chapter8 chisquare-test规培2015

第一部分计量资料的统计描述一、最佳选择题1、描述一组偏态分布资料的变异度，以（）指标较好。

A、全距B、标准差C、变异系数D、四分位数间距E、方差2．用均数和标准差可以全面描述（）资料的特征。

A．正偏态分布B．负偏态分布C．正态分布D．对称分布E．对数正态分布3．各观察值均加（或减）同一数后（）。

A．均数不变，标准差改变B．均数改变，标准差不变C．两者均不变D．两者均改变E．以上都不对4．比较身高和体重两组数据变异度大小宜采用（）。

A．变异系数B．方差C．极差D．标准差E．四分位数间距5．偏态分布宜用（）描述其分布的集中趋势。

A．算术均数B．标准差C．中位数D．四分位数间距E．方差6．各观察值同乘以一个不等于0的常数后，（）不变。

A．算术均数B．标准差C．几何均数D．中位数E．变异系数7．（）分布的资料，均数等于中位数。

A．对数正态B．正偏态C．负偏态D．偏态E．正态8．对数正态分布是一种（）分布。

（说明：设X变量经Y=lgX变换后服从正态分布，问X变量属何种分布？）A．正态B．近似正态C．左偏态D．右偏态E．对称9．最小组段无下限或最大组段无上限的频数分布资料，可用（）描述其集中趋势。

A．均数B．标准差C．中位数D．四分位数间距E．几何均数10．血清学滴度资料最常用来表示其平均水平的指标是（）。

A．算术平均数B．中位数C．几何均数D．变异系数E．标准差二、简答题1、对于一组近似正态分布的资料，除样本含量n外，还可计算，S和，问各说明什么？2、试述正态分布、标准正态分布及对数正态分布的某单位1999年正常成年女子血清联系和区别。

甘油三酯(mmol/L)测量结果3、说明频数分布表的用途。

4、变异系数的用途是什么？组段频数5、试述正态分布的面积分布规律。

0.6~ 10.7~ 3三、计算分析题0.8~ 91、根据1999年某地某单位的体检资料，116名正常0.9~ 13成年女子的血清甘油三酯（mmol/L）测量结果如右表， 1.0~ 19请据此资料： 1.1~ 25（1）描述集中趋势应选择何指标？并计算之。

整形外科练习姓名：秦毅得分：0.00 总分：100 及格分：60 考试时间：2016-一 . 单选题（共90题，每题1分）1 ．直肠长度为A . 5～10cmB . 12～15cmC . 16～20cmD . 21～25cmE . 26～30cm2 ． A 28-year-old previously healthy woman arrives in the emergency roomcomplaining of 24h of anorexia and nausea and lower abdominal pain that is more intensein the right lower quadrant than elsewherE.On examination she has peritoneal signs of theright lower quadrant and a rectal temperature of 38.38℃（101.8。

F）.At explorationthrough incision of the right lower quadrant，she is found tO have a small，containedperforation of a cecal diverticulum.Which of the following statements regarding thissituation is true？A . Cecal diverticula are acquired disordersB . Cecal diverticula are usually multipleC . Cecal diverticula are mucosal herniations through the muscularis proprlaD . Diverticulectomy，closure of the cecal defect，and appeildectorrly nlay be indicatedE . An ileocolectomy is indicated evell with well-localized inflammation3 ．胆总管直径的正常值为A . 6～8mmB . 10～12mmC . 13～14mmD . 15～16mmE . 17～18mm4 ．胃的区域淋巴结分为A . 3站16组B . 2站16组C . 3站14组D . 2站14组E . 3站10组5 ．跌倒，手掌撑地，肩外展外旋，出现肩痛，肿胀，活动受限，查体：Dugas征阳性。

住院医师规化培训英语试题：成绩第1部分：词汇选项（第1-15题，每题1分，共15分）下面每个句子中均有1个词或短语划有底横线，请为每处划线部分确定1个意义最为接近的选项。

