尊敬的编辑和审稿人, 我衷心感谢您对我的论文“Quantitative Assessment of Salivary Gland Scintigraphy with SPECT/CT in the Clinical Application of Sjögren's Syndrome”的细致审查和宝贵建议。您的反馈不仅专业,而且具有很强的洞察力,反映了您在审核过程中投入了大量时间和精力。根据您的意见,我们进行了全面的修订,显著提高了论文的整体质量。您的建议不仅改善了逻辑结构,而且极大地影响了我正在进行的研究。此外,这些修订为我未来的研究方向和学术发展提供了宝贵的视角。 我衷心感谢您对我的论文 "SPECT/CT唾液腺闪烁成像定量评估在Sjögren's Syndrome "临床应用中的细致审查和宝贵建议。您的反馈不仅专业,而且具有很强的洞察力,反映了您在审核过程中投入了大量的时间和精力。根据您的意见,我们进行了全面的修订,显著提高了论文的整体质量。
问题 3:我错过了论文结果部分引用的表 2 中子组的 p 值。回答: 非常感谢您对我们工作的详细评论和宝贵意见。关于表 2 中亚组比较的 p 值,我们首先进行了 KruskalWallis H 检验,结果表明组间存在显著差异。然而,Kruskal- 关于表 2 中亚组比较的 p 值,我们首先进行了 KruskalWallis H 检验,结果表明组间存在显著差异。
Wallis H 检验不直接提供成对组比较的 p 值,因此我们随后进行了 Dunn 检验以进一步评估对照组和每个亚组之间的具体差异。为了提供更详细的统计信息,我们在图 3 中提供了 Dunn 检验的 p 值。在修订版中,我们将更新表 2 以清楚地表明 Kruskal-Wallis H 检验的结果,并在手稿中增加有关 Dunn 检验的信息。
Answer: Thank you for your valuable comments. Your feedback is highly professional and insightful, and I apologize for any inappropriate expressions. I fully understand your concern regarding the lack of data supporting the conclusion that “salivary gland SPECT/CT is particularly valuable in early diagnosis.” Indeed, reduced salivary secretion is a time-dependent process, and with the progression of the disease, patients with a longer disease duration may exhibit more 请回答:感谢您的宝贵意见。您的反馈意见非常专业,也很有见地,如有不当之处,我深表歉意。我完全理解您对缺乏数据支持 "唾液腺 SPECT/CT 对早期诊断特别有价值 "这一结论的担忧。的确,唾液腺分泌减少是一个与时间相关的过程,随着病情的发展,病程较长的患者可能会表现出更多的唾液腺分泌减少。
pronounced clinical symptoms. Therefore, the absence of a clear distinction between newly diagnosed patients, those with shorter disease durations, and those with longer disease courses makes it difficult for the existing data to fully support the value of SPECT/CT in early diagnosis. I admit that the statement “salivary gland SPECT/CT is particularly valuable in early diagnosis” was not sufficiently precise. 明显的临床症状。因此,由于没有明确区分新诊断患者、病程较短患者和病程较长患者,现有数据难以完全支持 SPECT/CT 在早期诊断中的价值。我承认,"唾液腺 SPECT/CT 对早期诊断特别有价值 "这一说法不够准确。
The age-dependent impairment of salivary flow is indeed a well-known influencing factor, and we have carefully considered this aspect in the study design. Specifically, participants were categorized into three age subgroups: young group ( < 45<45 years), middle-aged group ( 45-5945-59 years), and elderly group ( >= 60\geqslant 60 years), which is consistent with common age categorization methods ^(3){ }^{3}. To control for the potential impact of age on salivary flow and ensure fairness in inter-group comparisons, we used analysis of covariance (ANCOVA) to adjust for age during data analysis. 唾液流量受年龄影响确实是一个众所周知的影响因素,因此我们在研究设计中仔细考虑了这一点。具体来说,我们将参与者分为三个年龄亚组:青年组( < 45<45 岁)、中年组( 45-5945-59 岁)和老年组( >= 60\geqslant 60 岁),这与常见的年龄分类方法 ^(3){ }^{3} 一致。为了控制年龄对唾液流量的潜在影响并确保组间比较的公平性,我们在数据分析过程中使用了协方差分析(ANCOVA)来调整年龄。
