JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/1471-230X-12-99 (2012)

Reviewer's report
Title:With the assistance of a "Rusch" intubation stylet for facilitating insertion of
a nasogastric tube in anesthesized patients: a randomized controlled trial
Version: 1Date:7 June 2012
Reviewer: Daqing Ma
Reviewer's report:
Dr. Yu's group reported that "Rusch" intibation stylet can enhance the success
rate of nasogastric tube placement. It is a very useful technique for daily practice
in Clinic, especially for patients who are very weak and can not tolerate more
attempts such proceduce. My commments are as follows:
1. Introduction: please shorten. Move the description of all techniques about NGT
to the discussion section. Please delete the last sentence of the first paragraph.
2. Results: Combining Fig 1 and Fig 2 to be one fig. Fig 2 can be insetted into Fig
1.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-12-99 (2012)

Reviewer's report
Title:With the assistance of a "Rusch" intubation stylet for facilitating insertion of
a nasogastric tube in anesthesized patients: a randomized controlled trial
Version: 1Date:10 June 2012
Reviewer: Wei-Zen Sun
Reviewer's report:
This is a well-conducted randomized controlled trial to compare "Rusch
intubation stylet facilitated NG tube insertion" to conventional blind insertion.
According to the data presented, this simple but innovative method can
significantly increase the first attempt success rate without increasing procedure
related complications. This method may significantly improve current clinical
practice without increasing medical expense.
Is the question posed by the authors well defined?
Yes
Are the methods appropriate and well described?
Generally yes. But there are some concerns the authors should futher address.
(Major Compulsory Revisions)
1. Why choose neutral position? The angle between nasopharyngeal axis and
pharyngeal axis is greater when the patient's head is in neutral position than in
sniffing position.
2. The stiffness of "Rusch stylet-NG tube apparatus" is greater than NG tube
alone. What is the curvature of the stylet when performing NG tube insertion? Is
there a manual bending necessary?
3. How to overcome the anatomic angle from nasopharyngeal axis to pharyngeal
axis? What is the maneuver needed when encountering resistance passing the
angle during insertion?
Are the data sound?
Yes
Does the manuscript adhere to the relevant standards for reporting and data
deposition?
Yes
Are the discussion and conclusions well balanced and adequately supported by
the data?
Generally yes. But there are some points the authos should futher discuss.
1. Besides nasal mucosal bleeding, what is the incidence of nasopharyngeal
mucosa trauma in this trial (Major Compulsory Revisions)?
2. Are there any supplemental data available? Such as patients satisfaction and
minor discomforts for example post-operative sore throat and nasal pain?
(Discretionary Revisions)
Are limitations of the work clearly stated?
Yes
Do the authors clearly acknowledge any work upon which they are building, both
published and unpublished?
Yes.
Do the title and abstract accurately convey what has been found? Yes
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-12-98 (2012)

Reviewer's report
Title:Leiomyosarcoma of sigmoid colon with multiple liver metastases and
gastric cancer: case report
Version: 1Date:4 May 2012
Reviewer: Ingmar Ipach
Reviewer's report:
Dear authors,
you are reporting a really interesting case. You are totally right, Leiomyosarcoma
of the large bowl are really rare. Especially the addition with a gastric cancer and
the diagnostic dilemma make this case worth getting published in BMC
Gastroenterology.
The immunophenotype especially the lack of KIT in LMS (in contrast to GIST) is
very important and you have pointed out this clearly.
Major compulsory revision
In the discussion you illuminate the diagnostic dilemma with liver metastasis.
Would you also perform a resection after primary diagnosis of a LMS on the
other hand it is very unusual to perform a resection of liver metastasis after the
diagnosis of a leiomyosarcoma.
You should also include a section with the possibility of a LMS-metastasis in the
large bowl and liver after an LMS of the soft tissue, as recently published (J Clin
Oncol. 2011 Nov 20;29(33):e799-802)
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
The reviewer declare no compenting interests
Review for 10.1186/1471-230X-12-98 (2012)