1 For some obscure reason, the simple game is becoming very popular.A unclearB obviousC majorD minor2 The sea turtle's natural habitat has been considerably reduced.A greatlyB suddenlyC generallyD slightly3 I got a note from Moira urging me to get in touch.A instructingB notifyingC pushingD inviting4 It is possible to approach the problem in a different way.A raiseB poseC experienceD handle5 The decision to invade provoked storms of protest.A ignoredB organizedC causedD received6 Jane said that she couldn't tolerate the long hours.A spendB takeC lastD stand7 At 80, Peck was still vigorous and living in Paris.A energeticB happyC aloneD busy8 Forester stared at his car, trembling with rage.A shakingB turningC jumpingD shouting9 A young man is being hailed a hero tonight after rescuing two children.A reportedB provedC praisedD caught10 I wanted to ask her out but was scared that she might refuse.A anxiousB sureC sadD afraid11 At that time, we did not fully grasp the significance of what had happened.A giveB attachC loseD understand12 Anderson left the table, remarking that he had some work to do.A doubtingB sayingC thinkingD knowing13 He asserted that nuclear power was a safe and non-polluting energy source.A maintainedB recommendedC consideredD acknowledged14 The study also notes a steady decline in the number of college students taking science courses.A relativeB generalC continuousD sharp15 She always finds fault with everything.A criticizesB simplifiesC evaluatesD examines第2部分：阅读判断(第16～22题，每题1分，共7分)下面的短文后列出了7个句子，请根据短文的容对每个句子做出判断：如果该句提供的是正确信息，请选择A；如果该句提供的是错误信息，请选择B；如果该句的信息文中没有提及，请选择C。

中华医学教育探索杂志2021年2月第20卷第2期Chin J Med Edu Res, Fehmary 2021，Vol. 20, No. 2• 205 ••住院医师规范化培训•M ini-CEX量表在儿科住院医师临床能力评价中的应用王晴晴朴梅花韩彤妍北京大学第三医院儿科 100191通信作者:韩形奸,Email:tongyanhan@【摘要】目的探讨Mini-C E X量表在儿科临床实践中的可行性及应用效果。

方法对2016年3月至2017年9月在北京大学第三医院儿科进行北京市住院医师规范化培训的住院医师，在每季度出科考核中应用Mini-C EX结构式表格评估其临床能力，评估其作为培训指导和考核方式的效果。

采用SPSS25.0软件进行t检验。

结果共在7次出科考核中引人Mini-C E X量表，共有36名住院医师参与测评，完成量表110份。

与2016年度相比，2017年度的Mini-C E X量表在问诊技巧[(7.4 ±0.9) vs.(7.7 ±0.7)]、体格检查[(7.5 ± 1.1) vs.C7.6± 0.9)]、临床判断[(7.5 ±0.9) vs. (7.6 ±0.9)]、组织效能[(7.4 士0.9) vs.f7.7± 0.9)]、整体临床胜任力[(7.5 ±0.9) vs. (7.7 ±0.9)]方面均有不同程度的提高，但差异无统计学意义(P>〇.〇5)。

