职称英语Screen Test
2021年职称英语考试试题及答案：《综合类》
2021年职称英语考试试题及答案：《综合类》下面共有15个句子，每个句子中均有1个词或短语划有底横线，请从每个句子后面所给的4个选项中选择1个与划线部分意义最相近的词或短语。
答案一律涂在答题卡相对应的位置上。
1 The nursery is bright and cheerful.A pleasantB cleanC peacefulD large2 This kind of material was seldom used in building houses during the Middle Ages.A neverB rarelyC oftenD only3 People from many places were drawn to the city by its growing economy.A fetchedB carriedC attractedD pushed4 The soldier displayed remarkable courage in the battle.A placedB showedC pointedD decided5 How do you account for your absence from the class last Thursday?A explainB examineC chooseD expand6 About one quarter of the workers in the country are employed in factoriesA thirdB fourthC tenthD fifteenth7 She was grateful to him for being so good to her.A carefulB hatefulC beautifulD thankful8 There are only five minutes left, but the outcome of the match is still in doubt.A resultB judgementC estimationD event9 He is certain that the dictionary is just what I want.A sureB angryC doubtfulD worried10 The last few weeks have been enjoyable.A closeB nearC pastD several11 What were the consequences of the decision she had made?A reasonsB resultsC causesD bases12 They didn't realize how serious the problem wasA knowB forgetC doubtD remember13 We shall keep the money in a secure placeA cleanB secretC distantD safe14 The great changes of the city astonished every visitor to that city.A attackedB surprisedC attractedD interested15 The city has decided to do away with all the old buildings in its centreA get rid ofB set upC repairD paint参考答案：1.A2. B3. C4. B5. A6. B7. D8. A9. A 10. C11. B 12. A 13. D 14. B 15. A阅读判断(第16～22题，每题1分，共7分)阅读下面这篇短文，短文后列出了7个句子，请根据短文的内容对每个句子做出判断。
职称英语考试《理工类》历年真题精选及答案0513-1
职称英语考试《理工类》历年真题精选及答案0513-11、How to Interview PeopleInterviewing (采访) is one of those skills that you can only get better at. You will never again feel so ill at ease when you try it for the first time, and probably you'll never feel entirely comfortable trying to get from another person answers that he or she may be too shy to reveal. ______ The rest is instinct, which can all be learned with experience.The basic tools for an interview are paper and two or three well-sharpened pencils. But keep your notebook or paper out of sight until you need it. There's nothing less likely to relax a person than the arrival of someone with a note-taking pad. Both of you need time to get to know each other. Take a while just to chat, judging what sort of person you're dealing with, getting him or her to trust you.Never go into an interview without doing whatever homework you can. If you are interviewing a town official, know his voting record. If it's an actor, know what plays he has been in. You willnot be liked if you inquire about facts that you could have learned in advance.Many beginning interviewers are afraid that they are forcing the other person to answer questions and have no right to inquire about his personal secrets. This fear is almost 103 percent unnecessary. Unless the person really hates being interviewed, he is delighted that somebody wants to interview him. Most men and women lead lives that are uninteresting, and they grasp any chance to talk to an outsider who seems eager to listen.This doesn't necessarily mean that it will go well. In general you will be talking to people who have never been interviewed before, and they will get used to the process awkwardly, perhaps not giving you anything that you can use. Come back another day; it will go better. You will both even begin to enjoy it-proof that you aren't forcing your victim to do something he doesn't really want to.【单选题】e back another day; it will go better.B.But at least half of the skill is mechanical.C.As one philosopher interviewed in the film notes, they lack irony.D.You will not be liked if you inquire about facts that you could have learned in advance.E.This fear is almost 100 percent unnecessary.F.Both of you need time to get to know each other.正确答案:B答案解析:空句后面有“rest”，其余的就是直觉“instinct”，需要后天从经历中总结出来，所以空句毫无疑问讲的是另外一种情况，所以B就显而易见为正确答案了。
职称英语考试小条
阅读1Ford abandons electric vehicles福特放弃电动汽车1give up,2Will not,3Toyota,4Run more miles,5w ill allo w2Word Crude oil production may peak a decade earlier than some predict原油产量可能会达到顶峰十年前比一些人预测1Stimulated,2Start to,3It provides,4It predic ts global,5Ku w aiti3Citizen scientiste 公民科学家1To collect,2To send,3citizen scientist,4Only,5To investigate4Motoring technology汽车技术1They focus,2mak e mis takes,3Windscreens,4gets jammed,5w ill ta k e5Late-night drinking 在深夜喝咖啡1Coffee is,2halves the,3Di ffei ne effec ts,4Caffein e,5We should 6Making light of Sleep轻睡眠1Is has,2Children before,3Staying up,4as w ell as,5one light-sensing7Sugar power for cell phones用糖为手机发电1is suitable,2enzymes in,3glucose from,4good beginning,5It w ill8 eiffel is an eyeful 引人注目的埃菲尔铁塔1Tourists of,2Visitors prefer,3climb ed747,4Conducting,5imagine9 egypt felled by famine埃及保守饥荒折磨1even,2Change,3w and b,4of drought,5damaging10 young female chimps outlearn their brothers年轻雌猩猩学习优于他们的兄弟1begin,2vegetation,3Females could,4w il l mak e 5Adul t11 the net cost of making a name for yourself 网上申请个人域名的费用1company,2US,3registrar,4pay up $,5registration12 florida hit by cold air mass 佛罗里达遭受冷气团袭击1temperatur e,2parts,3,w as caught,4encourage,5florida13 invisibility ring隐形环1invent,2longer,3bounce off,4dis k,5micro w aves14 japanese car keeps watch for drunk drivers日本用来监视醉酒司机的新型概念车1lock ed,2breathal yze r,3monitors,4aims,5car w ill automaticall y15winged robot learns to fly 有翅膀机器人学习飞行1programmed,2tw itched bu t ,3could neve r,4movemen t,5all above16japanese drilling into core of earth日本人的地心旅行1in1991,2predicting,3has many volcanos,4about half,5drill17a sunshade for the planet地球防晒霜1despite,2thin k,3effec tive,4apply,5decr eases18thirst for oil 石油匮乏1decreasing,2most environmentally,3unit ed states,4soon,5sea level19Graphene’s Superstrength超强的石墨烯1Graphene,2easy to,3P ut,4made of graphite,5It can help20explorer of the extreme deep 深海探索器1submersible,2can carry,3ocean,4shape,5both21plant gas 植物沼气1produced,2w i th the same,3higher,4microbes,5less methane22snowflakes 雪花1no tw o,2six-sided,3humidith,4admires,5snow fla k es23powering a city ? it’s a breeze 风力发电轻而易举1w ooden,2high-tec h,3carried,4small,5both24underground coal fires-a looming catastrophe地下煤着火-即将来临的灾难1poisonous,2coal,3coal,4detecte d,5cutting25eat to live 为生存而食1w e,2illustra te,3are,4mice,5dieting26male and female pilots cause accidents differently 男女飞行员引起的事故差异1differen ce,2only,3studied,4stalling,5decision-mak ing 27driven to distraction分散注意力驾驶1Coyne is not,2all above,3something else,4w ant to,5man prefer28sleep lets brain file memories睡眠促使记忆力归档存储1arrange,2and hippocampus,3 poorer poorer,4more poorer,5glucose29food fright对食物的惊恐1bring about,2dark side,3higher,4uniter states,5cannot tell30digital realm数码国王1 in its,2can be,3motivates,4all above,5in a person alized31hurricane katrina卡特里娜飓风1calm central,2tropical,3supply,4low pressure,5humanitarian32mind-reading machine读心机1neurons,2how the brain,3mar k ing,4tw o volunte ers,5your thoughts33experts call for local and regional control of sitesfor radioactive waste专家呼吁局部和区域控制放射性废物地点1canceling,2local,3l ocal communities,4nuclear,5close to reactors34Batteries Built by Viruses病毒建造的电视1Stay aw ay,2mak ing batteries,3Expand,4metallic disk,5Its w id th35putting plants to work植物效能1billions of years,2green plants,3 no oxygen,4too sl ow,5cheap eat36listening device provides landslide