Reviewer's report
Title:Leiomyosarcoma of sigmoid colon with multiple liver metastases and
gastric cancer: case report
Version: 1Date:5 May 2012
Reviewer: Odike Maxy
Reviewer's report:
MAJOR COMPULSORY REVISIONS
1. The outline of discussion should be: Abstract, Key words, Introduction (not
Background), Case presentation, Discussion (not Conclusion), and References.
Except this is the style accepted by BMC Gastroenterology.
2. Abstract ( case presentation) sentence 3 paragraph 1: 'The pathological
diagnosis of gastric cancer was a complete response...'. This phrase is not clear.
3. Key words. There are too many words here. I recommend a cut down, to a
maximum of 5 words.
4. Background. (a) A 2-sentence introduction is rather too short. (b) A clear
statement on why this report is being published should be added. Readers
should not be made to work this out themselves.
5. Case presentation. (a) patient's clinical features and relevant investigation
results should be stated. (b) sentence 2 paragraph 3 is not clear (see comment 2
above). (c) what prompted the discovery of the sigmoid colon mass? Was it
accidental, or patient presented with new clinical features? (d) sentence 1
paragraph 5: '...2 years and 5 months after starting therapy.' Which therapy is
referred to here, the first, second or third?
DISCRETIONARY REVISIONS
1. Background. Sentence 2 may be better rendered as, 'LMS frequently
metastasize to the liver, with poor prognosis'
2. Case presentation. (a) readers would benefit from explanations on why the
liver secondary deposits responded to the same therapy as did the gastric
adenocarcinoma, despite being leiomyosarcoma (b) was immunohistochemistry
done on tissues from the gastric lesion? What was the result?
3. Conclusion. Are there any possible explanations on why an individual would
have 2 separate primary malignancies simultaneously? This is a very unusual
presentation.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competing interests of any kind in relation to this paper.
Review for 10.1186/1471-230X-12-98 (2012)

Reviewer's report
Title:Leiomyosarcoma of sigmoid colon with multiple liver metastases and
gastric cancer: case report
Version: 1Date:7 May 2012
Reviewer: Thomas Resch
Reviewer's report:
Conclusions: “An immunohistochemical analysis is essential for a definitive
diagnosis of LMS, which is regularly negative for c-kit and CD34 and quite
positive for smooth muscle markers such as actin, desmin and h-caldesmon.”
Vimentin is another SMC marker with relevance for the diagnosis of LMS.
Furthermore, none of these SMC markers are specific for smooth muscle cell
differentiation. This should be mentioned in the text.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-12-97 (2012)

Reviewer's report
Title:Deletion of Foxp3+ regulatory T cells in genetically targeted mice supports
development of intestinal inflammation
Version: 1Date:18 September 2010
Reviewer: Aiping Bai
Reviewer's report:
Minor Essential Revisions
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-97 (2012)

Reviewer's report
Title:Deletion of Foxp3+ regulatory T cells in genetically targeted mice supports
development of intestinal inflammation
Version: 1Date:22 September 2010
Reviewer: Holm Uhlig
Reviewer's report:
Boehm et al. investigate the role of Foxp3+ regulatory T cells in intestinal
inflammation. In humans with IPEX syndrome and Foxp3 mutations intestinal
inflammation is found in many patients. Although there is strong evidence for the
role of these cells in several mouse model situations of intestinal inflammation
the understanding is still not absolutely clear since Foxp3 knockout mice develop
inflammation in several organs but typically not in the colon.
The authors aim to investigate the role of Foxp3+ cells by using a transgenic
system to deplete Foxp3+ cells that express DTR using DT. The finding that
deletion of Treg in mice with a functional immune system induces inflammation in
lung or liver, but hardly in the colon is consistent with previous findings in Foxp3+
knockout mice. However, the authors show a role for Foxp3+ cells in chemical
induced acute colitis as well as in the T cell transfer system. In these specific
model situations lack of Foxp3+ cells act as aggravating factor. Again, this is not
particular new since it has been shown by other authors using different depletion
methods.
The number of mice used for the different experiments are small and data about
repeat experiments are not clearly documented.
Minor points:
Method section Immunohistochemistry Sections were …pretreated with 3%
hydrogen peroxide … (and not hydrogenperoxidase as stated in the manuscript) I
wonder if the student t-test is appropriate for the evaluation of statistical
differences since for these kind of experiments it is typically not possible to show
a normal distribution of the measures. The Mann-Whitney U test is likely to be
more appropriate.
“Deletion of Treg is the onset of chronic T cell-mediated intestinal inflammation”
??
Review for 10.1186/1471-230X-12-97 (2012)

Reviewer's report
Title:Deletion of Foxp3+ regulatory T cells in genetically targeted mice supports
development of intestinal inflammation
Version: 2Date:10 February 2011
Reviewer: Aiping Bai
Reviewer's report:
I am satisfied with the answers provided by the authors.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-12-97 (2012)