共有17人完成3次及以上的评估，与2016年度相比，2017年度Mini-C E X量表平均分在问诊技巧、组织效能、整体临床胜任力方面有显著提高。

结论Mini-C E X量表简便易行，可能对儿科住院医师临床能力的提高有一定的帮助，可以作为对儿科住院医师临床能力进行评估的测评方法。

【关键词】Mini-CEX;住院医师规范化培训；儿科；临床能力【中图分类号】R-05DOI: 10.3760/l16021-20200130-00405Application of Mini-CEX in the clinical performance evaluation of residents in pediatricsdepartmentWang Qingqing, Piao Meihua, Han TongyanDepartment o f Pediatrics, Peking University Third Hospital, Beijing 100191, ChinaCorresponding author: Han Tongyan, Email:*****************【Abstract】Objective To explore the feasibility and application effect of Mini-CEX in pediatricclinical practice. Methods Residents who received standardized residency training in pediatrics departm entof Peking University Third Hospital from March 2016 to Septem ber 2017 were selected as researchobjects. The clinical ability of the residents were evaluated by application of the Mini-CEX structured form.Its effectiveness as a training guide and assessment method was also evaluated. SPSS 25.0 was used for ttest. Results The Mini-CEX scale was refined according to the characteristics of pediatrics. In this study,a total of 36 residents participated in the evaluation and 110 cases were com pleted by introducing Mini-CEX structured form in 7 examinations. Compared with 2016, the Mini-CEX scores of the residents in the2017 showed different degrees of improvement in information gathering [(7.4 土 0.9) vs. (7.7 ±0.7)]，clinicalexamination [(7.5 ± 1.1) vs. (7.6±0.9)】，clinical judgm ent [(7.5 ±0.9)vs. (7.6±0.9)]，organizationaleffectiveness [(7.4 ± 0.9) vs. (7.7 ± 0.9)]，and overall clinical competency [(7.5 ± 0.9) vs. (7.7 ± 0.9)]，withoutsignificant differences (P>0.05). A total of 17 residents com pleted the assessm ents more than or equal to 3times. Compared with 2016, the mean scores of the 17 individuals' Mini-CEX scales in 2017 were significantlyimproved in term s of information gathering, organizational effectiveness, and overall clinical competency.Conclusion The results have shown that the Mini-CEX scale is sim ple and easy to operate, it m aybe helpfulto improve the clinical ability of pediatric residents, and it can be used as a method to evaluate the clinicalability of pediatric residents.【Key words】Mini-CEX;Standardized residency training;Pediatrics;Clinical abilityDOI: 10.3760/l16021-20200130-00405• 206 •中华医学教育探索杂志2021年2月第20卷第2期Chin J Med Edu Res, February 2021，Vol. 20, No. 2目前，临床上采用的评估工具有Mini 临床评估 演练（mini-clinical evaluation exercise ,Mini -CEX )、操 作技能直接观察评估(direct observation of procedural skills，DOPS )、以病例为基础的讨论（case based discussion ，CBD )、多兀反馈（multi-source feedback , MSF )等M 。

