-02741-3 (2023)

Title: The effects of chemotherapy, primary tumor location and histological subtype on the
survival of stage III colon cancer patients
Version: 0 Date: 15 Aug 2022
Reviewer's report:
The authors examined a large number of patients with colorectal cancer and found that the right-
sided colon cancer, mucinous adenocarcinoma, and the presence of chemotherapy are important
survival factors. Although these results have some useful information for clinicians, novelty was
slight.
1. As the home page of ESMO, it is well-known that mucinous colorectal cancer is associated
with poorer survival and has a character with chemo-resistance. Mucinous Colorectal Cancer
| ESMO
2.  The authors should exclude the chemotherapy unknown patients.
3.  It is not clear that chemotherapy means either postoperative adjuvant therapy or systemic
therapy after disease-recurrence.
4.  Recently, it was revealed that high-frequency MSI (MSI-H) status reduced survival in
patients receiving 5-FU-based adjuvant chemotherapy. Therefore, various guidelines indicated
that MSI-status should be examined before adjuvant therapy.  So, the authors should show which
chemotherapy has been done in these patients.
Review for 10.1186/s12876-023-02741-3 (2023)

Title: The effects of chemotherapy, primary tumor location and histological subtype on the
survival of stage III colon cancer patients
Version: 0 Date: 24 Jan 2023
Reviewer's report:
a well written manuscript in which tumor location (RCC, LCC) chemo (Yes, NO) and histology
(AC, MAC) were evaluated in detail. I would recommand running a multivate Cox model with
only these 3 factors interacted with each other. The reference group will be LCC+AC+ No
chemo. The rest combinations will be comparison groups. Please show the result like your figure
7.
You can then add other patient, tumor or enviromental characterisics like your figure 7 to confirm
your result is similiar to the uncontrolled result as above.
lastly, cause of death is available in SEER . Please evaluate or comment on its potential impact
on your results and findings using overall survival. Patients who received chemo were more
likely to be healthier and influence the OS to some extent.
Review for 10.1186/s12876-023-02741-3 (2023)

Title: The effects of chemotherapy, primary tumor location and histological subtype on the
survival of stage III colon cancer patients
Version: 1 Date: 13 Mar 2023
Reviewer's report:
The authors revised the manuscripts seriously.
The authors pointed out that tumor location, the presence of postoperative chemotherapy and
mucinous cancer were independent prognostic factor in Stage III colorectal cancer patients.
These results are critical points for clinicians.
However, these three factors are already well-known prognostic factors.
Although the authors examined a large number of patients, this manuscript is lacking in new
insights.
Review for 10.1186/s12876-023-02735-1 (2023)

Title: Comorbid Psychiatric Disorders and Long-Term Survival after Liver Transplantation in
Transplant Facilities with a Psychiatric Consultation-Liaison Team: a Multicenter Retrospective
Study
Version: 1 Date: 07 Dec 2022
Reviewer's report:
The study evaluates the impact of psychiatric disorders on the outcome of liver transplantation in
the short and medium term in a retrospective study conducted in eight Liver Transplant Centers
with proven consultation-liaison psychiatry programs.
This study concludes that ad the multivariate analysis, the presence of psychiatric disorders did
not impact survival in the post-transplant.
The first observation was the relatively low rate of psychiatric disorders observed in the liver
transplant population studied. This result may be related to a very low prevalence of alcoholic
liver disease; in this population, HBV and HCV-related diseases were the prevalent cause of
liver disease.
The second reason could be the recruiting modality; during the pre-transplant period, the
psychiatric and psychologic team evaluated not all patients but only those with a previous
history of psychiatric disorders. In the post-transplant, psychiatrists evaluated patients only in
the presence of signs or symptoms of psychiatric disorders.
This approach could result in the loss of many psychiatric diagnoses in the control group and
make the study's conclusions debatable.
Review for 10.1186/s12876-023-02735-1 (2023)