early warning听觉仪器提供早期山崩预警1landslides,2all above,3false alarms,4filled in,5evidences37”don’t drink alone” gets new meaning“不要在就餐时间以外饮酒”有了新的含义1outside meals,2increases,3 3drink s,4laryngeal,5reduces38”L ife from found”on saturn’s Titan土卫六上发现生命1on Titan,2There are,3Methane-based,4 have differen t,5A differen t39clone farm克隆农场1cloned,2the us’s,3could grow,4has joined,5farmers40Teaching math,Teaching Anxiety学习数学，学习焦虑1confidence in,2A diffi cult,3Uneasy r eading,4betw een female,5be reteste d41too little for global warming为全球性变暖做得太少1oil,2cut,33500 billion,4think that,5burni ng,42renewable energy sources可持续的能源1AandB,2largest,3norw ay,4all,5renew able43forecasting methods预测的方法1imagination,2d o,3constant,4both,5differs44defending the theory of evolution still seems needed仍然需要保护进化1school,2d arw in,380 and 250000,4fundamental,5too45Small but wise小聪明1Its digital,2Mak e,3Catch es the,4Aste roids float,5infrared radiation46Ants have big impact on environment as “EcosystemEngineers”蚂蚁对生态系统有大的影响1their acti vity,2on small,3P roduc e such,4Ants BAA P,5do human47listening to birdsong听鸟鸣声1change,2son gs,3male,4themselves,5as48”hidden” species may be surprisingly common隐藏的物种常常是出人意料的1survival,2both,3Not,4tw o,5identifi ed49U.S. scientists confirm water on mars美国科学家确认火星上有水1w ate r,2got,3break,4both,5vision50cell phones increase traffic,pedestrian fatalities手机增加交通和行人恶性事故1both,2before,3traffic e,4it,5number完成句子1More than 8 hours sleep too much of a good thing每晚只需八小时睡眠过多不好1p2sleep problems,2p4dangers of,3p5k rip k e’s,4p6a w ay,5sleep more,6suffer sleep,7fall asleep,8sleep less2Soot and snow : a hot combination煤灰与雪白：火热的组合1p3 explanation,2p4 soot’s,3p6 greenhouse gases,4p7 observations,5contributed,6still surpass,7absorb more,8produces3Icy microbes冰冻微生物1p2antarctic frozen,2p4 significance of,3p4accidental discovery,4p6 2004revisit,5w as of,6may be,7is to collect,8is found4Compact disks光盘1p1&2w or k ing principle,2p3digital code,3p4are of many,4p5are durable,5w ritten,6ta k e many,7the k e y,8keep contac t5Led lighting LED 灯1p1replace traditional,2bow ers made,3p5many advantages,4p6almost everything,5more effici ent,6tradi tional lighting,7a laser,8america adopted6How we form first impression对别人的第一印象是怎样形成的1p2comparing,2p3illustration,3p4comment,4p5w ays of departure,5sights and sounds,6meaning of,7immature form,8most complex7Screen test透视检查1p2harm screening,2p3investigating,3p4effec ts predic ted,4p5small risk,5save life,6still open,7reduce ris k,8reduced minimum8The mir space station和平号空间站1p4rew ards follo w ing,2p5mir’s firsts,3problem,4undeniable,5quite psooible,6many firsts,7nothing,8great success9More rural research is needed需要进行更多的农业研究1p1increase,2p3same or improved,3p4more research,4p7research focus,5use modern,6drive yield,7strategic research,8fight against10Washoe learned American sign language washoe学会了美国手语1p1general information,2p2report about,3p3debate on,4p4reason w hy,5w h en she,6,if the gardene rs’,7w hile she,8because use sing11The tiniest electric motor in the world世界上最小的电动机1p2the w or k ing,2p4descrip tion,3p5previous inven tions,4p6possible fields,5remove disease,6resist separating,7transport,8shuffle12A strong greenhouse gas 一种强烈的温室气体1p1methane as strong,2p2w ays to reduce,3p4agriculture also,4p5w hy li ves toc k,5one of ,6ever-inc reasing,7big industries,8how to cut13face masks may not protect from super-flu对于超级流感面具不能保护1p1guidelines,2p3w hen,3p5reasons,4p6dan ger,5help,6overuse,7announce,8deal14the magic io personal digital pen神奇的个人数字笔1p2w or k ing,2p3w ays,3p5a,4p6examples,5it,6simple,7d on’t,8movement15maglev trains磁悬浮火车1p3main,2p4c omparison,3p5w ork ing,4p6high,5develop,6create,7pull,8travel补短文1Mobil phones移动电话1会议上说/he side,2增加2000/by the year2000,3denstyresidential areas/for example,4childen/he says children,5资助according to Robert bell/ research?2The world’s longest bridge世界上最长的桥1island of Sicily/if tur e,2suspension bridge/ common?,3the first/the second,4but the w eigh t/at 166500 tons,5anchors are essential/k eep b ridge anyw h ere3Reinventing the table更新发明元素周期表1bruce first/1871,2traditional table/ ordered the el ements,3unicersity of cambridge/”imagine”,4多次提到salphor/more then once,5symbols soil mater/and the size4Don’t rely on plankton to save the planet不要靠浮游生物拯救地球1touted atmosphere/opponents fear,2dioxide from air/asplank ton die,3for a month/found 100years,4disappointingresults/”ne w e r”,5massage same/ocean5The magic of sound神奇音乐1iron sheet/high sound,2few de cibels/there fore,3called ultrasonic/dolphins,4w ill vibrate/vibra tion of air,5person’s health/if inte nsity6Dung to death施肥致死1farm slurry/his fi ndings,2promote grow th/bu t rec ent ,3in dubendorf/and manure ,4then eaten/could also ,5call sulphonamides/do not easily7Time in the animal world动物界的时间1in Nature/it controls,2of the tide/tid e goes,3have matured/second spring,4speed of life/larger animal,5do few sports/an adult8Watching microcurrents flow观察微电流流程1physicists managed/pictur e progress,2object and/conve rting th e information,3obstacles/to mak ing chips,4fuselage/faults in,5schrag w or k ing/shrin k it9Heat is killer高温杀手1people ever y year/so does,2affect heal th/several of conditions,3stay out sun/doctors,4result heat str ess/most people,5danger heat stress/suchpersons10High dive从高空往下跳1在40千米into atmosphere/from there,2first/how?,3li k e abullet/”30 seconds”said,4higher climbs/handle seve ral,5soda bubbles/in short11Virtual driver虚拟驾驶员，和完形智能汽车差不多1his body/but,2built-in computer/brain of car,3how ever/itcompletes,4in any place/experts say,5regular shapes/how e ver12Musical training can improve communication skills音乐训练可以提高交流技能1she says/nina Kraus,2how to speak/both invol ve,3brainstem/brain ste m controls,4the ce llo/professor krauss,5thestrongest/show s impor tance13sleeping giant1then,2volcano,3three,4firat,5w hile14robotic highway cones1these,2and,3w or k,4w e,5he15the arctic ice is thawing1he,2how ever,3one,4if,5maybe完形填空1captain cook arrow legend库克船长弓箭的传说1F inally,2w ho,3no,4exhibition,5does,6discovering,7now,8w he n,9fight,10until,11lik ely,12refuse,13buried,14statement,15sure2Avalanche and its safety雪崩的安全问题1among,2that,3lik ely,4is,5risk,6gathe r,7flow,8between,9flat,10use,11process,12conditions,13reduce,14attention,15missing3Seeing red means danger ahead看见红色意味着危险在前方1accidents,2hey,3at,4before,5apart,6containing,7spotted,8chemical,9ever ything,10w ea k,11opening,12results,13light,14outside,15a lot of4Animal’s sixth sense动物的第六感1how e ver,2disasters,3missed,4even5sense,6w aves,7reser ve,8apparent,9specialist,10specific11assessment,12phenomenon,13certainly,14some,15as5Singing alarms could save the blind报警器救盲人1w ith,2run by,3blind,4the alarms,5sound,6heard,7that,8smok e-filled,9took,10w ithou t,11processes,12source,13based on,14or,15developed6Car thieves could be stopped remotely远程制止偷车贼1off,2are,3should,4in,5a,6if,7being,8that,9life,10by,11inform,12allow,13have helped,14put,15customer7An intelligent car智能汽车1these,2on,3traffic,4automatic,5other,6path,7instru ctions,8quick l y,9sending,10completes,11atleast,12besides,13rate,14w arn, 15limited8A biological clock生物钟1plants,2insects,3affect,4because of,5days,6flight,7preven ted from,8but,9parts,10seems,11cell,12aw ak en,13how,14it,15such9Wonder webs奇妙的网1tough,2silk,3move,4it,5reuses,6material,7length,8close,9w onde r,10supply,11w ork,12first,13mil k,14any,15as fast as10Chicken Soup for the Soul:Comfort food fightsLoneliness1but,2emotions,3personally,4look ed at,5favorite,6by,7participan ts,8group,9finally,10complete,11secure,12theri,13experience,14eating,15connections11China to help Europe develop gps rical中国帮助欧洲发展全球定位系统的竞争1w ill offer,2fund ing,3become,4by,5ago,6located,7w ith,8is due to,9consist of,10cost,11c alled,12officials,13the satellite,14location,15let12Free Statins with fast food could neutralize heartrisk1charge,2suggest,3amount,4risk,5enough,6eating,7unhealthy,8possobolity,9degree,10lik e,11provided,12customer,13measurts,14,w earing,15low ering13Solar power without solar cells太阳能电池1battery,2effec ts,3previously,4Unde r,5light,6source,7apart,8that,9material,10conduct,11effecti ve,12techni que,13converting,14modern,15both14sharks perform a service for earth’s waters1attack,2valuable,3existen ce,4earth,5because of,6w her e,7for,8times,9chemi cals,10senses,11other,12systems,13recover,14oceans,15great15”Liquefaction”Key to much of Japanese EartquakeDamage1w idespr ead,2extent,3func tion,4strength,5collapse,6shorter,7how,8recentl y,9phenomenon,10before,11events,12deposited,13near,14prevent,15standards。