After adjusting for age, we found that the effect of age did not significantly alter the difference between the normal group and the dry mouth syndrome group ( > 0.05>0.05 ), indicating no significant age-related confounding effect. This result suggests that, while age may influence salivary flow, its impact on the functional differences between the two groups was not significant in this study. 在对年龄进行调整后,我们发现年龄的影响并未显著改变正常组和口干综合征组之间的差异( > 0.05>0.05 ),这表明与年龄相关的混杂效应并不显著。这一结果表明,虽然年龄可能会影响唾液流量,但在本研究中,年龄对两组之间功能差异的影响并不明显。
In this study, we observed a significant difference in salivary secretion function between the normal group and the mildly impaired group in the submandibular glands, while no significant difference was found in the parotid glands. Existing studies have shown that the parotid and submandibular glands are not equally affected in disease progression, particularly in the early stages, where the submandibular glands tend to suffer more severe damage. Therefore, my study results support the notion that analyzing the functional parameters of the submandibular glands may provide important supplementary information for the early diagnosis of salivary gland dysfunction. However, I also recognize the limitation of the sample size, and these findings need to be further validated through larger studies. In future research, we plan to group patients based on the stages of their disease progression to more clearly assess the diagnostic value of salivary gland SPECT/CT in the early and different stages of the disease. 在这项研究中,我们观察到正常组和轻度受损组的颌下腺唾液分泌功能存在显著差异,而腮腺则无显著差异。现有研究表明,腮腺和颌下腺在疾病进展过程中受到的影响并不相同,尤其是在早期阶段,颌下腺往往受到更严重的损害。因此,我的研究结果支持这样一种观点,即分析颌下腺的功能参数可为唾液腺功能障碍的早期诊断提供重要的补充信息。不过,我也认识到样本量的局限性,这些研究结果还需要通过更大规模的研究来进一步验证。在未来的研究中,我们计划根据患者的疾病进展阶段进行分组,以更清晰地评估唾液腺SPECT/CT在疾病早期和不同阶段的诊断价值。
References: 参考资料
Shirai A, Ogura I. Maximum standardized uptake value for parotid and submandibular glands in patients with Sjögren’s syndrome and submandibular sialolithiasis using salivary gland SPECT/CT. Odontology. Published online October 4, 2024. doi:10.1007/s10266-024-01014-z Shirai A, Ogura I. 利用唾液腺SPECT/CT检查腮腺和颌下腺的最大标准化摄取值。Odontology.doi:10.1007/s10266-024-01014-z。
Kim JW, Jin R, Han JH, et al. Correlations between salivary gland scintigraphy and histopathologic data of salivary glands in patients with primary Sjogren’s syndrome. Clin Rheumatol. 2022;41(10):3083-3093. doi:10.1007/s10067-022-06269-x Kim JW、Jin R、Han JH 等:原发性 Sjogren's 综合征患者唾液腺闪烁成像与唾液腺组织病理学数据的相关性。临床风湿病学》。2022;41(10):3083-3093. doi:10.1007/s10067-022-06269-x
Yu W, Zhang ZZ. Age-Based Grouping Criteria in Medicine. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2023;45(2):285-289. doi:10.3881/j.issn.1000-503x. 15133 Yu W,Zhang ZZ.基于年龄的医学分组标准》。Zhongguo Yi Xue Ke Xue Yuan Xue Bao.2023;45(2):285-289. doi:10.3881/j.issn.1000-503x.15133
Kim J, Lee H, Lee H, et al. Quantitative Single-Photon Emission Computed Tomography/Computed Tomography for Evaluation of Salivary Gland Dysfunction in Sjögren’s Syndrome Patients. Nucl Med Mol Imaging. 2018;52(5):368-376. doi:10.1007/s13139-018- Kim J, Lee H, Lee H, et al.用于评估斯约格伦综合征患者唾液腺功能障碍的定量单光子发射计算机断层扫描/计算机断层成像。Nucl Med Mol Imaging.2018;52(5):368-376. doi:10.1007/s13139-018-