Reviewer’s report 
Title:  Increasing Rate of Inflammatory Bowel Disease: A 1 2-Year Retrospective Study in 
NingXia, China 
 
Version:  0 Date:  19 Aug 2015 
 
Reviewer:  Yue Li 
 
Reviewer's report: 
This is a retrospective study of IBD cases hospital ized in a tertiary hospital in Ningxia, northwest 
China, over the past 12 years. Although this study consists of a larger number size, which is the 
largest one of data from northwest China, the study  has some crucial defects. First of all, it's the 
confirmation of all cases being recruited. My sugge stion is to decide on acceptance or rejection 
until the authors have responded to the major revis ions.  
 
- Major Revisions  
 
1) Page 7, METHODS, Line 12-15 
 
"Data obtained were checked according to the 2012 g uidelines for the diagnosis and treatment of 
IBD" 
Is this the validation of IBD diagnosis in this stu dy? If there is a validation or confirmation of 
diagnosis based on 2012 consensus, please specify h ow many cases were excluded and how 
many cases were confirmed respectively.   
 
2) Page 5 ， BACKGROUND, Line 28-31 
Are these references (Reference 4-7 and reference 8 ) cited here really depicted the brief outline 
of prevalence and incidence rate in China? Would su ggest the author to cite more recent 
epidemiologic data from Hongkong, Guangzhou and Daq ing. 
3) Page 8, Hospitalization rates 
 
Is it meaningful of choosing hospitalization rate ( the proportion of IBD patients from the overall 
GI disease patients) as an indicator for increasing  rates of IBD? This indicator may be 
confounded by many factors that can vary each year,  like number of beds in GI ward, average 
days of hospitalization, as well as change of GI di sease diversity.  
 
4) Page 9, Results Line 20-26 
"Most frequent site of inflammation was colon (n = 39; 46.43%), followed by ileum(n = 25; 
29.76%) and upper gastrointestinal (n = 13; 15.48%) , and ileocolon the least often seen (n = 7; 
8.33%)." 
 
This data is interesting with more upper GI disease  than ileocolon disease. Questions would be, 
1) if the diagnosis of CD is accurate; 2) what does  the upper GI disease look like under 
endoscopy?  
 
5) Page 9, Treatment 
Is there any change of treatment over years? 
 
6) Background and Discussion parts are somehow leng thy. Key points would be more apparent 
after being shortened. 
 
Are the methods appropriate and well described? 
If not, please specify what is required in your com ments to the authors. 
No 
Does the work include the necessary controls? 
If not, please specify which controls are required in your comments to the authors. 
Unable to assess 
Are the conclusions drawn adequately supported by t he data shown? 
If not, please explain in your comments to the auth ors. 
Yes 
Are you able to assess any statistics in the manusc ript or would you recommend an 
additional statistical review? 
If an additional statistical review is recommended,  please specify what aspects require further 
assessment in your comments to the editors. 
Not relevant to this manuscript 
Quality of written English 
Please indicate the quality of language in the manu script: 
Not suitable for publication unless extensively edi ted 
Declaration of competing interests 
Please complete a declaration of competing interest s, considering the following questions: 
1. Have you in the past five years received reimbur sements, fees, funding, or salary from 
an organisation that may in any way gain or lose fi nancially from the publication of 
this manuscript, either now or in the future? 
2. Do you hold any stocks or shares in an organisat ion that may in any way gain or lose 
financially from the publication of this manuscript , either now or in the future? 
3. Do you hold or are you currently applying for an y patents relating to the content of 
the manuscript? 
4. Have you received reimbursements, fees, funding,  or salary from an organization that 
holds or has applied for patents relating to the co ntent of the manuscript? 
5. Do you have any other financial competing intere sts? 
6. Do you have any non-financial competing interest s in relation to this paper? 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give det ails below. 
I declare that I have no competing interests. 
 