2020年职称英语考试卫生类概括大意(5)
2020年职称英语考试卫生类概括大意(5) Screen Test1. Every year millions of women are screened with X-rays to pick up signs of breast cancer. If this happens early enough, the disease can often be treated successfully. According to a, survey published last year, 21 countries have screening programmes. Nine of them, including Australia, Canada, the US and Spain, screen women under 50.2. But the medical benefits of screening these younger women are controversial, partly because the radiation brings a small risk of inducing cancer. Also, younger women must be given higher doses of X-rays because their breast tissue is denser.3. Researchers at the Polytechnic University1 of Valencia analysed the effect of screening more than 160, 000 women at 11 local clinics. After estimating the women’s cumulative dose of radiation, they used two models to calculate the number of extra cancers this would cause.4. The mathematical model recommended by Britain’s National Radiological Protection Board (NRPB)predicted that the screening programme would cause 36 cancers per 100,000 women, 18 of them fatal. The model preferred by the UN Scientific Committee on the Effects of Atomic Radiation led to a lower figure of 20 cancers.5. The researchers argue that the level of radiation-induced cancers is “not very significant” compared to the far larger number of cancers that are discovered and treated.The Valencia programme, they say, detects between 300 and 450 cases of breast cancer in every 100,000 women screened.6. But they point out that the risk of women contracting cancer from radiation could be reduced by between 40 and 80 percent if screening began at 50 instead of 45, because they would be exposed to less radiation. The results of their study, they suggest, could help “optimise the technique”for breast cancer screening.7. “There is a trade-off between the diagnostic benefits of breast screening and its risks,” admits Michael Clark of the NRPB. But he warns that the study should be interpreted with caution. “On the basis of the current data, for every 10 cancers successfully detected and prevented there is arisk of causing one later in life. That’s why radiation exposure should be minimised in any screening programme.”词汇：polytechnic 多工艺的 cumulative 递增的radiological 放射性的 contract 感染optimize限度地完善 trade-off n.平衡注释：Polytechnic University：理工大学练习：1.Paragraph 2 ________________2.Paragraph 3 ________________3.Paragraph 4 ________________4.Paragraph 5 ________________A Harm Screening May Do to a Younger WomanB Investigating the Effect of ScreeningC Effects Predicted by Two Different ModelsD Small Risk of Inducing Cancers from RadiationE Treatment of CancersF Factors That Trigger Cancers5.Early discovery of breast cancer may________________.6.Advantages of screening women under 50are________________.7.Delaying the age at which screening startsmay________________.8.Radiation exposure should be ________________.A be costlyB harmfulC save a lifeD still open to debateE reduce the risk of radiation triggering a cancerF reduced to the minimum。
Screening and its Useful Tools
Purpose of Screening
• Aims to reduce morbidity and mortality from disease among persons being screened • Is the application of a relatively simple, inexpensive test, examinations or other procedures to people who are asymptomatic, for the purpose of classifying them with respect to their likelihood of having a particular disease • a means of identifying persons at increased risk for the presence of disease, who warrant further evaluation
– specificity – prevalence of preclinical disease – Sensitivity
• Prevalence =
a+c a+b+c+d
Disease
Present Absent
Screening Test
PositiveaFra bibliotekca+c
b
d
b+d
a+b
Negative
Diagnosis = Screening
• Screening tests can also often be used as diagnostic tests • Diagnosis involves confirmation of presence or absence of disease in someone suspected of or at risk for disease • Screening is generally in done among individuals who are not suspected of having disease
Rapid Screening Test for Primary
Rapid Screening Test for Primary Hyperaldosteronism:Ratio of Plasma Aldosterone to Renin Concentration Determined by Fully Automated Chemiluminescence Immunoassays Frank Holger Perschel,1*Rudolf Schemer,3Lysann Seiler,4Martin Reincke,4 Jaap Deinum,5Christiane Maser-Gluth,6David Mechelhoff,1Rudolf Tauber,1andSven Diederich2Background:The ratio of plasma aldosterone concen-tration to plasma renin activity(PAC/PRA)is the mostcommon screening test for primary hyperaldosteronism(PHA),but it is not standardized among laboratories.We evaluated new automated assays for the simulta-neous measurement of PAC and plasma renin concen-tration(PRC).Methods:We studied76healthy normotensive volun-teers and28patients with confirmed PHA.PAC andPRC were measured immunochemically in EDTAplasma on the Nichols Advantage®chemiluminescenceanalyzer,and PRA was determined by an activity assay.Results:In volunteers,PAC varied from33.3to1930pmol/L,PRA from 1.13to19.7ng⅐mL؊1⅐h؊1(0.215 ng⅐mL؊1⅐h؊1؍1pmol⅐L؊1⅐s؊1),and PRC from5.70 to116mU/L.PAC/PRA ratios ranged from4.35to494(pmol/L)/(ng⅐mL؊1⅐h؊1)and PAC/PRC ratios from0.69 to71.0pmol/mU.In PHA patients,PAC ranged from158 to5012pmol/L,PRA from0.40to1.70ng⅐mL؊1⅐h؊1, and PRC from0.80to11.7mU/L.PAC/PRA ratios were between298and6756(pmol/L)/(ng⅐mL؊1⅐h؊1)and PAC/PRC ratios between105and2328pmol/mU. Whereas PAC or PRC showed broad overlap between PHA patients and volunteers,the PAC/PRC ratio indi-cated distinct discrimination of these two groups at a cutoff of71pmol/mU.Conclusion:The PAC/PRC ratio offers several practical advantages compared with the PAC/PRA screening method.The present study offers preliminary evidence that it may be a useful screening test for PHA.Further studies are required to validate these results,especially in hypertensive cohorts.©2004American Association for Clinical ChemistryPrimary hyperaldosteronism(PHA)7is recognized as the most common endocrine form of secondary hypertension [see,e.g.,Refs.