Title: Comorbid Psychiatric Disorders and Long-Term Survival after Liver Transplantation in
Transplant Facilities with a Psychiatric Consultation-Liaison Team: a Multicenter Retrospective
Study
Version: 2 Date: 31 Jan 2023
Reviewer's report:
This is a retrospective, non-randomized, observational study report with the title “Comorbid
Psychiatric Disorders and Long-Term Survival after Liver Transplantation in Transplant
Facilities with a Psychiatric Consultation-Liaison Team: a Multicenter Retrospective Study”.
Although the authors had made many revisions to the manuscript according to the reviewer’s
suggestion and the reviewer could accept the revisions made for the first review, the authors
should consider the impact for liver transplantation care in psychiatry. The reviewer has the
following questions about this manuscript:
1. The reviewer noted some errors in the tables of this manuscript. The manuscript stated
that “Table 1 shows the demographic characteristics of liver transplant recipients. The CP
group contained more participants who were older, single, had fewer years of education, higher
MELD score, and longer hospitalization than the N-CP group.” However, Table 1 showed lower
participants in the CP group who were single (71 versus 387 in the non-CP group) and had fewer
years of education (10.41 ±4.99 versus 4.73 ±5.94 in the non-CP group).
2. The manuscript is not clear on what the definition of ‘Survival rate at the end point’ is as
written in Table 3 and 5.
3. The manuscript stated in the background that “A comprehensive meta-analysis of comorbid
psychiatric disorders in organ transplant recipients(3) demonstrated that recipients who present
with depression prior to and immediately after transplantation have 1.65 times the risk of
postoperative mortality compared with those without comorbid psychiatric disorders.” Also, the
manuscript stated that “Delirium and major depressive disorder were significantly associated
with shorter survival time, but insomnia was not (Table 3).” However, after further discussion
of the statistics, the manuscript then states that “The results showed that delirium, insomnia,
and major depressive disorder did not significantly affect survival.” Why does this outcome not
match other studies?
4. This is common knowledge that delirium influences prognosis of liver transplantation
recipients, which also results in longer hospitalization. Age, delirium, and hospitalization are
all covariates for survival time. The onset of delirium and resulting hospitalization days are
not a meaningful consideration for psychiatric consultation. Longer hospitalization days may
be necessary for the effort to save patients, which is common sense. The reviewer suggests the
authors remove the factor of hospitalization days from the regression models.
Review for 10.1186/s12876-023-02735-1 (2023)

Title: Comorbid Psychiatric Disorders and Long-Term Survival after Liver Transplantation in
Transplant Facilities with a Psychiatric Consultation-Liaison Team: a Multicenter Retrospective
Study
Version: 4 Date: 24 Feb 2023
Reviewer's report:
This is a retrospective, non-randomized, observational study report with the title “Comorbid
Psychiatric Disorders and Long-Term Survival after Liver Transplantation in Transplant
Facilities with a Psychiatric Consultation-Liaison Team: a Multicenter Retrospective Study”.
The authors had made many revisions to the manuscript according to the reviewer’s suggestion
and the reviewer could accept the revisions made for the second review. The authors should
consider the impact for liver transplantation care in psychiatry. The reviewer has the following
questions about this manuscript:
1. The authors discussed the reason to explain that their outcome did not match other studies.
However, the authors did not address the conflicting results and discussion in their manuscript.
The manuscript stated that “Delirium and major depressive disorder were significantly
associated with shorter survival time, but insomnia was not (Table 3).” However, after further
discussion of the statistics, the manuscript then also states that “The results showed that delirium,
insomnia, and major depressive disorder did not significantly affect survival.” What is the
reason for these conflicting statements and what is the final conclusion? Do delirium and major
depressive disorder affect survival or not?
2. The reviewer appreciates the further discussion made in the results regarding hospitalization
days in the regression models. However, the tables still do not reflect the changes made.
The manuscript still needs to be minorly revised for meaningful impact to the field of psychiatry.
Review for 10.1186/s12876-023-02735-1 (2023)

Title: Comorbid Psychiatric Disorders and Long-Term Survival after Liver Transplantation in
Transplant Facilities with a Psychiatric Consultation-Liaison Team: a Multicenter Retrospective
Study
Version: 6 Date: 09 Mar 2023
Reviewer's report:
This is a retrospective, non-randomized, observational study report with the title “Comorbid
Psychiatric Disorders and Long-Term Survival after Liver Transplantation in Transplant
Facilities with a Psychiatric Consultation-Liaison Team: a Multicenter Retrospective Study”.
The authors had made many revisions to the manuscript according to the reviewer’s suggestion
and the reviewer could accept the revisions made for the third review. The authors should
consider the impact for liver transplantation care in psychiatry. The reviewer has the following
question about this manuscript:
1. The reviewer appreciates the changes made for a clearer conclusion. However, it should be
made more apparent that the lack of impact of delirium and major depressive disorder on survival
after further Cox proportional hazards regression analysis is dependent on the fact that delirium
within the first week was excluded. Furthermore, previous studies have shown that delirium and
mortality are correlated, which contradicts the conclusion of this manuscript. Further discussion
regarding this point should be made.
Review for 10.1186/s12876-023-02739-x (2023)

