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男性，60岁，双下肢无力半年，右腿明显，近2个月行走不稳，右手不能扣纽扣，无外伤史，无发热。体格检查，颈背部无明显压痛，两上肢前臂、手及上臂尺侧皮肤感觉均减退，右侧尤其明显，四肢肌张力增高，肱二头肌反射亢进，双侧膝躁反射亢进，右髌阵挛阳性，右巴宾斯基征阳性。 应考虑的治疗是
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男性，60岁，双下肢无力半年，右腿明显，近2个月行走不稳，右手不能扣纽扣，无外伤史，无发热。体格检查，颈背部无明显压痛，两上肢前臂、手及上臂尺侧皮肤感觉均减退，右侧尤其明显，四肢肌张力增高，肱二头肌反射亢进，双侧膝躁反射亢进，右髌阵挛阳性，右巴宾斯基征阳性。 根据体格检查确定病变节段为
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46) Maybe they are too young to know better, or more probably they are young enough to know better than most, but two Intemet marketing whizzes from San Francisco say both dotcom cpmpanies and the Internet arm of conventional companies will continue to be where client growth and profit are most prolific.But a marketing strategy, including above-line advertising to drive people ’to your site,- will still be important, say 23-year-old Christopher George and 26-year-old Julio Cabanillas, interactive media specialists from the global advertising agency Foote Cone Belding (FCB).The two travel the world to instruct their counterparts on the rights and wrongs of Intemet as marketing strategies and the correct branding of dotcom companies. They should know. 47)Sixty per cent of billings issued by the’ San Francisco office of FCB are now to dotcom companies ihcluding the massive on-line book store Amazon. com, which boasts access to more than a million titles.48) On a smaller scale, but equally effective, has been the listen, com advertising banner, placed on a host of carefully selected music related sites and search engines. The banner has a request function where the user can select an artist and be taken directly to that artist’s web page and download MP3 audio tracks.“The fact that you can search within the banner and condition the user to know what you are offering is key. The creative approach is simple but effective, and conveys exactly what the site is about.”49) Although the Internet strategies follow the standard 1: 3 ratio of conventional advertising campaigns (roughly three times more should be spent on placing advertising in the various media such as television or newspapers than on the production of the advertising campaign), the cost to clients comes before and after the online campaign.For example of what not to do, Senior George and Cabanillas point to the giant supermarket chain Wal-Mart in the US as an Internet site that has not taken advantage of the unique properties of interactivity.“What they’ve done is take the bricks and mortar layout, store aisles, for example, and simply put it online,” Cabanillas says.50) “But the online experience is much more fluid than that, and should provide ’ smarter’ services like recommendations, discounts and other fun things to enhance the user experience. Not intrusive, just smarter.” 49) Although the Internet strategies follow the standard 1: 3 ratio of conventional advertising campaigns (roughly three times more should be spent on placing advertising in the various media such as television or newspapers than on the production of the advertising campaign), the cost to clients comes before and after the online campaign.
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