Reviewer's report
Title:Deletion of Foxp3+ regulatory T cells in genetically targeted mice supports
development of intestinal inflammation
Version: 2Date:1 January 2012
Reviewer: Alex Sánchez-Pla
Reviewer's report:
Major Compulsory Revisions
Dear Sirs
I have been asked to provide my statistical opinion about the analyses performed
in this paper.
The statistics support of this work seems very weak and the few references
made to statistical tests are difficult to link with the results.
For instance a reference to Kruskal Walllis and two way ANOVA are done.
But details of why they have decided to perform each one, or which are the
ANOVA factors, or where do these tests apply are either difficult to find or
unexistant.
The statistical support in this work has two main drawbacks that should be
remedied:
- Information about the experimental design is missing: how many animals have
been allocated to each treatment, and why this number has been chosen ("a
minimum of 5" may mean 5 or 50)
- For each comparison where a statement of difference is made in the results
part there should be information available on which test has been used and on
the results of the test (for instance the p-value) that lead to a decision of
significant difference.
- Statistical methods should be referenced in the methods part of the paper.
Without having to go into detail there should be some explanation of why a
method is chosen (why Kruskal wallis instead of anova?) or how is it applied (if a
two factor anova is used there should be an explanation of which are the factors
in the model.
It should be informative if the comparisons and their results where shown in a
tabular form. If the authors prefer to rely on plots, clear reference to the tests and
the results should appear in the caption of the figures. In this case the tables may
be provided as suplementary material.
In summary in my opinion there is need and place for a clear improvement in
both the statistical methods and the use of statistical results in the paper.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-12-97 (2012)

Reviewer's report
Title:Deletion of Foxp3+ regulatory T cells in genetically targeted mice supports
development of intestinal inflammation
Version: 3Date:3 June 2012
Reviewer: Alex Sánchez-Pla
Reviewer's report:
The authors have included the changes suggested so that the statistical reporting
of their findings could be assessed more cleraly.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-96 (2012)

Reviewer's report
Title:Evaluation of Patient Satisfaction of an Outpatient Gastroscopy Service in
an Asian Tertiary Care Hospital
Version: 1Date:4 April 2012
Reviewer: Richard Kozarek
Reviewer's report:
Major compulsory revisions:
1. Please comment in the extremely low dose of midazolam utilized for
endoscopy and compare this with previously published data. It is possible that a
significantly higher rate of patient satisfaction would have been realized with
improved sedation.
2. Please define the timing of post-procedural interviews in minutes
post-procedure and whether having a family member/significant other present
with the patient influenced patient satisfaction rate.
Minor essential revisions:
1. Minor grammar suggestions:
a. Problem rate, pages 10 and 13 = dissatisfaction rate.
b. Page 4, paragraph 3, line 1 = … satisfaction have been….
c. Page 5, paragraph 1, line 2 = … to date….
d. Page 12, paragraph 2, line 1 = As different health care systems vary in
aspects which patients consider important….
e. Page 13, paragraph 2, line 1 = … has been recognized….
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests. RAK
Review for 10.1186/1471-230X-12-96 (2012)

Reviewer's report
Title:Evaluation of Patient Satisfaction of an Outpatient Gastroscopy Service in
an Asian Tertiary Care Hospital
Version: 1Date:9 July 2012
Reviewer: P. Marco Fisichella
Reviewer's report:
v
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-12-95 (2012)

Reviewer's report
Title:CD44/CD24 Expression in Recurrent Gastric Cancer: A Retrospective
Analysis
Version: 1Date:17 April 2012
Reviewer: Neil Merrett
Reviewer's report:
Useful paper looking at CD44 and CD24 expression in gastric cancer attempting
to identify whether this expression may be a prognositc indicator based on
retrospective analysis of patients with gastric cancer compatring those with
recurrence after surgery to those without recurrence. Although a negative study,
it adds to our overall understanding of the disease
Minor essential revisions
1. Methods abstract is very confusing. My understanding is that of the 500
patients who had a curative resection, 95 had recurrence. Twenty patients from
the non recurrence group (405patients) and twenty from the recurrence group
(95patients) were randomly chosen. This should be made much clearer
2. It would be useful to know what was the minimum disease free timescale for
the patients chosen without recurrence. Obviously if it is 6mths, this may be
problematic, whereas the validity of using patients with a minimum of 3 or 5 yrs
disease free survival in the control group would be far more significant
3. Which edition of AJCC staging was used for the tumours. I would assume 7th,
but this must be clarified.
4.1st paragraph of discussion is simply a repeat of te results and should be
placed there
5. Needs better use of paragraphs in the discussion
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-95 (2012)

