摘要： 人们通常认为，实践是对客观世界积极能动地改造，是人类生存和发展的基础，具有天然合理性和绝对权威性。但实践在现代的发展愈来愈向人们显示，它在对客观世界改造时，也会产生负效应，它在对人的本质力量肯定时，也会产生反主体化。在造成实践的负效应和反主体化的诸多原因中，实践的失控是重要原因。失控的实践是一种可怕的力量，实践的无控制运行已经造成了全球性的生态环境恶化，预示着整个人类有可能面临自我毁灭的危险，因而树立实践控制意识，保持实践的良性运行已刻不容缓。本文试图从人与自然关系的角度，揭示实践控制意识的价值意义。 一 当前，环境问题成了人们关注的热点，全球性的环境恶化和生态危机日趋严重，如土地沙化、臭氧空洞、温室效应、物种灭绝和资源匮乏等，已严重威胁人类自身的存在和发展。对此，人们开始从人类自身的行为去寻找原因，把它归咎于人类征服主义和科技的异化。其实，人类征服主义和科技异化的产生又与人类实践活动的失控相关，在于缺乏自觉的实践控制意识。 为了说明问题，有必要对人与自然的关系演化史作一粗略的考察。在古代，生产力和实践水平低下，人在自然面前显得十分渺小，不得不依附于自然界，听任自然的摆布。“自然界起初是作为一种完全异己的、有无限威力的和不可制服的力量与人们对立的，人们同它的关系完全象动物同它们的关系一样，人们就象牲畜一样服从它的权力”①。人们慑于自然的威力，对自然产生了畏惧和崇拜的心态，“获罪于天，无所祷也”，把自然力神化的天命观长久地统治着人们的观念。这时，人们无力控制自然，当然也就谈不上实践的失控，也无须树立实践控制意识。 在近代，随着科学的发展和人类理性主义的产生，人类实践能力获得了巨大进步。人们改天换地，征服自然，使自然的面貌发生了巨大变化，人类的足迹遍布世界各个角落，人在自然面前充满了自信和自豪，俨然以自然的主人自居。康德说：“人为自然立法”。培根说人是“不朽的神明”，“要在宇宙中确立和扩展人的势力和统治”，正是表明了人对自然的至高无上、唯我独尊的地位。其实，人以自然的主人和征服者的姿态出现，只是虚假的外观。当时的真实情况是，人的实践只是控制了自然界的极小部分，只是触及了自然的表层结构，还无力干涉自然系统整体，还远未触动其深层结构，自然对人的活动不予“理睬”，依然“我行我素”，依靠自身的力量保持正常的运行和物质能量循环。而人们由于对自然及其与自身的关系缺乏全面深入的认识，就自我陶醉于对自然的“胜利”之中，赋予实践以绝对的权威性，造成了世界似乎是人造的，似乎只是由人的实践所决定的这样一种虚假的外观，这种虚假的外观，就潜藏着实践的失控和生态失衡的危险。

关键词： 环境意识   环境污染   城市   发展   环境保护  

摘要： 《城市发展与环境》世界大会，于11月7日～11月12日在香港会议及展览中心隆重举行，来自世界各国的近三百名环境专家学者欢聚一堂，共同研讨当今世界各国的城市发展对环境带来的各种问题，提出了对付这些问题的对策和措施，呼吁提高各国人民的环境意识，共同保护世界人民共有的家——地球。

关键词： DENTISTS EDUCATION   DIPLOMA COURSE   ANESTHESIA TRAINING   CONSCIOUS SEDATION   PAIN CONTROL  

摘要： The Diploma in Clinical Dentistry (Conscious Sedation and Pain Control) of the Faculty of Dentistry, University of Sydney, is the first dedicated programme devoted to this field in Australia. Its development followed a decision by the Dental Board of New South Wales to require a formal qualification from the University of Sydney before dental practitioners could offer sedation and pain management in practice. The programme is conducted at Westmead Hospital in conjunction with the Department of Anaesthetics, and satisfies the guidelines developed by the Royal Australasian College of Dental Surgeons and the Royal Australasian College of Surgeons. The course is conducted either over one or two years, With block sessions requiring attendance at Westmead Hospital, together with assignments which are completed outside the block sessions. In this way, a dental practitioner enrolled in the programme is able to continue practice. The block sessions need not be completed over one year, but must be completed within two years.