南方医院规培英语考试题库1. The old____ treated badly in some countries. [单选题] *isare(正确答案)has beenwas2. The secretary and driver___ very busy now. [单选题] *is(正确答案)arewaswere3. Both the secretary and manager___ agreed to cancel the meeting [单选题] * hashave(正确答案)arewas4. Tom as well as his two friends___invited to the party [单选题] *was(正确答案)werehad5. Either you or I___going to the manager's office after work [单选题] *am(正确答案)isarewill6. Most of the old lady's time___ spent in watching TV and sleeping. [单选题] * arewerewas(正确答案)have been7. This is one of the best product s that___sold this year. [单选题] *have been(正确答案)hashad beenhave8. Five thousand dollars___quite a large sum of him. [单选题] *areis(正确答案)were9. About 80 percent of the work___ done yesterday [单选题] *areiswerewas(正确答案)10. Mr.Smith together with his children___ just arrived [单选题] *arehas(正确答案)ishave11. ___that they found a new way to deliver cargo [单选题] *It was said(正确答案)They are saidIt saidIt says12. Beijing has taken on a new look before the olympic games. It isn't like___ it used to be. [单选题] *howwhat(正确答案)that13. ___is no possibility___ Tom will win the first prize in the swimming match. [单选题] *There;that(正确答案)It;thatThere;whetherIt;whether14. Have you seen Rebecca recently? Her client wants to know___ [单选题] *what is she getting alonghow is she getting alongwhat she is getting alonghow she is getting along(正确答案)15. ___surpised me most was___such a little girl of seven could play the violin so well [单选题] *That;whatWhat;that(正确答案)That;thatWhat;what16. It was ordered that all the staff___to the workshop [单选题] *should sendmust be sentshould be sent(正确答案)must go17. We are all for your proposal that the discussion___ [单选题] *be put off(正确答案)was put offshould put offis to put off18. Helen hopes to become a friend of___purchases her products [单选题] *anyonewhomeverwhoever(正确答案)no matter who19. Recently Mary bought an ancient Chinese vase,____was very reasonable [单选题] * which pricethe price of which(正确答案)its pricethe price whose of20. The tourist asked me to take his picture in the square___stood the famous tower. [单选题] *thatwhere(正确答案)whichthere21. The boss___department Mrs.Susan worked ten years ago looks down upon women [单选题] *in whichin thatin whose(正确答案)whose22. I don't like___you speak to your manage [单选题] *the way(正确答案)/the way whichthe way of which23. He made another wonderful discovery,___of great importance to science [单选题] *which I think is(正确答案)which I think it iswhich I think itI think which is24. He was very rude to the customer office,___of course made things even worse [单选题] *whowhatwhich(正确答案)25. There were dirty marks on Jim's uniform___he had wiped his hands [单选题] * where(正确答案)whichwhenthat26. She works in a business___almost everyone is waiting to be promoted [单选题] * howwhichwhere(正确答案)that27. The police asked the children___cross the street___the traffic lights turned green [单选题] *not;beforedon't;whennot to;until(正确答案)not;after28. I was late for class yesterday___there was something wrong with my bike [单选题] * whenuntilbecause(正确答案)29. I'll go swimming with you if I___free tomorrow [单选题] *will beshall beam(正确答案)was30. In the exam,the___you are,the___mistakes you will make [单选题] * careful;littlemore careful;fewestmore careful;fewer(正确答案)more careful;less31. You should finish your lesson___you go out to play [单选题] * before(正确答案)afterwhenwhile32. I hurried___I wasn't late for class [单选题] *sinceso that(正确答案)unless33. When you read the book,you'd better make a mark___you have any questions [单选题] *whichthatwhere(正确答案)though34. The teacher raised his voice___all the students could hear him [单选题] *forso thatbecausein order that(正确答案)35. He took off his coat___he felt hot [单选题] *because ofas toifsince(正确答案)36. It is___that we'd like to go out for a walk [单选题] *a lovely daytoo lovely a dayso lovely a day(正确答案)such lovely a day37. My brother is busy___for his first job interview [单选题] *preparing(正确答案)to preparepreparedprepares38. When he was decorating his house,he got the bedroom___first [单选题] *to paintpaintingpainted(正确答案)be painted39. The secretary worked late into the night,___a long speech for the president [单选题] *to preparepreparing(正确答案)praparedwas preparing40. There was nothing he could do___ [单选题] *to wantonly to wantexcept waitingbut wait(正确答案)41. A secretary's job isn't always easy___ [单选题] *of to dofor doingof doingto do(正确答案)42. The robber was brought in,with his hands___behind his back [单选题] *being tiedhaving tiedto be tiedtied(正确答案)43. I am going to the passport office___ [单选题] *to stamp my passportto have my passport stamped(正确答案)to have stamped my passportfor stamping my passport44. The visiting director expressed his satisfaction with the products,___that he had enjoyed his stay here [单选题] *having addedto addadding(正确答案)added45. The missing boys were last seen ___near the bank [单选题] *playing(正确答案)to be playingplayto play46. The manager ordered the work ___ [单选题] *be started at onceto be started at once(正确答案)to start at onceat once started47. I am not angry with him,_____jokes he___on me（不管他跟我开什么玩笑） [填空题] *_________________________________(答案：no matter what;plays)48. Mrs.Bruce was so kind to her students___they___her___their mother（以至于学生把我当成母亲） [填空题] *_________________________________(答案：that;regarded;as)49. Our parents will be pleased with our performance___（只要我们竭尽全力） [填空题] *_________________________________(答案：so long as we try our best)50. Will you please call me___（你一到上海）？ [填空题] *_________________________________(答案：as soon as you get to Shanghai) 51. None of us knew what had happened___（直到他们告诉我们） [填空题] *_________________________________(答案：until they told us)52. ____（虽然她很忙),she kept on learning English by herself [填空题] *_________________________________(答案：Although the was very busy) 53. He wants to be a journalist____（长大后） [填空题] *_________________________________(答案：after be grows up)54. ___（无论）whether it is windy or rainy,our teacher is always the first to get to school [填空题] *_________________________________(答案：No matter)55. ___（如果人人）protects the environment,the world will become much more beautiful [填空题] *_________________________________(答案：If everyone)56. Li Ming didn't come to school___（因为他病了） [填空题] *_________________________________(答案：because he was ill)。