Reviewer's report
Title:CD44/CD24 Expression in Recurrent Gastric Cancer: A Retrospective
Analysis
Version: 1Date:23 April 2012
Reviewer: Andrew Ruszkiewicz
Reviewer's report:
The main limitations of this work are the small size of study group and insufficient
pathological classification of the investigated cases. The authors have been able
to identify 95 patients with recurrent gastric cancer but only 20 (plus additional 20
from control group) were “randomly” selected for further investigation with
inexpensive immunohistochemical technique using two antibodies. It would be
desirable to include all 95 patients and matched control cases.
The studied cancers lack detailed pathological evaluation. While grading and
stage of the disease are provided, histological types are not. Some histological
types of gastric cancer are more often encountered in Asian population (such as
lymphoepithelial carcinomas). However, there is no even subdivision into
intestinal or diffuse cancer types. Other issue is with the samples from patients
with recurrent disease. Presumably, the originally resected primary tumours were
examined by immunohistochemistry for the purpose of the study. As patients with
recurrent disease had most likely histological confirmation of the cancer it would
be interesting to know the results of CD44/CD24 staining on these biopsies in
order to exclude the intratumour heterogeneity.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests' below.
Review for 10.1186/1471-230X-12-95 (2012)

Reviewer's report
Title:CD44/CD24 Expression in Recurrent Gastric Cancer: A Retrospective
Analysis
Version: 2Date:2 July 2012
Reviewer: Andrew Ruszkiewicz
Reviewer's report:
As the original manuscript has been modified and the submitted version
addresses the reviewers suggestions I recommend publishing of the revised
manuscript .
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Review for 10.1186/1471-230X-12-94 (2012)

Reviewer's report
Title:The value of a faecal immunochemical test in colorectal cancer
surveillance: a multi-centre cohort study
Version: 1Date:27 February 2012
Reviewer: FRANCISCO RODRIGUEZ MORANTA
Reviewer's report:
The authors report the results of a multicenter study that analyzes the value of a
quantitative fecal occult blood test in patients at high risk of CRC in endoscopic
surveillance program.
Major Compulsory Revisions
The article is interesting and provides relevant information. On the other hand,
the most relevant study is that it provides worse results than those published
regarding the usefulness of FOBTi.
The authors could provide some more information to explain the low rate of
advanced adenomas detected by FOBT.
For this reason it could take into account a number of considerations:
1. What source have the tumors detected in group with personal history of CRC?
Are local recurrence or metachronous tumors? Local recurrence (whose growth
is usually predominantly extraluminal) is certainly less likely to be detected by
FOBT. For this reason, may not be a good test for monitoring patients
undergoing surgery for CRC.
2. The rate of advanced adenomas and CRC detection is low (similar to
medium-risk population). What percentage of adequacy to clinical guidelines had
colonoscopies?
3. Do the researchers found differences between different hospitals in terms of
lesion detection rate and on the percentage of positive tests?
4. The completion of the test was performed 2 days before delivery (could be
more days in patients with constipation, I guess). The authors conducted a
questionnaire to ensure the proper (kept in the refrigerator). To avoid the doubts
of its completion could be given quantitative values of FOBT (median, standard
deviation). What percentage of FOBT had a value of 0ng/ml?
5. The number of CRC is too low to evaluate the sensitivity for CRC.
Minor Essential Revisions
6. Figure 2 is not displayed clearly. Should be improved image quality
Discretionary Revisions
7. It has been shown that taking antiplatelet improves the sensitivity of the test.
Patients completed the test a few days before undergoing a colonoscopy. Had
they stopped taking antiplatelet drugs?
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-94 (2012)

Reviewer's report
Title:The value of a faecal immunochemical test in colorectal cancer
surveillance: a multi-centre cohort study
Version: 3Date:7 May 2012
Reviewer: Enrique Quintero
Reviewer's report:
1) The author´s reply to the requested information on the individuals undergoing
colonoscopy at the recommended intervals clarifies that up to 63% of these
patients underwent surveillance colonoscopy earlier than the recommended
interval. In relation to this point, the explanation given by the authors (new
paragraph in page 9), for selecting an interval cut-off level of 2 years is very
confusing. The assumption that a surveillance interval of <2 years could be
associated with incomplete adenoma removal or lower quality bowel prep seems
to me incorrect, and is not supported by any evidence. Moreover, these two
circumstances only justify about 30% of colonoscopies performed at inadequate
intervals. Patients in both situations had an incomplete index colonoscopy and
colonoscopy should be repeated before considering the appropriate surveillance
interval. Overall, these patients represented about 30% (n=305) of the whole
series in this study. In fact, multivariate analysis shows that FIT positivity is
associated with short surveillance periods (what does this finding mean? Is it a
consequence of an incomplete previous polypectomy?). In my opinion, it does
not make any sense to perform FIT analysis in these patients. This represent a
major flaw in the methodology of the present study and in my opinion may
influence FIT results. Then, I suggest retrieving these patients from the analysis.
2) This paper is reporting interesting information on the accuracy of FIT for
detecting advanced colorectal neoplasia in a heterogeneous high-risk population,
and this should be the major endpoint of the manuscript. In this regard:
- the title should be modified accordingly, as the paper does not report any valid
conclusion regarding the role of FIT in CRC surveillance. In that sense, I suggest
also to delete the last paragraph of the introduction “These findings nay help to
decide…..and postponed colonoscopy surveillance”-
- The authors mention throughout the manuscript that are evaluating the “test
characteristics of FIT”. It would be more appropriate to say “test accuracy” rather
than “test characteristics”.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-12-94 (2012)