(1–6)]with an estimated prevalence be-tween5%and15%in the hypertensive population(7). Because diagnosis of PHA facilitates effective therapy, extended screening including normokalemic patients is widely accepted(7–9).The most common screening test for PHA is the ratio of plasma aldosterone concentration to plasma renin activity(PAC/PRA)(7,9).Because the measurement of PRA requires special preanalytical prerequisites,is time-consuming,and shows poor interlaboratory reproducibil-ity(10–12),this strategy is not well recommended for screening of hypertensive patients in primary care cen-ters.The lower limit of detection varies among the differ-1Clinical Chemistry and Pathobiochemistry and2Endocrinology,Diabe-tes,and Nutritional Medicine,Charite´-Universita¨tsmedizin Berlin,Campus Benjamin Franklin,Berlin,Germany.3Nichols Institute Diagnostics,Bad Vilbel,Germany.4Department of Internal Medicine II,University of Freiburg,Freiburg, Germany.5Department of Medicine,University Medical Center Nijmegen,Nijme-gen,The Netherlands.6Department of Pharmacology,Ruprecht-Karls-University of Heidelberg, Heidelberg,Germany.*Address correspondence to this author at:Institut fu¨r Klinische Chemie und Pathobiochemie,Charite´-Universita¨tsmedizin Berlin,Campus BenjaminFranklin,Hindenburgdamm30,D-12200Berlin,Germany.Fax49-30-8445-4152;e-mail frank.perschel@charite.de.Received February23,2004;accepted June18,2004.Previously published online at DOI:10.1373/clinchem.2004.0331597Nonstandard abbreviations:PHA,primary hyperaldosteronism;PAC, plasma aldosterone concentration;PRA,plasma renin activity;PRC,plasma renin concentration;RLU,relative light unit(s);APA,aldosterone-producing adenoma;and IHA,idiopathic hyperaldosteronism.Clinical Chemistry50:91650–1655(2004)Endocrinology andMetabolism1650ent PRA assays;therefore,the effect on the PAC/PRA ratio and the resulting cutoff values for PHA can be dramatic(12).The validity and usefulness of the PAC/ PRA ratio for screening for PHA has therefore been challenged(13–15).Recently developed immunoassays for measurement of circulating renin in plasma(PRC)may overcome this limitation.However,studies evaluating these assays with regard to the diagnosis of PHA are rare(16,17).An additional problem is that the proposed cutoff values published to date are derived from measurements of aldosterone in either plasma(2,3,6,11,13,15,17)or se-rum(1,4,16)and are based on different assays.Because both PRA and PRC are measured in plasma and because a simple screening test should be done from only a single specimen,aldosterone should also be measured in plasma.We therefore compared the“new”ratio between plasma aldosterone concentration and plasma renin concentration (PAC/PRC)with the established PAC/PRA screening test in patients with PHA and in healthy volunteers to evalu-ate its clinical and diagnostic significance.Materials and Methods immunoassays and instrumentationThe PAC and PRC were measured on a fully automated chemiluminescence analyzer(Nichols Advantage®;Ni-chols Institute Diagnostics).This system incorporates sen-sitive acridinium ester detection technology in combina-tion with magnetic particles as solid phase.Samples, reagents,and magnetic particles are pipetted into dispos-able cuvettes and incubated at37°C until the reaction is stopped by a washing step,and the emitted light is measured in relative light units(RLU).The system is calibrated by a two-point recalibration against a stored master curve.PRC was measured with the Nichols Advantage Direct Renin TM assay.This two-site immunometric assay uses an acridinium-ester-labeled monoclonal antibody,a second biotinylated monoclonal antibody,and streptavidin-coated magnetic particles.To avoid prorenin activation during the assay,the incubation time is limited to30min at37°C.This assay is calibrated to the WHO reference material(National Institute for Biological Standards and Control code68/356).In an evaluation study(18)this PRC assay showed the following performance:Precision.The intraassay variation for three samples with various concentrations of renin was1.7–5.3%.Interassay variation in seven samples with renin concentrations from 10to466.5mU/L was between2.7–8.2%.Accuracy.Dilution of four plasma samples with the sam-ple diluent gave parallel lines whose slopes did not differ. Renin measurements in two series of mixtures prepared from two plasma samples with low and high renin concentrations,respectively,yielded renin values be-tween86%and111%.Limits of detection and functional sensitivity.The limits of detection,defined as the means plus3SD in two series of 20runs of the sample diluent,were0.013and0.094 mU/L,respectively.The functional sensitivity,defined as the sample renin concentration at which the CV for four series of five assay runs isϽ20%,was2.65mU/L;1mU/L is equivalent to0.6ng/L(18,19).The aldosterone assay on Nichols Advantage is a competitive one-site immunometric assay that uses a biotinylated monoclonal antibody bound to streptavidin-coated magnetic particles.Acridinium-ester-labeled aldo-sterone competes with sample aldosterone for the limited amount of biotinylated antibody.The cross-reactivity to any steroid hormones is negligible.According to the manufacturer’s package insert,the assay has an analytical sensitivity of33.3pmol/L,and the dynamic range is 0–3330pmol/L.The within-run imprecision(CV)at119, 228,547,835,and1990pmol/L is14.0%,5.4%,4.1%,4.4%, and2.9%,respectively.The total CV at119,228,547,835, and1990pmol/L is18.6%,8.5%,5.2%,6.3%,and4.9%, respectively.Addition and dilution study results are between88%and110%.Parallelism results are between 91%and116%.A method comparison with a commer-cially available RIA gave a correlation coefficient of0.96 and a slope of1.04;1pmol/L is equivalent to0.36ng/L.PRA was measured as described previously(10,11). The intraassay variation of this assay was3.9%at11.7 ng⅐mLϪ1⅐hϪ1;the interassay variation was3.6%at11.0 ng⅐mLϪ1⅐hϪ1and6.2%at3.29ng⅐mLϪ1⅐hϪ1,respec-tively.The detection limit was0.40ng⅐mLϪ1⅐hϪ1(0.215 ng⅐mLϪ1⅐hϪ1ϭ1pmol⅐LϪ1⅐sϪ1).All laboratory testing was done by qualified staff of the Charite´.The study was not performed as a blind study. Data analysis and estimation of cutoff values by ROC curve analysis were done with the Analyze-It software package(Analyze-It Software Ltd.).volunteers and patientsWe tested76healthy,normotensive volunteers[employ-ees and students of the Charite´;23males(age range,22–75 years)and53females(age range,16–69years)],who were not taking any relevant medications.Smoking and use of oral contraceptives were not exclusion criteria.Blood samples were drawn in an upright sitting posture.The patients studied included28patients with con-firmed PHA[16males and12females;mean(SD)age,51 (13.1)years;age range,26–72years]:9patients had aldosterone-producing adenomas(APAs),18had idio-pathic hyperaldosteronism(IHA),and1patient had glu-cocorticoid-suppressible hyperaldosteronism.The charac-teristics of these PHA patients are summarized in Table1.The screening of our patients was done according to a generally accepted protocol(7–9),in which plasma aldo-Clinical Chemistry50,No.9,20041651sterone was measured with a commercially available RIA (not with the new immunometric assay)and had to be Ͼ416pmol/L(150ng/L).The ratio between PAC andPRA had to beϾ555(pmol/L)/(ng⅐mLϪ1⅐hϪ1)[Ͼ(200 ng/L)/(ng⅐mLϪ1⅐hϪ1)].Diagnosis was confirmed by successful surgery(all APAs),pathologic saline infusion test(7–9),and in-creased24-h urinary aldosterone excretion on a high-sodium diet(12)(for details see Table1).Seven of the28 patients were normokalemic[mean(SD)serum potas-sium,3.4(0.5)mmol/L;range,2.0–4.3mmol/L].Systolic blood pressure was between140and220mmHg[mean (SD),179(21)mmHg];diastolic blood pressure was be-tween80and140mmHg[mean(SD),104(12.5)mmHg].The described characterization of the PHA patients was done