1、下列哪种说法是错误的（） *• A.计算相对数尤其是率时应有足够数量的观察单位数或观察次数• B.分析大样本数据时可以构成代替率• C.应分别将分子和分母合计求合计率或平均率• D.相对数的比较应注意其可比性2、多样本定量资料比较，当分布类型不清时应选择（） *• A.方差分析• B.检验• C.Z检验• D.Kruskal-Wallis检验3、两样本均数的比较，P<0.01,可认为两总体均数（） *• A.差别非常大• B.有差别• C.无差别• D.差别较大4、两样本均数比较时，能用来说明两组总体均数间差别大小的是（） *• A.t值• B.P值• C.F值• D.两总体均数之差的95%置信区间5、设配对设计资料的变量为X1与X2，则配对设计的符号的秩检验（） *• A.把X1与X2的差数军队之从小到大编秩，排好后秩次保持原差数的正负号• B.把X1与X2的差数绝对值从小到大编秩，秩次不保存正负号• C.把X1与X2综合按绝对值从小到大编秩• D.把X1与X2的差数从小到大编秩6、欲比较两地的钩虫感染率，今调查了甲、乙两乡居民的钩虫感染率，但甲乡人口女多于男，而乙乡男多于女。

适当的比较方法是（） *• A.分性别进行比较• B.两个率比较的u检验• C.不具可比性• D.对性别进行标准化后再比较7、配对设计的目的是() *• A.操作方便• B.为了应用t检验• C.提高组间可比性• D.减少实验误差8、完全随机设计多个样本均麩比较的方差分析，当p≤0.05，可认为（） *• A.各样本均数不等或不全相等• B.各样本方差不等或不全相等• C.各总体均数不等或不全相等• D.各总体方差不等或不全相等9、调查1000名女性乳腺癌患者，发现50名为孕妇，据此可推断（） *• A.孕妇易患乳腺癌• B.孕妇不易患乳腺癌• C.该组乳腺癌患者中5.0%是孕妇• D.妊娠可诱发乳腺癌10、多个样本均数间两两比较时，若用t检验，则出现（） *• A.结果与q检验相同• B.结果比q检验更合理• C.可能出现假阴性的结果• D.可能出现假阳性的结果11、随机区组设计方差分析中，SS误差等于（） *• A.SS总-SS处理+SS区组• B.SS总-SS处理-SS区组• C.SS总-SS处理• D.SS总-SS区组12、常用的变量变换的方法有（） *• A.对数变换• B.平方根变换• C.平方根反正弦变换• D.倒数变换13、定量资料两样本均数的比较，可采用（） *• A.t检验• B.F检验• C.Bonferroni检验• D.t检验与F检验均可14、配对计量资料进行假设检验时（） *• A.仅能用配对t检验• B.仅能用成组t检验• C.仅能用随机区组设计的方差分析• D.用配比t检验和随机区组设计的方差分析均可15、关于假设检验，下列说法正确的是（） *• A.单侧检验优于双侧检验• B.采用配对t检验还是成组t检验有实验设计方法决定• C..检验结果若P值大于0.05，则接受H0犯错误的可能性较小• D.用u（Z）检验进行两样本总体均数比较时，要求方差齐性16、完全随机设计方差分析中，总变异等于（） *• A.SS组间+SS组内• B.SS组间-SS组内• C.MS组间+MS组内• D.MS组间-MS组内17、描述分类资料的主要统计指标是（） *• A.平均数• B.相对数• C.变异系数• D.相关系数18、两样本均属比较，经t检验，差别有统计学意义时，P值越小，说明（） *• A.两样本均数差别越大• B.两总体均数差别越大• C.越有理由认为两总体均数不同• D.