Reviewer's report
Title:The value of a faecal immunochemical test in colorectal cancer
surveillance: a multi-centre cohort study
Version: 3Date:7 May 2012
Reviewer: FRANCISCO RODRIGUEZ MORANTA
Reviewer's report:
- Major Compulsory Revisions:
The authors have justified all question raised. However I have doubts about my
question number 3. “Do the researchers found differences between different
hospitals in terms of lesion detection rate and on the percentage of positive
tests? “ The authors have explained differences in positivity rates between
hospitals and explain their possible causes.
However, I think that is not explained enough, the high difference in the rate of
detection of advanced neoplasia (AN) among hospitals located in a relatively
close area.
One of the hospitals performed 50% of colonoscopies and found 61% of the AN
(AN detection rate =12%). Therefore, the remaining hospitals have only a
detection rate of 8% for AN. A rate of 12% is relatively low for a high risk
population. However, a rate of 8% is similar to that obtained in screening
average-risk population (individuals over age 50 asymptomatic without personal
or family history of colorectal cancer). Racial differences are argued with lower
risk of CRC. However, this lower risk population had a higher probability of
positive test. These results may question the quality of endoscopy performed in
some of the participating centers.
I agree with the authors to justify this point involves providing many details but I
think it is worth clarifying this point because the most delicate of the study is the
low detection rate of advanced adenomas obtained with FOBT.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests
Review for 10.1186/1471-230X-12-94 (2012)

Reviewer's report
Title:Faecal immunochemical test accuracy in patients referred for surveillance
colonoscopy: a multi-centre cohort study
Version: 4Date:18 June 2012
Reviewer: Enrique Quintero
Reviewer's report:
The authors have satisfied the questions raised by this reviewer. The paper has
been improved and in my opinion is ready to be published.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Review for 10.1186/1471-230X-12-94 (2012)

Reviewer's report
Title:Faecal immunochemical test accuracy in patients referred for surveillance
colonoscopy: a multi-centre cohort study
Version: 4Date:19 June 2012
Reviewer: FRANCISCO RODRIGUEZ MORANTA
Reviewer's report:
The authors have justified the questions asked. I have no other issues.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-37 (2012)

Reviewer's report
Title:Effectiveness of CO2-insufflated Endoscopic Submucosal Dissection with
the duodenal balloon occlusion method for early esophageal or gastric cancer
Version: 3Date:8 January 2012
Reviewer: Reginald V. Lord
Reviewer's report:
Review of Mori et al. “Effectiveness of CO2-insufflated endoscopic submucosal
dissection with the duodenal balloon occlusion method for early esophageal or
gastric cancer: a randomized prospective study”
The authors have performed a RCT of CO2 insufflation for endoscopic
submucosal dissection with an overtube allowing the CO2 to escape through the
mouth. In the study arm, a duodenal balloon for occlusion was used. This is the
first report on CO2 for esophageal and gastric ESD. In the control arm standard
insufflations was used without a duodenal balloon. Intestinal CO2 gas volume
measured by 3DCT before and after ESD was highly significantly lower in the
duodenal balloon group. Volume was reported as unchanged after balloon
occlusion but the post-therapy CT was performed the following day.
COMPULSORY REVISIONS
1. The chief limitation of this study is the lack of accuracy of CT for measuring
intestinal volume. More information should be provided regarding exactly how
these measurements were made by the radiology technicians. Were any of the
authors involved in making these measurements?
2. End tidal CO2 was lower in the balloon arm but pH levels were similar. Why
was measurement of end-tidal CO2 concluded at 2 hours even if the procedure
took longer than this to perform?
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competing interests.
Review for 10.1186/1471-230X-12-37 (2012)