routinely in the outpatient clinics of the depart-ments of endocrinology at the Universities of Freiburg and Berlin.For this evaluation study,separate blood samples were drawn from all PHA patients in an upright sitting posi-tion at0800.The results presented in Tables2–4and Fig. 1are from this standardized blood sampling.Although several authors have recommended PAC/PRA screening without discontinuing hypertensive medications(20–22), our study protocol for the evaluation of PAC/PRC was the following:Most of the patients were on antihyperten-sive therapy,but-blockers,angiotensin-converting en-zyme inhibitors,angiotensin antagonists,and diuretics were stopped for at least3days and spironolactone for at least4weeks before blood sampling.Table1.Characterization of28patients with confirmed PHA.aPatient Sex Age,years DiagnosisConfirmatory tests Differential diagnostic testsTherapy Salineinfusion test b24-h urinaryaldosterone cPosturetest d CT e or MRT fAdrenal veinsampling g1F46APA leftϩϩ2ϩND Surgery 2F52APA right NDϩ1ϩLateral.Surgery 3M38APA leftϩϩ2ϪLateral.Surgery 4M49APA rightϩϩ2ϩND Surgery 5F50APA rightϩϩ2ϩND Surgery 6F52APA left NDϩ2ϩLateral.Surgery 7F41APA right NDϩ1ϩLateral.Surgery 8F50APA leftϩϩ2ϩNU Surgery 9M38APA leftϩND2ϩND Surgery 10F34IHAϩϩ1ϪNU Spiro.11F62IHA NDϩNUϪNo lateral.Spiro.12F63IHAϩϩ1ϪND Spiro.13M53IHA NDϩ2ϪNo Lateral.Spiro.14M72IHAϩϩ1ϪND Amiloride 15M31IHA NDϩNUϪNo lateral.Spiro.16M54IHAϩϩ1ϪND Eplerenone 17F31IHAϩϩ1ϪND Spiro.18M59IHAϩNU1ϪND Spiro.19M60IHAϩND1ϪNo lateral.Amiloride 20F54IHAϩND1ϪND Spiro.21M63IHAϩϩ1ϪND Spiro.22M72IHAϩϩ1ϪND Others23M52IHAϩND1ϪND Spiro.24M68IHAϩNU1ϪND Spiro.25M59IHAϩϩ1ϪNo lateral.Spiro.26F55IHAϩND1ϪND Spiro.27M65IHA NDϩ1ϪND Amiloride 28M26GSH h NDϩ2ϪND Dexa.,Spiro.a For details on test protocols,see Quinkler et al.(8)and Young(12).Only specific medications,which were used after confirmatory and differential diagnostic tests, were given.Most patients with IHA needed additional antihypertensive drugs.b Saline infusion test:ϩ,plasma aldosteroneϾ230pmol/L(Ͼ85ng/L)after2L of isotonic saline;ND,not done.c24-h Urinary aldosterone:ϩ,urinary aldosteroneϾ39nmol/day and urinary sodiumϾ200mmol/day;ND,not done;NU,not usable(urinary sodiumϽ200 mmol/day).d Posture test:2,decrease in plasma aldosterone;1,increase in plasma aldosterone;NU,not useable because of concomitant increase in serum cortisol.e CT,computed tomography;MRT,magnetic resonance tomography;Spiro.,spironolactone;GSH,glucocorticoid-suppressible hyperaldosteronism;Dexa., dexamethasone.f CT or MRT:ϩ,unilateral tumor;Ϫ,no tumor.g Adrenal vein sampling:lateral.,lateralization;ND,not done;NU,not usable because of unsuccessful catheterization.h Glucocorticoid-suppressible hyperaldosteronism was confirmed by genetic testing.1652Perschel et al.:Rapid Screening Test for PHAResultsevaluation of pac assay on nichols advantageThe intraassay imprecision (CV)at concentrations of 114,566,and 1906pmol/L was 8.2%,4.1%,and 4.4%,respec-tively.The interassay CV at 128,611,and 1956pmol/L was 20%,6.6%and 4.2%,respectively.The linearity on dilution was evaluated in two samples with concentrations of 525and 1141pmol/L.The mea-sured concentrations were 76–100%of the expected.Par-allelism in two samples of different concentrations was 89.5–118.3%.Calibration stability was evaluated with eight different calibrations.The CV was 3.0%for calibrator A (mean of 60127RLU)and 3.2%for calibrator B (mean of 23062RLU).The analytical sensitivity was 25pmol/L.clinical resultsAll methods tested (Fig.1and Table 2)differed signifi-cantly between PHA patients and healthy volunteers.Whereas single measurements of PAC,PRA,or PRC concentrations showed broad overlap between both groups,the ratios PAC/PRA and PAC/PRC provided distinct discrimination between these two groups.PRC and PRA showed good correlation [Pearson re-gression coefficient (r )ϭ0.72].Because the same PAC values served for calculation of the ratios,PAC/PRC and PAC/PRA correlated similarly (r ϭ0.73).As expected,differences occurred more frequently at the ends of lower renin concentration and activity ranges near the detection limits of both methods.ROC analysis (Table 3)showed the superiority of the ratios compared with PAC,PRA,and PRC alone.The PAC/PRC ratio performed at least as well as the PAC/PRA ratio for differentiating PHA patients from healthy volunteers.With respect to the requirements of a screen-ing test,we evaluated the cutoff values at a sensitivity of 100%(Tables 3and 4).DiscussionBecause PHA is a common cause of secondary hyperten-sion and its diagnosis can lead to cure or improvementofFig.1.PAC,PRA,PRC,and the resulting PAC/PRA and PAC/PRC ratios for 76healthy volunteers and 28patients with PHA.The data points for PAC,PRA,PRC,and the ratios are plotted logarithmically;᭛,healthy volunteers;F ,patients with PHA.Table 2.PAC,PRA,PRC,and the resulting PAC/PRA and PAC/PRC ratios for 76healthy volunteers and 28patientswith PAH.MethodUnitsMedian (range)Healthy volunteersPHA patientsPAC pmol/L182(33.3–1930)751(158–5012)PRA ng ⅐mL Ϫ1⅐h Ϫ1 4.64(1.13–19.7)0.57(0.40–1.70)PRCmU/L 27.8(5.70–116) 1.63(0.80–11.7)PAC/PRA(pmol/L)/(ng ⅐mL Ϫ1⅐h Ϫ1)46.9(4.35–494)1393(298–6756)PAC/PRC pmol/mU 6.24(0.69–71.0)388(105–2328)PAC ng/L 65.8(12.0–69.6)271(56.9–1806)PRA ng ⅐mL Ϫ1⅐h Ϫ1 4.64(1.13–19.7)0.57(0.40–1.70)PRC ng/L 16.7(3.42–69.4)0.98(0.48–7.02)PAC/PRA (ng/L)/(ng ⅐mL Ϫ1⅐h Ϫ1)16.9(1.57–178)502(107–2435)PAC/PRC ng/ng 3.75(0.41–42.6)233(63.2–1398)Clinical Chemistry 50,No.9,20041653hypertension(APA)or targeted pharmacotherapy(IHA), validated and cost-effective routine screening protocols need to be established.At present,the most common screening test is the ratio between serum or plasma aldosterone(PAC)and PRA. Because several authors have determined PAC/PRA cut-offs to screen for PHA(1–9),this procedure is widely accepted as the best validated screening protocol.How-ever,simultaneous measurement of PAC and PRA has some disadvantages:The method for measuring PRA requires cooling of the specimen during transport and storage,is time-consuming,and shows weak interlabora-tory reproducibility(10–12).Because aldosterone is usu-ally measured in serum,determination of the PAC/PRA ratio requires an additional,simultaneously drawn,blood tube.In addition,PAC,PRA,and the PAC/PRA ratio show large intra-and interpatient variations in patients with PHA(15);therefore,several authors have cast doubt on the validity and sensitivity of the PAC/PRA ratio (13–15).Alternative screening procedures that overcome these disadvantages seem to be necessary.Measurement of PRC instead of PRA may reduce some preanalytical and ana-lytical problems and,therefore,improve intra-and inter-laboratory reproducibility(23,24).Major advantages of the new PAC and PRC assays evaluated in our study include the ease and performance of the test(no cooling, a single plasma sample,and good interlaboratory repro-ducibility because the assays are automated)and the rapid availability of results(automated immunochemilu-minometric assays),which is a prerequisite for extensive screening of hypertensive patients for PHA.The performance of the new PAC assay was evaluated with a preliminary reagent lot.However,our results confirmed the assay specifications given by the manufac-turer.Because this is the first study with a fully automatedsystem and only two studies with manual PRC assays forscreening for PHA have been published to date(16,17),the comparison of our data with data from the literature islimited.Trenkel et al.