男，65岁，双下肢行走无力，有踩棉感2个月。体格检查：躯干自剑突平面以下痛觉减退，双上肢前臂外侧痛觉减退，双膝反射（++++），双踝反射（+++），双巴氏征（+），肌张力升高。
最可能的诊断是（）.
A.神经根型颈椎病
B.脊髓型颈椎病
C.胸椎病变
D.腰椎间盘突出症
E.吉兰－巴雷综合征
F.运动神经元病
G.脊髓侧索硬化
参考答案：B
解析：1.本题考查的重点是有关颈椎病的知识，该患者有脊髓受压的临床表现，双膝反射（＋＋＋），双踝反射（＋＋＋），有踩棉感2个月，可谓排除A、D，躯干自剑突平面以下痛觉减退，可排除F和G、C，根据患者的年龄推断最可能的诊断是B。2.本题考查的重点是有关颈椎病的知识，为明确诊断可进行颈椎MRI和颈椎CT，还应该进行肌电图和颈椎前后位平片检查。3.本题考查的重点是有关颈椎病手术治疗的知识，颈椎前路手术的并发症有吞咽困难、声音嘶哑、脑脊液漏以及临近节段椎间盘退变。
Henry was a boy of nine. He was born in a family. His father was often ill and couldn’t go to work. Only his mother worked in a factory. She worked hard and hoped to give her four children and husband food and clothes. But she failed. Her family was sometimes hungry. Of course, she couldn’t send Henry to school. She was it but she didn’t know what to do. The boy was very clever and taught himself to read，write and at home in the evening. And in the daytime he was polishing（擦）shoes in the street, so he could make some for his family. One afternoon the boy saw a young man’s shoes were , so he said to him, “ Let me polish your shoes.” “No, thank you,” the young man said and walked away. “You may pay me only one dollar, sir,” the boy shouted him. But the young man said no again. Then the boy thought for a while and told him that he would polish his shoes for nothing. The young man to this, and soon one of his shoes was shining brightly. The man showed shoe to the boy, but the boy said no to polish it if he wasn’t paid two dollars for his work. .The young man refused（拒绝）to anything on it and went away. But his shoes were so different that he had to stop. He turned back and gave the boy two dollars. In a very short time the shoe was as bright as the other one.
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