Title: Impact of chemoradiotherapy on the survival of unresectable locally advanced pancreatic
cancer: A retrospective cohort analysis
Version: 2 Date: 02 Feb 2023
Reviewer's report:
In this study, the authors tried to study the role of chemoradiotherapy on the survival of
unresectable locally advanced pancreatic cancer by from the Surveillance, Epidemiology,
and End Results Program database. A total of 5002 patients with unresectable locally
advanced pancreatic cancer were included. The results showed that chemoradiotherapy is highly
recommended for patients with unresectable locally advanced pancreatic cancer. The conclusion
of this study has certain significance. But there are some problems with this article.
1. This study uses the existing online database data for analysis, which has no novelty and
uniqueness. And the results are already well established.
2. This study is a single-arm retrospective study. Although the sample size is large, the reliability
of the results is greatly affected by the data itself.
3. The resolution and layout of the pictures in this paper need to be improved.
4. There are many grammatical and spelling mistakes in this article, which should be corrected
by native English speakers.
5. There are some defects in the references quoted, so the author is suggested to revise them
one by one.
Review for 10.1186/s12876-023-02739-x (2023)

Title: Impact of chemoradiotherapy on the survival of unresectable locally advanced pancreatic
cancer: A retrospective cohort analysis
Version: 2 Date: 15 Feb 2023
Reviewer:  Kenjiro Okada
Reviewer's report:
The manuscript titled " Impact of chemoradiotherapy on the survival of unresectable locally
advanced pancreatic cancer: a retrospective cohort analysis" highlights the survival benefits of
chemoradiotherapy for unresectable locally advanced pancreatic cancer patients according to
the results of univariate and multivariate Cox regression analysis and propensity score matching
analysis.
The manuscript is well written and balanced in its discussion. I have several questions.
1. In the enrolled patients, were there patients with new metastatic lesions during chemotherapy
or chemoradiotherapy?
2. In the future problem, do you intend to perform conversion surgery for locally advanced
patients with good response? If so, you describe the indication of conversion surgery for locally
advanced patients.
3. Tumor marker status including CA19-9 is highly associated with prognosis of PDAC patients.
Why did you not include the pretreatment tumor marker status in univariate or multivariate
overall analysis?
Review for 10.1186/s12876-023-02739-x (2023)

Title: Impact of chemoradiotherapy on the survival of unresectable locally advanced pancreatic
cancer: A retrospective cohort analysis
Version: 3 Date: 15 Mar 2023
Reviewer's report:
In this study, the authors obtained the following results by re-integrating the clinical data of
pancreatic cancer patients from multiple databases. The results showed that chemoradiotherapy
is highly recommended for patients with unresectable locally advanced pancreatic cancer. After
modification, this paper has been greatly improved, and I personally think it can be considered
for publication.
Review for 10.1186/s12876-023-02739-x (2023)

Title: Impact of chemoradiotherapy on the survival of unresectable locally advanced pancreatic
cancer: A retrospective cohort analysis
Version: 3 Date: 21 Mar 2023
Reviewer:  Kenjiro Okada
Reviewer's report:
Appropriate corrections have been made to the comments. Thank you very much.
Review for 10.1186/s12876-023-02746-y (2023)

Title: Early symptoms preceding post-infectious irritable bowel syndrome following
COVID-19: A retrospective observational study incorporating daily gastrointestinal symptoms
Version: 1 Date: 05 Mar 2023
Reviewer's report:
This study attempts to collect daily GI symptoms  during hospitalizations to determine  risk
factors for developing IBS post-Covid infection. Even though the sample size is small and
details of IBS symptoms were not recorded, these limitations were appropriately addressed by
the authors. This study adds to the much needed information in the literature on post-Covid IBS
phenomenon, and highlights the importance of larger studies in this area .
Review for 10.1186/s12876-023-02734-2 (2023)