越有理由认为两样本均数不同19、各组数据方差不齐时，可以做（） *• A.近似检验• B.秩和检验• C.数据转换• D.ABC均可20、两小样本均数比较，方差不齐时，下列说法不正确的是（） *• A.采用秩和检验• B.采用t′检验• C.仍用t检验• D.变量变换后再作决定21、针对食管癌的某大型调查，获得了几十万分资料，所选的危险因素有200余个，现对资料做初步分析，筛选出一部分危险因素，为进一步的统计分析做准备，宜采用（） *• A.Logistic回归• B.多元线性回归• C.方差分析• D.非参数检验22、两组数据中的每个变量值减去同一常数后做两个样本均数差异的t检验（） *• A.t值变小• B.t值变大• C.t值不变• D.t值变小或变大23、第I类错误的概念是（） *• A.H0是不对的，统计检验结果未拒绝H0• B.H0是对的，统计检验的结果未拒绝H0• C.H0是不对的，统计检验结果拒绝H0• D.H0是对的，统计检验结果拒绝H024、反应疾病发生频度的指标是（） *• A.患病率和发病率• B.患病率和感染率• C.发病率和病死率• D.病死率和感染率25、随机区组设计的方差分析用于（） *• A.多个样本均数间的两两比较• B.比较各个区组间的样本均数有无差别• C.比较各个区组间的总体均数有无差别• D.比较各个处理组间的样本均数有无差别26、正态性检验，按α=0.10检验水准，认为其总体服从正态分布，此时若推断有错，其错误（） *• A.大于0.10• B.等于0.10• C.小于0.10• D.等于β,而β未知27、当组数等于2时，对于同一资料，方差分析结果与t检验结果相比，（） *• A.检验结果更为准确• B.方差分析结果更为准确• C.完全等价且• D.不完全等价且28、当两总体方差相同时，以下方法中不适用于两样本均数比较的是（） *• A.t检验• B.t’检验• C.Z检验• D.方差齐性F检验29、配对设计资料的符号秩检验，对差值编秩，遇有差值绝对值相等时（） *• A.符号不同，按数值大小编秩• B.取平均秩次• C.符号不同，按顺序编秩• D.不考虑符号，按顺序编秩30、对于配对t检验和成组t检验，下列哪一种说法是错误的（） *• A.对于配对设计资料应作配对t检验，如果作成组t检验，不但不合理，而且平均起来统计效率降低• B.成组设计的资料用配对t检验，不但合理，而且平均起来可以提高统计效率• C.成组设计的资料，无法用配对t配对t检验• D.做配对或成组t检验，应根据原始资料的统计设计类型而定31、在方差分析中，如果P≤α，则结论为（） *• A.各个总体均数相等• B.至少有两个总体均数不等• C.至少有两个样本均数不等• D.各个样本均数不全相等32、配对设计的符号秩检验的基本思想是：如果检验假设成立，则对样本来说（） *• A.正秩和的绝对值小于负秩和的绝对值• B.B总的秩和等于0• C.C正秩和的绝对值与负秩和的绝对值不会相差很大• D.D正秩和的绝对值与负秩和的绝对值相等33、方差分析的前提条件是（） *• A.计量资料• B.正态性• C.随机性• D.方差齐性34、如果t≥t0.05/2,v可以认为再检验水准a=0.05处（） *• A.两个总体均数不同• B.两总体均数相同• C.两个样本均数不同• D.两个样本均数相同35、非参数统计的应用条件是（） *• A.样本数据来自正太总和• B.若两组比较，要求两样本方差相等• C.总体分布类型未知• D.要求样本例数很大36、在进行成组设计资料的t检验之前，要注意两个前提条件。