Reviewer's report
Title:Effectiveness of CO2-insufflated Endoscopic Submucosal Dissection with
the duodenal balloon occlusion method for early esophageal or gastric cancer
Version: 4Date:20 March 2012
Reviewer: Yutaka Saito
Reviewer's report:
1) The References were incorrect.
Ref. No. 11 is paper about CO2 insufflation for colorectal ESD not for routine CS.
The other paper about CO2 use for colorectal ESD is as below;
Kikuchi T, et al. Transcutaneous monitoring of partial pressure of carbon dioxide
during endoscopic submucosal dissection of early colorectal neoplasia with
carbon dioxide insufflation: a prospective study. Surg Endosc. 2010
Sep;24(9):2231-5. Epub 2010 Feb 23.
2) Introduction
The authors described that “ little investigation has been performed on how CO 2
gas used in ESD for the treatment of early esophageal or gastric cancer affects
the human body.” In the Introduction section but this description is incorrect.
The usefulness and safety of CO2 use in upper GI ESD were already reported.
Please refer to papers as follows;
Nonaka S, et al. Safety of carbon dioxide insufflation for upper gastrointestinal
tract endoscopic treatment of patients under deep sedation. Surg Endosc. 2010
Jul;24(7):1638-45. Epub 2010 Jan 28.
Maeda Y, et al. A pilot study to assess mediastinal emphysema after esophageal
endoscopic submucosal dissection with carbon dioxide insufflation. Endoscopy.
2012 Mar 9. [Epub ahead of print]
Uemura M, et al. Effects of Carbon Dioxide Insufflation in Esophageal
Endoscopic Submucosal Dissection. Hepatogastroenterology. 2011 Oct
14;59(115-116). doi: 10.5754/hge11547. [Epub ahead of print]
3) Discussion
The same issue in the introduction
The authors described as “The advantage of CO 2 -insufflated ESD for early
colorectal cancer has been previously reported [5]. However, no study has
scientifically examined the influences of CO 2 insufflation on the human body
during ESD of the upper gastrointestinal (GI) tract. “
This is not correct. Please refer to appropriate papers.
According to the previous papers, upper GI ESD using CO2 can be conducted
safely so please discuss the comparison with these previously reported papers.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-35 (2012)

Reviewer's report
Title:Apolipoprotein E COG 133 mimetic peptide improves
5-fluorouracil-induced intestinal mucositis
Version: 2Date:24 August 2011
Reviewer: Wei Han
Reviewer's report:
The manuscript is generally acceptable, but has many specific problems, some
of which I have noted as follows. So this manuscript needs some language and
format corrections before being published. And there are some recommended
experiments to the author which are useful to clarify the effect of apoE mimetic
peptide in 5-Fu induced intestinal mucositis.
- Major Compulsory Revisions
1)Slight compliance was found between In vivo with in vitro studies. Detecting
apoptosis and proliferation after 5-Fu challenged with or without apoE mimetic
peptide treatment in vivo, by TUNEL, Brdu or PCNA respectively or other widely
used methods. Then, the results become more persuasive.
2)Morphological Figures of IEC-6 after 5-Fu challenged with or without apoE
treatment are needed to show in the manuscript. Just a result from flow
cytometry is not convincing.
- Minor Essential Revisions
There are some minor mistakes in the manuscript, which the author should
correct. Such as:
1)Abstract,”…Improvements were also found with IEC-6 necrosis and migration
following apoE treatment” According to the experiment results, necrosis should
be replaced by apoptosis.
2)The information about the role of apoE plays in 5-Fu induced mucositis in the
background is insufficient.
3)Methods, ninth paragraph, 95#,60#are the correct writing; Twelfth paragraph,
“After 24 h”, h is missing.
4)Discussion, sixth paragraph, the quotation labeling is wrong, maybe
“…suggesting that IL-1 peptides are key players in the intestinal inflammatory
response following 5-Fu treatment[21]” should be changed to”…[22]”.
5)Please make sure the formats of the entire manuscript are consistency.
Whether or not beginning with two spaces in each paragraph; The tittles of
FIGURE 6 A and B will be better if both are bold or not; The figures should be
showed with uniform format; The abbreviation of apolipoprotein E COG 133
mimetic peptide should be consistent, and so on.
6)The descriptions of each figure should be more clearly.
7)Specify references expression
- Discretionary Revisions
1)Using immunohistochemistry method or specific assay kit to detect iNOS
expression in the intestine after 5-Fu challenged with or without apoE mimetic
peptide treatment (protein level detecting).
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-35 (2012)