Title: SPINK4 promotes colorectal cancer cell proliferation and inhibits ferroptosis
Version: 2 Date: 13 Feb 2023
Reviewer's report:
This paper is an important contribution and I recommend that it be accepted for publication.
This manuscript addresses an important the effect of SPINK4 on CRC pathogenesis and
ferroptosis.
This is an interesting observation that SPINK4 was decreased in CRC tissues and promoted cell
proliferation and metastasis; overexpression of SPINK4 inhibited CRC cell ferroptosis.
I look forward to the elucidation of the underlying mechanism that SPINK4 was able to inhibit
CRC ferroptosis.
Review for 10.1186/s12876-023-02734-2 (2023)

Title: SPINK4 promotes colorectal cancer cell proliferation and inhibits ferroptosis
Version: 2 Date: 23 Feb 2023
Reviewer's report:
1.In figure 1 I and J, it did not show which picture represnets normal tissues and which represents
the tumor tissues,  I think this may confuse the readers; moreover, the rulers are missing in
Figure 1 I and J, I think it should be added  .
2.It did not show p values between different groups in Figure 2 A, I think it should be added.
3.According to the author's study showed that SPINK4 expression was reduced in CRC tissues
compared with normal tissues, however, SPINK4 expression in four CRC cell lines is higher than
that in the human colon mucosal epithelial cell line NCM460, and overexpression of SPINK4
significantly facilitated the proliferation and metastasis of LoVo and HCT116 cells. I think this
is contradictionary, please explain it.
4. I think the language needs polishing.
Review for 10.1186/s12876-023-02732-4 (2023)

Title: Regression in hepatic fibrosis in elderly Chinese patients with hepatitis C receiving direct-
acting antiviral treatment
Version: 0 Date: 08 Dec 2022
Reviewer's report:
Authors demonstrated age, LSM, and CAP were identified as independent predictors of fibrosis
regression in elderly patients with CHC.
This phenomenon is interesting, as our field asks how little is known about the benefits of
successful anti-viral treatment to older patients with hepatic fibrosis.
Authors report that the degree of hepatic steatosis expressed by the CAP value did not
significantly change as a result of treatment for the elderly group. Nutritional status and the
presence of sarcopenia should also be considered as influencing factors.
Alcoholic disease is an exclusion criterion, but the duration and amount of alcohol consumption
should be considered as an influence on fibrosis progression.
Review for 10.1186/s12876-023-02732-4 (2023)

Title: Regression in hepatic fibrosis in elderly Chinese patients with hepatitis C receiving direct-
acting antiviral treatment
Version: 0 Date: 25 Dec 2022
Reviewer's report:
The article discusses an important topic and the objective is clear, well addressed and reasonably
discussed.
I have few comments for minor revision;
Mention CAP in full ay first mention in the article
Patient’s grouping is 70 years or older NOT older than 70 years
#GT abbreviation is gamma-glutamyl transferase
Use either elder OR elderly consistently in the article
Sysmex XN-2000 reagents are not supplied by Roche
Revise all ranges in tables and highlight the significant p-value
In the results section; no need to add all these numbers in text as long as it mentioned in tables
in a very clear format
The discussion needs to be shorter and more focused on the article’s objective. Also no need to
mention other non-invasive tests for liver fibrosis, its not related. The on-invasive tests used to
assess liver fibrosis in the current study are validated in several published studies and ne need
to question its accuracy compared to liver biopsy.
Review for 10.1186/s12876-023-02732-4 (2023)

Title: Regression in hepatic fibrosis in elderly Chinese patients with hepatitis C receiving direct-
acting antiviral treatment
Version: 1 Date: 31 Jan 2023
Reviewer's report:
Thank you for the provided corrections.
Few minor corrections are required.
-No clear definition or reference was added for classification into younger and older patients
according World Health Organization’s criterion
-Table 1; Why you didn’t add p-value in genotype, although it was mentioned in the text that
genotype 3 was more prevalent in younger patients
-Table 3; Revise heading
-Add references to the new added texts in the discussion.
Review for 10.1186/s12876-023-02721-7 (2023)