I agree to the open peer review policy of the journ al. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted o n the website along with the authors' 
responses. I agree for my report to be made availab le under an Open Access Creative Commons 
CC-BY license (http://creativecommons.org/licenses/ by/4.0/). I understand that any comments 
which I do not wish to be included in my named repo rt can be included as confidential comments 
to the editors, which will not be published. 
I agree to the open peer review policy of the journ al 
Reviewer’s report 
Title:  Increasing Rate of Inflammatory Bowel Disease: A 1 2-Year Retrospective Study in 
NingXia, China 
 
Version:  0 Date:  19 Aug 2015 
 
Reviewer:  Yue Li 
 
Reviewer's report: 
This is a retrospective study of IBD cases hospital ized in a tertiary hospital in Ningxia, northwest 
China, over the past 12 years. Although this study consists of a larger number size, which is the 
largest one of data from northwest China, the study  has some crucial defects. First of all, it's the 
confirmation of all cases being recruited. My sugge stion is to decide on acceptance or rejection 
until the authors have responded to the major revis ions.  
 
- Major Revisions  
 
1) Page 7, METHODS, Line 12-15 
 
"Data obtained were checked according to the 2012 g uidelines for the diagnosis and treatment of 
IBD" 
Is this the validation of IBD diagnosis in this stu dy? If there is a validation or confirmation of 
diagnosis based on 2012 consensus, please specify h ow many cases were excluded and how 
many cases were confirmed respectively.   
 
2) Page 5 ， BACKGROUND, Line 28-31 
Are these references (Reference 4-7 and reference 8 ) cited here really depicted the brief outline 
of prevalence and incidence rate in China? Would su ggest the author to cite more recent 
epidemiologic data from Hongkong, Guangzhou and Daq ing. 
3) Page 8, Hospitalization rates 
 
Is it meaningful of choosing hospitalization rate ( the proportion of IBD patients from the overall 
GI disease patients) as an indicator for increasing  rates of IBD? This indicator may be 
confounded by many factors that can vary each year,  like number of beds in GI ward, average 
days of hospitalization, as well as change of GI di sease diversity.  
 
4) Page 9, Results Line 20-26 
"Most frequent site of inflammation was colon (n = 39; 46.43%), followed by ileum(n = 25; 
29.76%) and upper gastrointestinal (n = 13; 15.48%) , and ileocolon the least often seen (n = 7; 
8.33%)." 
 
This data is interesting with more upper GI disease  than ileocolon disease. Questions would be, 
1) if the diagnosis of CD is accurate; 2) what does  the upper GI disease look like under 
endoscopy?  
 
5) Page 9, Treatment 
Is there any change of treatment over years? 
 
6) Background and Discussion parts are somehow leng thy. Key points would be more apparent 
after being shortened. 
 
Are the methods appropriate and well described? 
If not, please specify what is required in your com ments to the authors. 
No 
Does the work include the necessary controls? 
If not, please specify which controls are required in your comments to the authors. 
Unable to assess 
Are the conclusions drawn adequately supported by t he data shown? 
If not, please explain in your comments to the auth ors. 
Yes 
Are you able to assess any statistics in the manusc ript or would you recommend an 
additional statistical review? 
If an additional statistical review is recommended,  please specify what aspects require further 
assessment in your comments to the editors. 
Not relevant to this manuscript 
Quality of written English 
Please indicate the quality of language in the manu script: 
Not suitable for publication unless extensively edi ted 
Declaration of competing interests 
Please complete a declaration of competing interest s, considering the following questions: 
1. Have you in the past five years received reimbur sements, fees, funding, or salary from 
an organisation that may in any way gain or lose fi nancially from the publication of 
this manuscript, either now or in the future? 
2. Do you hold any stocks or shares in an organisat ion that may in any way gain or lose 
financially from the publication of this manuscript , either now or in the future? 
3. Do you hold or are you currently applying for an y patents relating to the content of 
the manuscript? 
4. Have you received reimbursements, fees, funding,  or salary from an organization that 
holds or has applied for patents relating to the co ntent of the manuscript? 
5. Do you have any other financial competing intere sts? 
6. Do you have any non-financial competing interest s in relation to this paper? 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give det ails below. 
I declare that I have no competing interests. 
 