Reviewer's report
Title:Apolipoprotein E COG 133 mimetic peptide improves
5-fluorouracil-induced intestinal mucositis
Version: 9Date:6 January 2012
Reviewer: Wei Han
Reviewer's report:
- Major Compulsory Revisions
1#Method of how to assess the “mitotic index” is not well described, maybe not
easy to understand.
- Minor Essential Revisions
There are some minor mistakes in the manuscript, which the author should
correct. Such as:
1) Methods, Cell proliferation assays, WST assay, “104 cells /ml in 100 µl of
standard DMEM media” is the correct writing;
2) Please make sure the formats of the entire manuscript are consistency. The
tittles of FIGURE 6 A and B will be better if both are bold or not; The figures
should be showed with uniform format; The abbreviation of hour should be
uniform. And so on.
- Discretionary Revisions
1) The difference of the NF-#B Immunohistochemistry within each group is not
obvious. Maybe because of the imperfect biopsy. I think Western blot is a better
choice.
I advise that the manuscript will be accepted after major compulsory revisions
and minor essential revisions
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-35 (2012)

Reviewer's report
Title:Apolipoprotein E COG 133 mimetic peptide improves
5-fluorouracil-induced intestinal mucositis
Version: 9Date:15 January 2012
Reviewer: Jerzy-Roch Nofer
Reviewer's report:
The revised version of the manuscript entitled „ApoE COG 133 mimetic peptide
improves 5-fluorouracil-induced intestinal mucositis“ by Azevedo and colleagues
contains results of several new experiments. The paper has been significantly
improved and the authors satisfactorily responded to most of my comments.
While no further experimentation is in my view necessary, some points still
deserve authors’ attention:
1. The authors have apparently overlooked to respond to point 4 of my initial
criticism
2. The authors claim (in the reply to reviewer) that COG 133 comprises only
residues of N-terminal domain responsible for binding to LDL-receptor and is not
amphipathic. This is in contradiction to the information available in the web,
according to which COG133 may assume the structure of an amphipathic alpha
helix, which is responsible for its anti-inflammatory activity. At least two results of
the present study reinforce the notion that amphipathicity is critical to the
protective effects of COG 133. First, some effects of COG 133 examined by the
authors were imitated by D-4F, which is also amphipathic, but most likely does
not bind to members of LDL-receptor family. Second, the 5FU-induced injury was
not exacerbated in apoE-KO mice, which argues against the contention that the
protective effects of COG133 are apoE-specific (or - to be more precise -
mediated via one or more of apoE receptors). The authors should include the
information regarding COG133 amphipathicity into the manuscript and discuss
their results in context of potential mechanisms (amphipathicity vs. apoE-receptor
binding) accounting for protection against 5FU injury.
3. I suggest that the figures are put together and better structured. In the present
manuscript panels of the same figure are dispersed and figures are difficult to
follow
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-12-35 (2012)

Reviewer's report
Title:Apolipoprotein E COG 133 mimetic peptide improves
5-fluorouracil-induced intestinal mucositis
Version: 18Date:27 March 2012
Reviewer: Jerzy-Roch Nofer
Reviewer's report:
No further comments
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Review for 10.1186/1471-230X-12-35 (2012)

Reviewer's report
Title:Apolipoprotein E COG 133 mimetic peptide improves
5-fluorouracil-induced intestinal mucositis
Version: 18Date:3 April 2012
Reviewer: Wei Han
Reviewer's report:
The revised version of the manuscript entitled “APOLIPOPROTEIN E COG 133
MIMETIC PEPTIDE IMPROVES 5-FLUOROURACIL-INDUCED INTESTINAL
MUCOSITIS” has been significantly improved and the authors satisfactorily
responded to most of my comments. I advise that the manuscript will be
accepted without revisions.
Level of interest—An article whose findings are important to those with closely
related research interest Quality of written English—Acceptable Statistical
review—No, the manuscript does not need to be seen by a statistician.
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-93 (2012)