(16)suggested a cutoff value of50(aldosterone measured in serum by RIA,expressed inng/L;PRC measured by IRMA,expressed in ng/L),which corresponds to83when using the units in Table2(PAC expressed in pmol/L,PRC in mU/L).Ferrari et al.(17)recommended a cutoff of150(aldosterone measuredin plasma by RIA,expressed in ng/L;PRC measured byIRMA,expressed in ng/L)corresponding to90whenusing the units in Table2.Our data analysis(Tables2and3;Fig.1)produced a tentatively proposed cutoff value of71.Subsequent studies including essential hypertensivecohorts may necessitate readjustment,although there isgood concordance with the recommendations made byTrenkel et al.(16)and Ferrari et al.(17).Although the simultaneous measurement of PAC/PRCin plasma samples from28patients with known PHAshowed no overlap with healthy volunteers(Fig.1),thereare certain limitations to our study:The PAC/PRC ratioseems to be superior to the PAC/PRA ratio.Althoughthe PAC/PRA ratio of our PHA patients in the initialoutpatient characterization was clearly above the cutoffvalue of555(pmol/L)/(ng⅐mLϪ1⅐hϪ1)[200(ng/L)/ (ng⅐mLϪ1⅐hϪ1)],the standardized reexamination of these patients by use of a second blood sample showedthat some patients would have failed this diagnosticcriterion.Our proposed cutoff value(Table3),which waschosen to achieve a100%sensitivity with the new auto-mated assay,was therefore somewhat lower than thevalues recommended in the literature.In addition,somepatients with confirmed PHA had PACs in the standard-ized reexamination that wereϽ414pmol/L(150ng/L)and therefore would also fail the second diagnostic crite-rion for positive screening of PHA.Because there is no doubt in the correct characteriza-tion of our patients as having PHA,we have two expla-nations for these findings:(a)a recent study by Tanabe etal.(15)has demonstrated high intraindividual variabilityof PAC,PRA,and the PAC/PRA ratio in patients withPHA;and(b)we measured plasma aldosterone with thenew immunochemiluminometric assay,these data showthat each PAC and PRC assay requires separate validationof cutoff values.Evaluating diagnostic tests in a group of patientsalready known to have the disease and in a group ofhealthy volunteers can lead to overestimation of diagnos-tic accuracy(25).Thus,our data necessarily need to becomplemented by further studies in hypertensive cohorts,e.g.,in groups of patients with essential hypertension andgroups with renovascular disease.The clinical conditions necessary for testing of thePAC/PRC or PAC/PRA ratios,such as discontinuingTable3.Calculated cutoff values and resulting specificity with respect to100%sensitivity to differentiate patients with PHA from healthy volunteers.Method Units Optimum valuefor cutoffSensitivity,%Specificity,%PAC pmol/L15510043.4 PRA ng⅐mLϪ1⅐hϪ1 1.710094.7 PRC mU/L 5.210089.5PAC/PRA ratio (pmol/L)/(ng⅐mLϪ1⅐hϪ1)18510098.7PAC/PRCratiopmol/mU71100100Table4.Proposed cutoff values for the PAC/PRC ratio with different units used in the literature.PAC unit PRC unitCutoff value for PAC/PRCpmol/L mU/L71pmol/L ng/L118ng/L mU/L26ng/L ng/L431654Perschel et al.:Rapid Screening Test for PHAdrug therapy,recording of dietary sodium intake,or time of day for sampling,are not yet sufficiently standardized, which contributes to the different published cutoff values and complicates the use of the screening test in clinical routine.An adequate standardization that meets general acceptance is required.In summary,our results suggest that the simultaneous measurement of PAC and PRC with automated immuno-chemiluminometric assays may be useful in screening for PHA.Nevertheless,subsequent studies are required for further comparison of the PAC/PRC ratio vs the PAC/ PRA ratio used for screening at present.These studies will have to deal with the following questions:(a)Because we tested only for the differentiation of patients from normo-tensive volunteers,has the PAC/PRC ratio similar sensi-tivities for screening of large hypertensive populations? Prospective studies are needed.(b)Is the newly devel-oped assay for PAC really a method that offers reliable results if performed by different laboratories in clinical routine?(c)How is the PAC/PRC ratio influenced by clinical conditions,especially drug effects?Regardless of the answers to these questions,we expect that the new ratio method will evolve as a rapid and easily performed screening test for PHA.We would like to acknowledge J.Wilde for statistical calculations and P.Exner,R.Go¨ber,K.Hanusa,and M. Schro¨dter for excellent technical assistance.References1.Fardella CE,Mosso L,Gomez-Sanchez C,Cortes P,Soto J,GomezL,et al.Primary hyperaldosteronism in essential hypertensives: prevalence,biochemical profile,and molecular biology.J Clin Endocrinol Metab2000;85:1863–7.2.Loh KC,Koay ES,Khaw MC,Emmanuel SC,Young WF Jr.Prevalence of primary aldosteronism among Asian hypertensive patients in Singapore.J Clin Endocrinol Metab2000;85:2854–9.3.Calhoun DA,Nishizaka MK,Zaman MA,Thakkar RB,WeissmannP.Hyperaldosteronism among black and white subjects with resistant hypertension.Hypertension2002;40:892–6.4.Mosso L,Carvajal C,Gonzalez A,Barraza A,Avila F,Montero J,etal.Primary aldosteronism and hypertensive disease.Hypertension 2003;42:161–5.5.Lim PO,MacDonald TM.Primary aldosteronism,diagnosed by thealdosterone to renin ratio,is a common cause of hypertension.Clin Endocrinol(Oxf)2003;59:427–30.6.Stowasser M,Gordon RD,Gunasekera TG,Cowley DC,Ward G,Archibald C,et al.High rate of detection of primary aldosteronism, including surgically treatable forms,after‘non-selective’screening of hypertensive patients.J Hypertens2003;21:2149–57.7.Young WF Jr.Minireview:primary aldosteronism-changing con-cepts in diagnosis and treatment.Endocrinology2003;144: 2208–13.8.Quinkler M,Lepenies J,Diederich S.Primary hyperaldosteronism.Exp Clin Endocrinol Diabetes2002;110:263–71.9.Montori VM,Young WF e of plasma aldosterone concentra-tion-to-plasma renin activity ratio as a screening test for primary aldosteronism.A systematic review of the literature.Endocrinol Metab Clin North Am2002;31:619–32.10.Oelkers W,Diederich S,Bahr V.Diagnosis and therapy surveil-lance in Addison’s disease:rapid adrenocorticotropin(ACTH)test and measurement of plasma ACTH,renin activity,and aldoste-rone.J Clin Endocrinol Metab1992;75:259–64.11.Oelkers W,Diederich S,Bahr V.Primary hyperaldosteronismwithout suppressed renin due to secondary hypertensive kidney damage.J Clin Endocrinol Metab2000;85:3266–70.12.Young WF Jr.Primary aldosteronism:management issues.AnnN Y Acad Sci2002;970:61–76.13.Montori VM,Schwartz GL,Chapman AB,Boerwinkle E,Turner ST.Validity of the aldosterone-renin ratio used to screen for primary aldosteronism.Mayo Clin Proc2001;76:877–82.14.Schwartz GL,Chapman AB,Boerwinkle E,Kisabeth RM,Turner ST.Screening for primary aldosteronism:implications of an increased plasma aldosterone/renin ratio.Clin Chem2002;48:1919–23.15.Tanabe A,Naruse M,Takagi S,Tsuchiya K,Imaki T,Takano K.Variability in the renin/aldosterone profile under random and standardized sampling conditions in primary aldosteronism.J Clin Endocrinol Metab2003;88:2489–94.16.Trenkel S,Seifarth C,Schobel H,Hahn EG,Hensen J.Ratio ofserum aldosterone to plasma renin concentration in essential hypertension and primary aldosteronism.Exp Clin Endocrinol Diabetes2002;110:80–5.17.Ferrari P,Shaw SG,Nicod J,Saner E,Nussberger J.Active reninversus