Thyroid cancer detection significance of Bcl-2[Abstract] Objective To investigate the expression of Bcl-2 in the incidence of thyroid cancer, development and prognosis.Methods immunohistochemical methods, mouse anti-human monoclonal antibodies to Bcl-2 mark 77 cases of thyroid cancer, 58 cases of thyroid adenoma and 40 cases of adjacent thyroid tissue and 28 cases of normal thyroid tissue. observe the different thyroid tissue expression of Bcl-2, and compare the positive rate of Bcl-2 positive results seen in thyroid cancer, thyroid adenoma and adjacent thyroid tissue. in thyroid carcinoma Bcl-2 positive rate was 45.5%, higher than the thyroid adenoma (22.4%) (P = 0.006), adjacent thyroid tissue (17.5%) (P = 0.003) and normal thyroid Organizations (0) (P = 0.000). anaplastic thyroid carcinoma and follicular carcinoma of the Bcl-2 positive rate was significantly higher. presence lymph node metastasis and clinical stage Ⅲ, Ⅳcases, Bcl-2 positive rate significantly increased. Conclusions Bcl-2 overexpression may be associated with the occurrence of thyroid tumors, cancer tissue expression of Bcl-2 can be used as a reference indicator of thyroid cancer prognosis.[Keywords:] Thyroid Cancer, Bcl-2 Gene, Proto-Oncogenes, Gene Expression, ImmunohistochemistryThyroid cancer is a common endocrine cancer, women with a high incidence of clinical thyroid tumors in 5% to 10% of thyroid cancer [1] which differentiated thyroid cancer accounts for 90 percent, including papillary thyroid carcinoma and follicular thyroid carcinoma , undifferentiated carcinoma are rare, its high degree of malignancy and poor prognosis. domestic data show that the incidence of thyroid cancer in a significant increase in [2] In recent years, thyroid cancer-related genes and tumor marker studies progressed very quickly. study confirmed [3,4], Bcl-2 gene is an apoptosis suppressor gene, first discovered in follicular B-cell lymphomas, and its product Bcl-2 protein inhibits apoptosis and prolong cell survival. The Studies using immunohistochemical techniques, by detecting Bcl-2 in thyroid cancer, thyroid adenoma, thyroid cancer tissue and normal thyroid tissue levels of Bcl-2 study in thyroid cancer incidence in the development process role in order to reveal the Bcl-2 and thyroid cancer biological behavior and prognosis of relationships.1 Materials And Methods1.1 MaterialsAll specimens were obtained from Peking University Shenzhen Hospital General Surgery from 2001 to 2009 cases of thyroid surgery between specimens, including: thyroid cancer, 77 cases (28 males and 8 females, mean 50 years), 58 cases of thyroid adenoma (male 22 cases, 36 females, mean 36 years), while taking 40 cases of adjacent thyroid tissue (10 males and 30 females, with an average 37 years old, had nodiagnosed by pathological examination of thyroid cancer invasion), 28 cases of normal thyroid tissue ( 9 males and females l9 cases, mean 35 years). pair of 77 cases of thyroid cancer histological classification according to WHO criteria: 55 cases of papillary carcinoma, follicular carcinoma l4 cases, undifferentiated carcinoma in 8 cases, according to standard clinical AJCC staging : I period of 30 cases, Ⅱ 23 cases, Ⅲ of 16 cases, Ⅳ of eight cases, of which 33 patients with lymph node metastasis, no lymph node metastasis in 44 cases. specimens were fixed in 10% formalin solution, embedded in paraffin buried, routine biopsy, 60 ℃ baking sheet 2 h, 37 ℃ overnight reserve.1.2 Immunohistochemistry ReagentsBcl-2 mouse anti-human monoclonal antibody, for the United States ZYMED company's products. SP-9000 Universal kit U.S. ZYMED Company. Using known Bcl-2-positive tonsil as a positive control, with PBS instead of primary antibody as negative space controls.1.3 Test MethodsDewaxing hydration, 3% H2O2 treatment at room temperature 15 min, microwave antigen retrieval, normal goat serum incubated 30 min, dropping a resistance, 4 ℃refrigerator overnight incubation. Dropping biotinylated secondary antibody sign incubated at room temperature 30 min, dropping horseradish peroxidase-labeled streptavidin at room temperature 30 min, DAB color. dyed by hematoxylin, dehydrated, transparent, mounted.1.4 criteria Bcl-2 located in the cell membrane and cytoplasm to the cell membrane and cytoplasm appear yellow to dark yellow granules positive cells without Bcl-2 positive cells was negative, there are positive Bcl-2 positive cells in all specimens are two pathologists blinded read the piece, the results are inconsistent harmonization judge the final result.1.5 Statistical AnalysisAll data using SPSS 13.0 statistical package on a computer for statistical analysis, for χ.2 test to P ≤ 0.05 was considered statistically significant.2 Results2.1 Bcl-2 In Different Tissues Of The Thyroid Condition, Are Shown In Table 1.Bcl-2 light microscope showed positive reaction cell membrane and cytoplasm stained tan, brown granules seen as negative. Bcl-2 positive rateof thyroid cancer was 45.5%, higher than the thyroid adenoma (22.4%) (P ≤ 0.01) and