Reviewer's report
Title:A magic pill? A qualitative analysis of patients' views on the role of
antidepressant therapy in inflammatory bowel disease (IBD)
Version: 1Date:16 November 2011
Reviewer: Hillary Bogner
Reviewer's report:
Comments on “A magic pill? A qualitative analysis of patients’ views on the role
of antidepressant therapy in inflammatory bowel disease. ”
This manuscript is an interesting examination of the experiences of patients with
IBD on antidepressants. I hope the following comments will be helpful to the
authors is any subsequent revision of the paper.
Introduction: I was not clear on the authors’ rationale for selecting study
participants solely from among the practice’s patients on antidepressants versus
all patients with IBD if the objective is to ascertain the acceptability of
antidepressants. The authors bring up this point in the discussion but maybe they
should rephrase their objective.
Methods: I was confused if the team used any specific qualitative software to aid
in the coding and analysis of transcripts.
Results: The reader would have more confidence in the results by verification
through “triangulation,” “member checking,” discussion presence/absence of
divergent patient views, or other method.
Results: It would be useful to differentiate between gender, IBD type differences
in terms of study end-points. Do men, older adults, ulcerative colitis patients have
different views?
Discussion: I would appreciate some discussion of the current results obtained in
a specialty setting compared to results of studies conducted in other settings
such as a primary care setting.
Discussion: The authors discuss the acceptance of clinical trials but these
patients were those who agreed to be in a research study.
Tables: Could the authors please add more information to the tables and figures
such as where the data is gathered from and the year. The n should be added to
table 1.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-93 (2012)

Reviewer's report
Title:A magic pill? A qualitative analysis of patients' views on the role of
antidepressant therapy in inflammatory bowel disease (IBD)
Version: 1Date:5 March 2012
Reviewer: Pali Hungin
Reviewer's report:
This is a useful paper as it ascertains the views of patients with IBD already on
antidepressant therapy. The authors chose to use a random selection of patients
in this category. Whilst at first sight the sample size appears small the
justification is that sufficient data (saturation) will have been attained from this
group. Much useful information has been gained about the attitudes and
perceptions of these patients.
The challenges are that there was no comparator group – i.e., it would have been
useful to know what the views and attitudes were of patients not yet on
antidepressant therapy – for clinicians the real difficulty is in persuading patients
to commence such treatment because of the psychological connotations.
Secondly, we do not know whether this group was indeed suffering from an
anxiety or depression related disorder prior to treatment and whether the
improved mentioned by so many of the sufferers related to that or to the IBD
itself. Although the paper is primarily concerned with patients’ views it does
contain an element of IBD outcomes and indeed, of overall QoL. These might
have been evaluated using already available, validated instruments. This, there
is a mix of factors which makes it difficult to recognise whether antidepressant
therapy is appropriate for all, some or a selected group of people with IBD. The
research , therefore, falls short of assisting clinicians in their decision making
about using antidepressant therapy in IBD sufferers although it does confirm that
in this particular group there was good, overall satisfaction.
Despite this the paper does make a contribution to our knowledge – perhaps the
limitations could be more clearly recognised – my sense is that many patients
outright refuse such treatment and that there should be a clearer, rationalised
basis for considering such treatment, including an assessment of psychological
status. A post- treatment analysis without comparators. whilst interesting, is of
limited value.
Level of interest: An article of limited interest
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-91 (2012)

Reviewer's report
Title:Imbalanced shift of cytokine expression between T helper 1 and T helper 2
(Th1/Th2) in intestinal mucosa of patients with post-infectious irritable bowel
syndrome
Version: 1Date:25 March 2012
Reviewer: Junping Wang
Reviewer's report:
In the present study, the authors found that the intestinal mucosa of PI-IBS
patients exhibits an increased IFN-# and decreased IL-10 levels, suggested the
infection may affects the Th1/Th2 balance. The deregulations of immune
response are likely an important cause of IBS. The study is well designed and
the description of the results and technologies are clear. The study had clinical
meaningfulness. However, the article should be revised according to the
following comments:
Discretionary Revisions
1. How long did patients with acute gastroenteritis and bacillary dysentery
develop to PI-IBS.
2. D-IBS and C-IBS may have different pathogenesis, if possible, separated
D-IBS to C-IBS.
Minor Essential Revisions
1. It is better to cite the references within past 3 years.
2. The figure and the notes should not be separated in different pages.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Review for 10.1186/1471-230X-12-91 (2012)

Reviewer's report
Title:Imbalanced shift of cytokine expression between T helper 1 and T helper 2
(Th1/Th2) in intestinal mucosa of patients with post-infectious irritable bowel
syndrome
Version: 1Date:8 May 2012
Reviewer: Mark Pimentel
Reviewer's report:
in this manuscript, the authors gather colon biopsies in PI-IBS, non-PI-IBS, and
controls and measured mRNA and protein expression for interferon, IL-10, IL-12
and IL-4 to examine the Th1 and Th2 balance. They find elevated interferon and
lower IL-10 but not IL-12 or IL-4.
This is an important finding and taking biopsies is a direct technique compared to
serum measurements. Two things are problematic. First, the authors take
biopsies throughout the colon and yet comment only on one result. Was the first
result an average of all three segments. I see that the segments were consistent
in most cases.
Secondly, the standard deviation for all measurements is too small. This must be
standard error, not standard deviation.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.