Title: Transmission of oral microbiota to the biliary tract during endoscopic retrograde
cholangiography
Version: 2 Date: 12 Dec 2022
Reviewer's report:
The results of this study highlight the importance of adequate biliary drainage in patients
undergoing ERCP. In theory, bile is sterile. One of the important mechanisms that provides
this is the papillary sphincter structure. When endoscopic sphincterotomy and/or biliary stenting
removes this barrier during ERCP, the bile duct becomes contaminated. The bile duct is
contaminated with microorganisms either from the duodenum or from the oral cavity or
contaminated duodenoscope, as we understand from this study.
The growth of microorganisms in the bile duct in almost all patients, but this does not affect the
clinic shows the importance of drainage. This should be one of the main messages of the study.
Today, there are new studies claiming that disposable duodenoscopes will prevent biliary
infective complications due to microorganisms that cannot be removed during reprocessing.
The result of this study shows that even with a disposable duodenoscope, biliary contamination
cannot be reduced to zero as it would have to pass through the oral cavity.
The authors can also emphasize these points if they wish.
Review for 10.1186/s12876-023-02721-7 (2023)

Title: Transmission of oral microbiota to the biliary tract during endoscopic retrograde
cholangiography
Version: 2 Date: 12 Feb 2023
Reviewer's report:
Dear editor and authors, thank you for giving me the chance to review this interesting paper
intitled “Transmission of oral microbiota to the biliary tract during endoscopic retrograde
cholangiography”. I raised some queries about this manuscript.
1. In table 1, the statistical comparison of number of patients is unnecessary.
2. In table 1 B), cholangitis is post-ERCP cholangitis?
3. In table 1 B), all variables were involved to multivariate analysis. Only choledocholithiasis,
post OLT should be involved to multivariate analysis.
4. Table 2 is difficult to understand. Besides, statistical comparison isn’t necessary in table 2?
5. In table 2, what does “likely pathogens for no cholangitis” mean?
6. Is the setting of group1 and group2 necessary?
7. In table3 and 5, “Total” is missing.
8. The main themes of this study were: (1) is there contamination of the bile during ERC, (2)
where does it come from, (3) is it clinically relevant? The methods used in this study were too
complicated.
Can authors investigate these main themes by methods as follows?
#extract the bacteria that existed between (oral or pre-ERCP scope) and bile and post-ERCP
scope.
#
#compare the patient characteristics and the amount of extracted bacteria between cholangitis
and no cholangitis.
#
#involve the factors which are significantly different between cholangitis and no cholangitis to
Logistic regression analysis for cholangitis.
#
#involve the factors which are elicited from Logistic regression analysis to Cox proportional
hazards model for hospitalization.
Review for 10.1186/s12876-023-02731-5 (2023)

Title: Hyperprogressive disease during atezolizumab plus bevacizumab treatment in patients
with advanced hepatocellular carcinoma from Japanese real-world practice
Version: 5 Date: 13 Feb 2023
Reviewer's report:
Many of my previous comments have been suitably addressed, whereas a few points still remain
that need to be clarified.
Major:
- Regarding the patients who received effective treatments (mainly lenvatinib) during the
reference period: I am not fully convinced that these patients can be included in the analysis.
Although I appreciate your effort to discuss it as a limitation of the study, it remains questionable
to me if the treatment might have slowed down the tumor progression in the reference period
to a degree that can not be quantified, hence possibly distorting the difference of tumor growth
between reference and experimental period (which defines "hyperprogression"). At the moment,
I do not see any data or analysis within the manuscript that is able to convincingly refute this
concern.
Minor:
- The sentence "Third, we discovered a few advanced HCC patients with HPD treated by Atez/
Bev in our cohort (twofold: 8 patients, fourfold: 5 patients)." in the Discussion section of the
manuscript is not fully clear to me. Please rephrase.
Review for 10.1186/s12876-023-02742-2 (2023)