关键词： BASAL FOREBRAIN   SUBSTANTIA INNOMINATA   CORTICAL BLOOD FLOW   CORTICAL PO2   CORTICAL PCO2   AGING   ALZHEIMERS DISEASE   FISCHER 344 RAT   CEREBRAL BLOOD FLOW REGULATION   HELIUM CLEARANCE   PHYSOSTIGMINE   INTRINSIC CHOLINERGIC INNERVATION  

摘要： Cholinergic projections from the basal forebrain are capable of influencing local cortical blood flow (CoBF). The effect of age on this influence was investigated by measuring CoBF and tissue gas partial pressures (PtO2, PtCO2) by mass spectrometry in conscious young adult (2-4 months) and aged (22-28 months) Fischer 344 rats. Electrical stimulation (50 mu A) of the substantia innominata (SI) increased frontal (+ 100.9%) and parietal (+ 28.4%) CoBF in young rats, but the effects were less in aged rats (frontal, + 48.6%, P < 0.05;parietal, + 18.9%, difference N.S.). Frontal PtO2 was increased in young but not aged rats (P < 0.01.). During standard hypercapnia, changes in CoBF, PtO2 and PtCO2 did not differ between young and aged rats. Under physostigmine infusion (0.15 mg/kg/h, i.v.), the CoBF increases to SI stimulation were approximately doubled in both cortices, in young and aged rats, and PtO2 increases were also significantly greater. However, frontal PtO2 increases were significantly smaller in aged (+ 7.6%) than in young (32.7%) rats, as were frontal PtCO2 reductions. We conclude: (i) the influence of the SI on frontal CoBF and PtO2 is substantially reduced with age;(ii) although physostigmine treatment potentiates this influence in both groups, the beneficial effects are relatively limited for aged rats.

关键词： STOMACH   GASTRIC SECRETION   GASTRIN   GASTRIC BLOOD FLOW  

摘要： Nitric oxide (NO) was shown to mediate gastric hyperemia following secretory stimulation but its role in the control of gastric secretion has not been clarified. Secretory studies were carried out on conscious dogs with chronic gastric fistula, Heidenhain pouch and esophageal fistula, while changes in gastric blood flow were measured in the mucosa of Heidenhain pouuch by laser Doppler flowmetry. Plasma gastrin was determined by radioimmunoassay. Infusion of N-G-nitro-L-arginine (L-NNA) (bolus i.v. injection of 2.5 mg/kg followed by infusion of 0.5 mg/kg/h), a potent inhibitor of nitric oxide synthase, failed to affect basal gastric secretion or plasma gastrin level but suppressed an increase of this secretion induced by sham-feeding, ordinary meat feeding or i.v. infusion of bombesin (0.5 mu g/kg/h), pentagastrin (4 mu g/kg/h) or histamine (40 mu g/kg/h). In tests with feeding and bombesin infusion, L-NNA caused a significant and dose-dependent reduction in plasma gastrin levels. The inhibition by L-NNA of gastric acid secretory response to pentagastrin, histamine or feeding was accompanied by a decline in blood flow. Addition of L-arginine (bolus i.v. dose of 50 mg/kg followed by infusion of 5 mg/kg/h) significantly attenuated the L-NNA induced inhibition of gastric secretion and the reduction in plasma gastrin response as well as in the fall of gastric blood flow. We conclude that endogenous nitric oxide affects the gastric secretion and that this effect is mediated, at least in part, by the changes in the gastrin release and gastric blood flow.