plasma renin activity to define aldosterone-to-renin ratio for primary aldosteronism.J Hypertens2004;22:377–81.18.De Bruin RA,Bouhuizen A,Diederich S,Perschel FH,Boomsma F,Deinum J.Validation of a new rapid renin assay.Clin Chem;in press.19.Simon D,Hartmann DJ,Badouaille G,Caillot G,Guyenne TT,Corvol P,et al.Two-site direct immunoassay specific for active renin.Clin Chem1992;38:1959–62.20.Gallay BJ,Ahmad S,Xu L,Toivola B,Davidson RC.Screening forprimary aldosteronism without discontinuing hypertensive medi-cations:plasma aldosterone-renin ratio.Am J Kidney Dis2001;37:699–705.21.Seifarth C,Trenkel S,Schobel H,Hahn EG,Hensen J.Influence ofantihypertensive medication on aldosterone and renin concentra-tion in the differential diagnosis of essential hypertension and primary aldosteronism.Clin Endocrinol(Oxf)2002;57:457–65.22.Mulatero P,Rabbia F,Milan A,Paglieri C,Morello F,Chiandussi L,et al.Drug effects on aldosterone/plasma renin activity ratio in primary aldosteronism.Hypertension2002;40:897–902.23.Cartledge S,Lawson N.Aldosterone and renin measurements.Ann Clin Biochem2000;37:262–78.24.Morganti A,Pelizzola D,Mantero F,Gazzano G,Opocher G,Piffanelli A,on behalf of the Italian Multicenter Study for Standard-ization of Renin Measurement.Immunoradiometric versus enzy-matic renin assay:results of the Italian Multicenter Comparative Study.J Hypertens1995;13:19–26.25.Lijmer JG,Mol BW,Heisterkamp S,Bonsel GJ,Prins MH,van derMeulen JHP,et al.Empirical evidence of design-related bias in studies of diagnostic tests.JAMA1999;282:1061–6.Clinical Chemistry50,No.9,20041655。
2014年职称英语等级考试理工类A级(第二套)
2014年职称英语等级考试理工类A级模拟试卷（二）第一部分：词汇选择（第1-15题，每题1分，共15分）下面共有15句子，每个句子均有一个词或短语划有底横线，请从每个句子后面所给的四个选项中选择一个与划线部分意义最相近的词或短语。
答案一律涂在答题卡相应的位置上。
1. During the past ten years there have been dramatic changes in the international situation.A) permanent B) powerfulC) striking D) practical2. The substance can be added to gasoline to accelerate the speed of automobiles.A) quicken B)shortenC) loosen D) enlarge3. We should never content ourselves with a little knowledge only.A) convince B)satisfyC) comfort D) benefit4. We should contemplated the problem from all sides.A) deliberated B)thoughtC) described D) designed5. His health had deteriorated while he was in prison.A) became better B)became worseC) became stronger D) became weaker6. If you want my advice, you should revise your plan for the trip to Beijing.A) change B)exchangeC) enlarge D) encourage7. Smoking is inhibited in public places.A) instructed B)inquiredC) forbidden D) strived8. Are you positive that there’s been no mistake?A) rational B)reasonableC) certain D) bound9. Do you believe these two intimate friends used to be enemies?A) bearable B) internalC) close D) believable10. Contact your doctor if the cough persists.A) insists B) variesC) resists D) continue11. I gave a concise answer about this.A）short B) clearC) touching D) detailed12. He had gone insane.A) clever B) diligentC) mad D) sincere13. He was ingenious enough to overcome the limited budgetA) kind B) activeC) original D) industrious14．He was advised to terminate the contract.A）end B) determineC) resume D) suspend15．Some scientists are working hard at how tide can be harnessed to produce electricity.A）convert B) storeC) use D) receive第二部分：阅读判断（每题1分，共七分）阅读下面这篇短文，短文后列出了七个句子，请根据短文的内容对每个句子作出判断。
职称英语综合类A级-49_真题无答案
职称英语综合类A级-49(总分100, 做题时间90分钟)第1部分：词汇选项下面每个句子中均有1个词或短语画有底横线，请为每处画线部分确定1个意义最为接近的选项。
1.These are their motives for doing it.• A. reasons• B. excuses• C. answers• D. plansSSS_SIMPLE_SINA B C D2.It's an advisable idea to get out of the dispute.• A. wise• B. urgent• C. useless• D. properSSS_SIMPLE_SINA B C D3.Take vigorous exercise for several hours a week.• A. energetic• B. physical• C. regular• D. freeSSS_SIMPLE_SINA B C D4.The river widens considerably as it begins to turn west.• A. twists• B. stretches• C. broadens• D. bendsSSS_SIMPLE_SINA B C D5.Everybody is aware of the hazards of smoking.• A. evidence• B. danger• C. case• D. pictureSSS_SIMPLE_SINA B C D6.This text is too difficult to comprehend.• A. understand• B. digest• C. summarize• D. readSSS_SIMPLE_SINA B C D7.Henry cannot resist the lure of drugs.• A. abuse• B. flavor• C. temptation• D. consumptionSSS_SIMPLE_SINA B C D8.His department will merge with mine.• A. combine• B. sell• C. close• D. breakSSS_SIMPLE_SINA B C D9.The benefits are immense.• A. immediate• B. great• C. equal• D. moderateSSS_SIMPLE_SINA B C D10.But decent, affordable accommodation for new city residents is thin on the ground.• A. private• B. general• C. good• D. specialSSS_SIMPLE_SINA B C D11.The room was furnished with the simplest essentials, a bed, a chair, and a table.• A. supplied• B. gathered• C. grasped• D. madeSSS_SIMPLE_SINA B C D12.These programmes are of enormous value to old people.• A. natural• B. fatal• C. tiny• D. immenseSSS_SIMPLE_SINA B C D13.He emphasized a feasible plan which can be accepted by the both sides.• A. favorable• B. possible• C. formal• D. genuineSSS_SIMPLE_SINA B C D14.When does the next train depart?• A. pull up• B. pull down• C. pull out• D. pull inSSS_SIMPLE_SINA B C D15.•Because administering the **pany, he sometimes has to work around the clock.A. adjusting• B. evaluating• C. engaging• D. managingSSS_SIMPLE_SINA B C D第2部分：阅读判断FoodIrradiating fruits, vegetables, pork and chicken to kill insects and bacteria has been approved by the Food and Drug Administration over the past decade or so. Irradiation of other meats, such as beef and lamb, is being reviewed. Federal approval does not require that industry adopt the process, and few food processors presently offer irradiated products.Market studies have shown that many consumers are afraid that eating irradiated foods may cause cancer, despite scientific studies that prove the safety of treated foods. Some people argue that more severe government inspection, higher food safety standards, and more careful-preparation practices by consumers are all that is needed to ensure that food is safe. Consequently, companies currently see no need to spend millions of dollars outfitting processing plants with the equipment necessary for a process that very few shoppers are in favor of.All supermarkets that sell irradiated food must label the food either directly on the packaging, or, in the case of bulk items like fruits and vegetables, by placing a sign nearby. There is no requirement for the labeling of irradiated food served by chain restaurants or hospitals that buy directly from distributors, nor any regulations for products that contain irradiated ingredients.Presently, the FDA allows food to be treated with three types of radiation—gamma rays, high-energy electrons, and X rays—and sets limits on doses, depending on the type of food. The principle is that the dose to be used for a certain type of food should not exceed the amount that is sufficient to kill most harmful insects and bacteria present in it. Different types of food, because of their **positions, may require different doses of radiation.SSS_SIMPLE_SIN16.•According to the passage, killing insects and bacteria present in foods by irradiating is **pletely approved by the USgovernment.A. Right• B. Wrong• C. Not mentionedA B C DSSS_SIMPLE_SIN17.There are quite a number of food processors which are interested in producing irritated foods.• A. Right• B. Wrong• C. Not mentionedSSS_SIMPLE_SIN18.Some consumers are doubtful of the safety of irradiated foods and suggest a more severe government inspection be taken.