adjacent thyroid tissue (17.5%) (P ≤ 0.01), while the no rmal thyroid tissue were negative. shown in Table 1.2.2 thyroid cancer Bcl-2 expression and thyroid cancer related pathological parameters, see Table 2.Bcl-2 expression levels and histological type of thyroid cancer, lymph node metastasis and clinical staging a significant relationship. Higher in malignant undifferentiated carcinoma and follicular carcinoma, Bcl-2 were significantly higher than lower grade papillary carcinoma with lymph node metastasis and clinical stage Ⅲ, Ⅳ cases, Bcl-2 was higher than the corresponding without lymph node metastasis and clinical I, Ⅱ stage cases, the differences were statistically significant (P <0.01). posted on free download 3 DiscussionApoptosis, also known as programmed cell death, regulated by genes, regulatory genes can be divided into apoptosis gene and apoptosis-promoting genes, both of the shift, the regulation of apoptosis, cells of their research will be solved The fundamental mechanism of apoptosis, but its exact mechanism of action is still not so far fully understood.bcl-2 gene family in the regulation of apoptosis plays an important role,is one of the hot. Bcl-2 gene that B-cell lymphoma / leukemia gene -2 (B-cell lymphoma/leukemia-2), is Tsujimoto, etc. [ 5] in 1984 for the first time in follicular lymphoma B found thus named Bcl-2. normally located in the long arm of chromosome 18 Zone 2 a band to start is by chromosomal translocation (14,18) breaking point Molecular cloning method, from follicular lymphoma in the isolated, is believed to be human follicular lymphoma cytogenetics mark by two exons, and its gene product expression in humans cell longevity related to recent years, people discovered through extensive research, Bcl-2 gene block cell apoptosis effect, it is considered to be anti-apoptotic genes [6]. their anti-apoptotic mechanisms, previously reported general said by preventing apoptosis signaling the final common pathway and work. Through the bcl-2 and bcl-2 binding protein homologous protein research on the regulation of apoptotic bcl-2 family, the basic model has a new understanding. bcl-2 homolog proteins including bcl-2, bcl-xL, bax, bad and nematode ced-9, bcl-2, bax can form homodimers can also form heterodimers, bax homodimer formation, induction of apoptosis, bax - bcl-2 heterodimer formation, inhibition of apoptosis, and when the bcl-xs exists, preferentially form heterodimers bcl-2, bax to make free homodimer formation and induce apoptosis, therefore, sometimes bcl-2 expression does not necessarily inhibit cell apoptosis. generally believed, bcl-2 gene expression and tumor cell differentiation and proliferation related to the low degree of differentiation, proliferative ability of the tumor cells, the bcl-2 overexpression trend showed in this study, the authors systematically examined thyroid cancer, thyroid adenoma, thyroid cancer tissue and normal thyroid tissue andother thyroid tissue Bcl -2 expression, as shown in thyroid cancer tissue expression of Bcl-2 was 45.5%, significantly higher than the thyroid adenoma (22.4%, P = 0.006), thyroid cancer adjacent tissues (17.5%, P = 0.003) and normal thyroid tissue (0, P = 0.000), reveals the thyroid follicular cell adenomas bcl-2 positive staining intensity and number of positive cells compared with normal thyroid follicular epithelial cells enhanced increase in thyroid cancer has more than adenoma, suggesting bcl-2 may regulate thyroid epithelial apoptosis associated with play an important role in thyroid epithelial cells have more ability to evade apoptosis, the incidence of thyroid cancer may be associated with overexpression of bcl-2 related study showed that For thyroid cancer, tumor histological type, age, lymph node metastasis and clinical staging is to assess the prognostic indicators [7,8] in this group research results show a very low degree of differentiation of undifferentiated carcinoma and relatively low follicular carcinoma, Bcl-2 expression rates were 100% and 78.6%, significantly higher than papillary carcinoma of Bcl-2 expression rate (29.1%), the differences were statistically significant, in patients with lymph node metastasis or III, IV cases of thyroid cancer, carcinoma of Bcl-2 expression was significantly increased, the differences were statistically significant. Bcl-2 in all types of thyroid cancer were expressed, and the higher the degree of differentiation of the poorer expression, Therefore, it is reasonable that, Bcl-2-positive prompts thyroid cancer with poor prognosis, and the higher the degree of expression is also worse prognosis. cancer tissue expression of Bcl-2 high degree of differentiation of thyroid cancer, histological subtype, value invasion , lymph node metastasis and prognosis, thyroid cancer prognosis could be used as an important reference. Therefore, thyroid adenoma patients for tumor tissue Bcl-2 positive cases detected and close follow-up may have important significance.甲状腺肿瘤检测Bcl-2的意义【摘要】目的探讨Bcl-2的表达与甲状腺癌的发生、发展及预后的关系。