关键词： FUZZY LOGIC   CONTROL   REFRIGERATION   ENVIRONMENTALLY CONSCIOUS DESIGN  

摘要： This paper introduces the reader to the concepts of fuzzy sets and fuzzy logic and to their capabilities in the area of control systems. To understand the capabilities of fuzzy logic in real-time controller design, a controller for an environmentally conscious refrigeration system was designed and implemented. Initial results show that a fuzzy logic controller is easy to implement, does not need an exact system model, does not need precise and expensive hardware, and deals with human concepts in a fairly natural and obvious way. This would be, hopefully, a potential avenue for future production of intelligent manufactured products.

关键词： analgesia   children   conscious   emergency medicine   pain   pediatrics   procedure   residency training   sedation  

摘要： Objective: To determine the availability and relative use of pediatric analgesia and sedation at sites of U.S. emergency medicine residency training programs. Methods: A mail/telephone survey of residency directors at 80 U.S. emergency medicine residencies regarding resident experience with pediatric analgesia and sedation for painful procedures conducted during November 1991. Results: Sixty of 80 surveys (75%) were completed and available for analysis. Emergency medicine faculty supervised conscious sedation and analgesia in 87% of responding programs, while pediatrics faculty and pediatrics‐emergency medicine fellows supervised in the remainder. Ninety‐three percent of the programs had sedating agents available in the emergency department;only four programs needed to have drugs brought from the pharmacy. Thirty‐four programs (57%) had formal protocols for the administration of these drugs. Seventy‐seven percent of the programs had airway resuscitation equipment at the bedside, while only 63% brought resuscitation drugs. However, 60% of the programs reported complications of sedation, including respiratory depression, prolonged sedation, agitation, and vomiting. The most commonly used agents were midazolam (82%), meperidine alone (68%) and with promethazine and chlorpromazine (67%), and chloral hydrate (67%). Only 25% of the programs used nitrous oxide, and 30% used ketamine. Conclusions: Emergency medicine residencies generally have available agents for pain control and conscious sedation in children, although the agents used vary widely. Appropriate instruction by trained faculty should enhance resident experience with pediatric pain control and sedation. Copyright © 1994, Wiley Blackwell. All rights reserved

关键词： 电影检查   中国电影   意识形态   国民党南京政府   民族主义文艺运动   文化运动   国民党政府   电影事业   国民党统治   共产党  

摘要： 两种意识形态的对立──中国电影文化运动初期所面对的政治控制李少白正如我们在《简论中国３０年代“电影文化运动”的兴起》一文中所阐述，中国电影艺术发展的新变，实际上标志着一种新的文化观念和意识形态的崛起。但是，这种新的文化观念和意识形态的崛起，显然是与当...

关键词： 医疗质量   控制度   质量监   强化质量   医疗文书   质量意识   符合率   质量标准体系   医务人员   质量管理  

摘要： 随着医学科学知识的普及和社会舆论、监督的不断加强,人们对医疗服务质量的要求越来越高,医疗质量已成为全社会普遍关注的问题。在治理整顿、改革开放的新形势下,进一步加强医疗质量管理,为病人提供优质服务,保证病人心身健康和生命安全是现代医院管理的核心和基本内容。为此,我们结合医院工作实际建立了医疗质量分级监控管理制度,不断强化医务人员的质量意识,全院医疗质量明显提高。多年来未发生等级医疗事故,绝大多数差错被消灭在萌芽状态,保证了医院改革开放顺利进行。现将我们的做法和体会介绍如下:

关键词： 质量管理   时间控制   医疗服务  

摘要： 医疗服务过程中屡禁不止的“红包”及吃请受礼现象,大部分与病人所需要的医疗服务时间有关。如等候入院时间、等候手术时间、康复治愈时间等。如能在医院管理中加强对各个医疗环节所需时间的控制,将会对强化医务人员服务意识,制止医疗服务过程中出现的不正之风,提高医院的整体服务水平,起到事半功倍的作用。