Title: The Effect of Biological Agent on Body Composition in Patients with Crohn’s Disease
Version: 1 Date: 11 Jan 2023
Reviewer's report:
In the manuscript entitled „ The Effect of Biological Agent on Body Composition in Patients
with Crohn’s Disease”, Eun Jeong Choi and colleagues present a multicenter study to explore
the influence of biologics on body composition in Crohn’s disease. Firstly, authors reported that
the prevalence of sarcopenia was high, and the body composition values were different between
patients with and without sarcopenia. Then they compared the body composition before and
after biological therapy, and found biologics could improve body composition in CD patients
with sarcopenia but not those without sarcopenia. Finally, the authors investigated the predictors
of surgery in patients with sarcopenia, and found gender and penetrating CD were risk factors
of surgery. The authors conclude that biological agents could increase all body composition
parameters in CD patients with sarcopenia. These patients are more likely to experience surgery.
It is hard for me to understand the key point of the manuscript very well. In my opinion, the
manuscript includes two irrelevant parts: sarcopenia affected the efficacy of biologics on body
composition, and sarcopenia increased the risk of surgery which has been proved previously. As
the authors found biologics were able to improve body composition in CD, it will be interesting
to investigate whether the improvement of body composition caused by biologic therapy could
reduce the risk of surgery in CD patients with sarcopenia.
In addition, I have a few comments.
1. The design of the present study should be a longitudinal study instead of a cross-sectional
study.
2. What was the criteria for moderate-to-severe CD, and what was the indication for biologics
therapy?
3. What was the time point of follow-up abdominal CT?  CT conducted at different time points
(remission or active disease?) would influence the results.
4. The body composition could be influenced by other factors such as diet and physical activity
during the period of therapy.
5. Why there was no difference in patients without sarcopenia? Did all those patients response
well to biologics?
Review for 10.1186/s12876-023-02742-2 (2023)

Title: The Effect of Biological Agent on Body Composition in Patients with Crohn’s Disease
Version: 5 Date: 15 Mar 2023
Reviewer's report:
Thank you for the extensive revisions you have made to the manuscript based on my suggestions.
I think the manuscript is improved by the modifications and I do not have significant issues with
the methods, results or discussion. I do think that some of the use of English language requires
minor revision for consistency and clarity. For example, the use of tenses in the introduction: in
general, this should be in the present tense. I do not have other suggestions at this time as I am
satisfied by the work of the authors to revise the paper.
Review for 10.1186/s12876-023-02728-0 (2023)

Title: Developing the modified 4-item version of Perceived Stress Scale for functional dyspepsia
Version: 1 Date: 03 Oct 2022
Reviewer's report:
The study will make an important contribution to the literature. however, the fit index values 
did not fully meet some criteria for scale validity. For example, the acceptable value of x2 /df
is below 5. Also, the RMSA value must be less than 0.08. Are some fit index values acceptable
enough for the scale to be valid? These points should be reconsidered. In my opinion, for the
validity of the scale, if it was not used as a parallel form, the regression analyzes should be
published in another article.
Review for 10.1186/s12876-023-02728-0 (2023)

Title: Developing the modified 4-item version of Perceived Stress Scale for functional dyspepsia
Version: 1 Date: 08 Feb 2023
Reviewer's report:
-The article has typographical and grammatical errors
- The objectives are not specific
- The methodology does not follow the objectives. Too many scales are used to assess anxiety,
depression, quality of life and stress, while only stress has been mentioned in the objective
- Sample size estimation for the study is not clear. Was a formula or software used?
- Why was CONSORT guidelines or checklist used, for this particular study design?
- When ANOVA was used in statistical analysis and significant difference was found, why was
post hoc test not used.
- Table 1 is for demographic characteristics. It does not show "that female patients were more
common in FD, and the education level of patients was generally low, mainly in middle school"
though it is mentioned in text under demographic characteristics.
- Shouldn't the new modified  PSS-4 be tested again for validity and reliability in a group of
patients before coming to a conclusion regarding it being a more valid and reliable tool?
Review for 10.1186/s12876-023-02733-3 (2023)

Title: Comparison of clinical and pathological features between early-stage gastric-type and
intestinal-type differentiated adenocarcinoma: a retrospective study
Version: 1 Date: 11 Dec 2022
Reviewer's report:
This single-center retrospective study aimed to investigate the relationship between histological
phenotype and clinicopathological features in patients with early gastric cancer undergoing ESD.
The authors concluded that gastric phenotype is associated with deep submucosal invasion and
durability of ESD. Although the large sample size is appreciated, the following comments should
be addressed.
1. The main weakness of this study is the lack of novelty. Several studies already reported the
relationship between gastric phenotype and low creative ESD resection rate.
2. The Second issue is the substantial selection biases. This study should have included mixed-
type and unclassified phenotypes to eliminate the biases as much as possible.
3. Comment on IRB approval and patient consent.
4. Clarify the use of immunostaining to evaluate lymphovascular invasion.
5. The authors should discuss how researchers apply the data of this study in clinical practice.