• A. Right• B. Wrong• C. Not mentionedA B C DSSS_SIMPLE_SIN19.•**panies foresee the promising future of setting up food processing factories, although they do not see the need now.A. Right• B. Wrong• C. Not mentionedA B C DSSS_SIMPLE_SIN20.It is required that labels placed on irradiated food or nearby bulk items such as vegetables and fruits should indicate irradiated ingredients.• A. Right• B. Wrong• C. Not mentionedA B C DSSS_SIMPLE_SIN21.Restaurants can serve irradiated food bought directly from distributors without labeling it.• A. Right• B. Wrong• C. Not mentionedSSS_SIMPLE_SIN22.The passage tells us that FDA approves irradiating food to some extent but irradiated food is not widely accepted.• A. Right• B. Wrong• C. Not mentionedA B C D第3部分：概括大意与完成句子The Magic Io Personal Digital Pen1. Check out the io Personal Digital Pen launched by Logitech: It's a magic pen that can store everything you write and transfer it to **puter. And you don't have to lug a hand held device along with you for it to work.2. Logitech's technology works like this: The pen writes normally, using normal ballpoint pen ink. But while you are writing, a tiny camera inside the pen is also taking 100 snapshots per second of what you are doing, mapping your writing via a patchwork of minute dots printed on the paper. All this information—the movement of your pen on the paper, basically—is then stored digitally inside the pen, whether you are writing notes or **plex diagrams. You can store up to 40 pages worth of doodles in the pen's memory. As far as you are concerned, you are just using a normal pen.3. It is only when you drop the pen into its PC-connected cradle that the fun begins. Special software on your PC will figure out what you have done, and begin to download any documents you have written since the last time it was there. Depending on whether you have ticked certain boxes on the special notepad, it can also tell whether the document is destined to be an e-mail, a "to do" task, or a diagram to be inserted into a word processing document. Once the documents are downloaded you can view them, print them out or convert them to other formats.4. The io Personal Digital Pen is a neat and simple solution to the problem of storing, sharing and retrieving handwritten notes, as well as for handling diagrams, pictures and other non-text doodling. You don't have to carry a laptop along with you. All you have to do is just whip out the pen and the special paper and you are off.5. It is a great product because it does not force you to work differently—walking around with a screen strapped to your arm, orcarrying with you extra bits and pieces. The pen is light and works like a normal pen if you need it to, while the special notepads look and feel like notepads. The only strange looks will be from people who are curious why you are writing with a cigar.6. The io Personal Digital Pen also has potential elsewhere. FedEx, for example, is introducing a version of the pen so that customers can fill out forms by hand—instead of punching lettersinto cumbersome devices. Once that data is digital more or less anything can be done with it—transferring it wirelessly to a**puter, for example, or via a hand phone. Doctors could transmit their prescriptions directly to pharmacies, reducing fraud: policemen could send their reports back to the station, reducing paperwork.A. Friendly and Convenient DeviceB. Ways to Download the Stored InformationC. Examples of Other Potential Applications of the Io PenD. Customers' Passion for the Io PenE. FedEx the First User of the Io PenF. Working Principle of the Io Personal Digital PenSSS_FILL23.Paragraph 2 ______SSS_FILL24.Paragraph 3 ______SSS_FILL25.Paragraph 5 ______SSS_FILL26.Paragraph 6 ______SSS_FILL27.There is no need to learn how to use the io Personal Digital Pen because ______.A. you don't have to carry your laptop alongB. the information will be shown digitally on the penC. FedEx has special software to store your informationD. it works like an ordinary penE. you simply place the pen into **puter connected cradleF. the movement of your pen is recorded digitally inside the penSSS_FILL28.If you want to download what you have done with the magic pen,______.SSS_FILL29.The magic pen is particularly convenient when you work away from home or office because ______.SSS_FILL30.No matter what you write or draw, ______.第4部分：阅读理解下面有3篇短文，每篇短文后有5道题。
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Screen Test
透视检查
1.Every year millions of women are screened with X-rays to pick up signs of breast cancer. 每
年上百万的女性都做X射线透视，检查是否有乳腺癌迹象。
If this happens early enough, the disease疾病 can often be treated 治疗successfully.
如果检查得足够早，疾病就可以被成功地治疗。
According to a survey （调查）published last year, 21 countries have screening programmes.
根据去年公布的一项调查，21个国家有透视计划。
Nine of them, including Australia, Canada, the US and Spain, screen women under 50.
其中9个国家，包括澳大利亚、加拿大、美国和西班牙为50岁以下女性进行透视。
2.But the medical benefits of screening these younger women are controversial（有争议的）,
但是，用X射线检查年轻女性，就医学上的好处而论，是有争议的，
partly because the radiation（辐射） brings a small risk of inducing cancer.
部分原因是辐射有诱发癌症的小小的危险。
Also, younger women must be given higher doses of X-rays because their breast tissue（组织） is denser.
另外，年轻女人乳房组织紧密，给予的X射线的剂量要多一些。
3.Researchers at the Polytechnic University1 of Valencia analysed the effect of screening more t
han 160,000 women at 11 local clinics.
理工大学的研究人员分析了11个社区诊所用X射线检查16万以上女性的结果。
After estimating the women’s cumulative dose of radiation, they used two models to calculate the number of extra cancers this would cause. Valencia估测了女性的辐射累积剂量之后，他们用两种模型计算由此导致额外癌症数量。
4. The mathematical model recommended by Britain’s National Radiological Protection Board (N RPB) predicted that the screening programme would cause 36 cancers per 100,000 women, 18 of t hem fatal. The model preferred by the UN Scientific Committee on the Effects of Atomic Radiatio n led to a lower figure of 20 cancers. 英国国家辐射保护委员会推荐的数学模型预言，透视计划会导致每10万个女性中有36人患上癌症，18人致死。
联合国原子辐射影响科学委员会首选的模型得出了一个较低的数字-20人患上癌症。
5. The researchers argue that the level of radiation-induced cancers is “not very significant” compa red to the far larger number of cancers that are discovered and treated. 研究人员争辩说，与发现后接受治疗的癌症数字相比，由辐射诱发癌症的数字是很小的。
The Valencia programme, they say, detects between 300 and 450 cases of breast cancer in every 1 00,000 women screened.他们说，Valencia计划在每10万接受透视的妇女中发现300到450个乳腺癌病例。
6. But they point out that the risk of women contracting cancer from radiation could be reduced by between 40 and 80 percent if screening began at 50 instead of 45, because they would be exposed to less radiation. 但是他们指出如果X射线检查从50岁而不是45岁时开始，会使妇女由于辐射而患癌的危险减少40%到80%，因为她们可以接受更少的辐射。
The results of their study, they suggest, could help “optimiz e the technique” for breast cancer scre ening.他们暗示说，他们研究的结果有助于使乳腺癌透视的技术更加完善。
7. “There is a trade-off（平衡） between the diagnostic（诊断的，判断的） benefits of breast screening and its risks,” admits Michael Clark of the NRPB. 英国国家辐射保护委员会的Michael Clark承认“在胸透的诊断益处和危险之间有一个平衡”。
But he warns that the study should be interpreted with caution. 但是他警告说应该谨慎地解释此项研究。
“On the basis of the current （目前的）data, for every 10 cancers successfully detected and prevented there is a risk of causing one later i n life. “基于目前的数据，每成功地发现10例癌症就有可能导致今后出现一例癌症。
That’s why radiation exposure should be minimized in any screening programme.”这就是为什么在所有的透视计划中，辐射应该减少到最小的原因。
”。