女性，24岁，发现皮肤瘀点、紫癜4天。查体：双下肢较多紫癜，对称分布，浅表淋巴结不大，肝脾未触及。血象：血小板130×109/L，血小板聚集功能正常，骨髓象：增生活跃，全片见巨核细胞30个，其中产板巨核细胞19个。该患者最可能的诊断为
A．血管性血友病
B．特发性血小板减少性紫癜
C．过敏性紫癜
D．再生障碍性贫血
E．急性白血病
参考答案：C
解析：患者女性，24岁，双下肢皮肤较多紫癜，对称分布，浅表淋巴结不大，肝脾不大。血小板数量正常，血小板聚集功能正常，骨髓象：增生活跃，全片见巨核细胞30个，其中产板巨核细胞19个。考虑过敏性紫癜。
The concept of homeschooling is not a new one. Homeschooling means educating children at home instead of sending them to public or private schools. Nowadays, homeschooling has become popular in many countries for a variety of reasons. One of them is poor quality of education in public schools and it’s also because private schools are quite expensive. Some parents believe that because they know their child’s strengths and weaknesses, they can teach him or her better. Some parents prefer homeschooling so as to prevent their children from getting into bad company. There is another group of people who choose to educate their children at home because they want them to learn spirit and values of the family and also their religious beliefs. They also think that homeschooling would help in development of strong family bonds(家庭纽带). However, there are some negative effects of homeschooling on students as well as parents. Homeschooling is a full-time job and not fit for parents who have their own careers. It takes a lot of time for parents’ side to make homeschooling a success. Other family members’ responsibilities may also be affected. They may give their full attention to the needs of their children. Besides, a parent may have high educational qualifications, but that does not make him or her a good teacher. Teaching is an art, which requires the ability to understand the needs of the children. It is likely that the parent might have forgotten what he or she has learned, and the curriculum(课程) of the children would also be different. This would make it difficult for the parents to explain the concepts to their children. Parents also have the responsibility of designing the curriculum of students. In today’s world, competition(比赛) is seen in every field, and school prepares children to face these competitions. However, homeschooling does not give the children a chance to compare with other kids. They will also not be aware of where they stand in educational position among their classmates. This may affect their future lives. Education is not the only thing that the children need to become successful human beings. It is necessary that they learn to communicate in the society, and public school provides them with such an environment, where they meet many people. Schools also provide children with a chance to take part in various activities to improve their overall development. It is true that it has many benefits, but one must realize that school teaches children skills to face and survive. Homeschooling
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