I agree to the open peer review policy of the journ al. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted o n the website along with the authors' 
responses. I agree for my report to be made availab le under an Open Access Creative Commons 
CC-BY license (http://creativecommons.org/licenses/ by/4.0/). I understand that any comments 
which I do not wish to be included in my named repo rt can be included as confidential comments 
to the editors, which will not be published. 
I agree to the open peer review policy of the journ al 
Please review this paper.
user
Reviewer’s report 
Title:  Increasing Rate of Inflammatory Bowel Disease: A 1 2-Year Retrospective Study in 
NingXia, China 
 
Version:  0 Date:  19 Aug 2015 
 
Reviewer:  Yue Li 
 
Reviewer's report: 
This is a retrospective study of IBD cases hospital ized in a tertiary hospital in Ningxia, northwest 
China, over the past 12 years. Although this study consists of a larger number size, which is the 
largest one of data from northwest China, the study  has some crucial defects. First of all, it's the 
confirmation of all cases being recruited. My sugge stion is to decide on acceptance or rejection 
until the authors have responded to the major revis ions.  
 
- Major Revisions  
 
1) Page 7, METHODS, Line 12-15 
 
"Data obtained were checked according to the 2012 g uidelines for the diagnosis and treatment of 
IBD" 
Is this the validation of IBD diagnosis in this stu dy? If there is a validation or confirmation of 
diagnosis based on 2012 consensus, please specify h ow many cases were excluded and how 
many cases were confirmed respectively.   
 
2) Page 5 ， BACKGROUND, Line 28-31 
Are these references (Reference 4-7 and reference 8 ) cited here really depicted the brief outline 
of prevalence and incidence rate in China? Would su ggest the author to cite more recent 
epidemiologic data from Hongkong, Guangzhou and Daq ing. 
3) Page 8, Hospitalization rates 
 
Is it meaningful of choosing hospitalization rate ( the proportion of IBD patients from the overall 
GI disease patients) as an indicator for increasing  rates of IBD? This indicator may be 
confounded by many factors that can vary each year,  like number of beds in GI ward, average 
days of hospitalization, as well as change of GI di sease diversity.  
 
4) Page 9, Results Line 20-26 
"Most frequent site of inflammation was colon (n = 39; 46.43%), followed by ileum(n = 25; 
29.76%) and upper gastrointestinal (n = 13; 15.48%) , and ileocolon the least often seen (n = 7; 
8.33%)." 
 
This data is interesting with more upper GI disease  than ileocolon disease. Questions would be, 
1) if the diagnosis of CD is accurate; 2) what does  the upper GI disease look like under 
endoscopy?  
 
5) Page 9, Treatment 
Is there any change of treatment over years? 
 
6) Background and Discussion parts are somehow leng thy. Key points would be more apparent 
after being shortened. 
 
Are the methods appropriate and well described? 
If not, please specify what is required in your com ments to the authors. 
No 
Does the work include the necessary controls? 
If not, please specify which controls are required in your comments to the authors. 
Unable to assess 
Are the conclusions drawn adequately supported by t he data shown? 
If not, please explain in your comments to the auth ors. 
Yes 
Are you able to assess any statistics in the manusc ript or would you recommend an 
additional statistical review? 
If an additional statistical review is recommended,  please specify what aspects require further 
assessment in your comments to the editors. 
Not relevant to this manuscript 
Quality of written English 
Please indicate the quality of language in the manu script: 
Not suitable for publication unless extensively edi ted 
Declaration of competing interests 
Please complete a declaration of competing interest s, considering the following questions: 
1. Have you in the past five years received reimbur sements, fees, funding, or salary from 
an organisation that may in any way gain or lose fi nancially from the publication of 
this manuscript, either now or in the future? 
2. Do you hold any stocks or shares in an organisat ion that may in any way gain or lose 
financially from the publication of this manuscript , either now or in the future? 
3. Do you hold or are you currently applying for an y patents relating to the content of 
the manuscript? 
4. Have you received reimbursements, fees, funding,  or salary from an organization that 
holds or has applied for patents relating to the co ntent of the manuscript? 
5. Do you have any other financial competing intere sts? 
6. Do you have any non-financial competing interest s in relation to this paper? 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give det ails below. 
I declare that I have no competing interests. 
 
I agree to the open peer review policy of the journ al. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted o n the website along with the authors' 
responses. I agree for my report to be made availab le under an Open Access Creative Commons 
CC-BY license (http://creativecommons.org/licenses/ by/4.0/). I understand that any comments 
which I do not wish to be included in my named repo rt can be included as confidential comments 
to the editors, which will not be published. 
I agree to the open peer review policy of the journ al 
assistant