มีน้องๆ ถามมาว่าอยากเป็นโปรแกรมเมอร์ได้มั๊ย
.
ดังนั้นผมจึงทำลิสต์ไว้ 3 ข้อเอาไว้เช็ค
ดูว่าเราเองนี้มีคุณสมบัติเหมาะกับการเป็นโปรแกรมหรือเปล่า
.
😍 1) ต้องมีความเป็นนักประดิษฐ์
การเขียนโปรแกรมต้องมีการสร้างโน่นสร้างนี้ตลอดเวลา
สร้างเว็บ เกม แอพลิเคชั่นมือถือ สร้างโปรแกรมต่างๆ บนโลกคอมพิวเตอร์
.
พูดง่ายๆ คือสร้างซอฟต์แวร์บนคอมนะครับ
นี้คือสิ่งประดิษฐ์ที่ล้วนเกิดจากแป้นพิมพ์คีย์บอร์ด
ที่เหล่าโปรแกรมเมอร์เสมือนร่ายเวทมนต์เสกมันออกมา
.
จะให้ลองนึกถึงนักวิทยาศาสตร์ นักประดิษฐ์ระดับโลก
เช่น โทมัส อัลวา เอดิสัน (Thomas Alva Edison)
ถ้าสมัยนี้ก็ พี่มาร์ค ซัคเคอร์เบิกผูสร้างเฟสบุ๊ค
บิลเกตผู้ก่อตั้งไมโครซอฟต์
สติฟจอป ผู้ก่อตั้งบริษัทแอปเปิล
.
นี้ขอยกตัวอย่างคนดังๆ
ถ้าน้องไม่รู้จักลองคนเหล่านี้
ลองเอาชื่อที่เอ่ยมาสักครู่ไปค้นประวัติดูได้
.
แล้วถ้าเกิดชอบ
รู้สึกว่ามีคนพวกนี้เป็นไอดอล
อยากขอลายเซนต์
อยากถ่ายรูปด้วย
ก็อยากจะกวักมือให้อ่านบทความนี้จนจบ
.
เอาเป็นว่าอยากให้ลองถามหัวใจตัวเอง
ถ้าน้องๆ ชื่นชอบการสร้าง การประดิษฐ์คิดค้น
มีความสุขที่ได้สร้างอะไรขึ้นมาด้วยสองมือเราเอง
ยิ่งมันเสร็จขึ้นมา เราจะรู้สึกวาว
มันเจ๋ง มันเยี่ยมยองกระเทียมเจียว
แล้วยิ่งมีคนมาใช้งานสิ่งที่เราสร้าง
.
ลองนึกถึงน้องๆ ได้สร้างเฟสบุ๊คมากับมือ
น้องภูมิใจไหมที่มีคนใช้กันเป็นพันล้านคนทั่วโลก
ถ้าน้องๆ รู้สึกโคตรภูมิใจมากๆๆ มีความสุข
ที่เห็นสิ่งประดิษฐ์เราออกสู่สายตาโลก
ยินดีด้วยนี้คือก้าวแรกของเส้นทางการเขียนโปรแกรม
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😍 2) ต้องเป็นนักแก้ปัญหา
นึกถึงคนที่เขียนโปรแกรม
พวกเขาจะมีอุปสรรคปัญหาให้แก้ตลอดเวลา
.
✔ จากลูกค้าที่โยนปัญหามาให้เรา
✔ หรือโปรแกรมเราที่ติดบั๊ก แต่ไม่ติดรอหัวใจ
✔ โปรแกรมเกิด error หรือข้อผิดพลาดในโปรแกรม
✔ เวลาทำงานไม่ผ่าน ทำงานไม่ตรงตามจุดประสงค์
✔ โปรแกรมก็ต้องมานั่งตามเช็คตามล้าง
.
อาชีพนักเขียนโปรแกรม พวกเขาต้องมานั่งขบ คิด
บางทีปัญหาไม่จบในที่ทำงาน
นอกเวลาก็ต้องมานั่งคิด
เช่น กินข้าว อาบน้ำ นั่งถ่ายในห้องน้ำ ก็ต้องนั่งมานั่งคิด
.
เพราะบ้างทีชั่วโมงทำงานมันจบไปแล้ว
แต่หัวสมองเรายังไม่จบ
ยังเกิดความรู้สึกคาใจ อยากแก้ปัญหาคาใจให้ออก
.
บางคนขนาดตอนหลับก็เอาไปฝัน
สามารถคิดแก้ปัญหาตอนหลับได้ก็มี
หัวสมองเราต้องเป็นนักสู้
สู้ในที่นี้ หมายถึงสู้เพื่อแก้ไขปัญหา
พอแก้ปัญหาได้ รู้สึกว่ากูเจ๋ง กูเยี่ยมว่ะ
เราเองสุดยอดที่แก้ปัญหาได้
.
ลองนึกถึงเวลาเล่นเกมปัญหาเชาว์ต่างๆ เช่น
จับผิดสิ่งที่อยู่รูปภาพ
หรือทายปริศนาคำศัพท์
หรือเล่นเกมรูบิก เป็นต้น
.
ถ้าน้องรู้สึกชอบว่ะ พยายามสู้
พยายามแก้ปัญหาเชาว์พวกนี้
แก้ให้ได้ แก้ไม่ได้ จะไม่เลิก
.
ยิ่งแก้ได้ ยิ่งจะกระโดดโลดเต้น
ถ้าน้องมีความรู้สึกแบบนี้ ยินดีด้วยครับ
นี้คือก้าวที่สองของเส้นทางสู้การเขียนโปรแกรม
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😍 3) ต้องสนใจและติดตามเทคโนโลยี
งานเขียนโปรแกรม
งานส่วนใหญ่อยู่ใลกไอที คอมพิวเตอร์
พื้นฐานจะเป็นนักเขียนโปรแกรมได้
ต้องสนใจและติดตามเทคโนโลยี
ตรงไปตรงมามากๆ
อยากลืมว่าเทคโนโลยีมันเปลี่ยนแปลงเร็ว
บ้างตัวมา แล้วไปฆ่าเทคโนโลยีอื่นตาย
.
✔ กล้องถ่ายรูปแบบฟิล์ม เดี่ยวนี้เป็นกล้องดิจิตอล
✔ โทรศัพท์มือถือเมื่อก่อนยังขาวดำ ปุ่มกดธรรมดา
ปัจจุบันเป็นทัสสกรีน หน้าจอสัมผัส เป็นสมาร์ทโฟน
.
การที่คนเขียนโปรแกรมต้องเรียนรู้
ปรับตัวตามกระแสเทคโนโลยีให้ทัน
จะทำให้คนภายนอกมองว่าเราคือผู้เชี่ยวชาญ
เขามาจ้างเราเพราะอะไรรู้ไหมครับ?
.
เพราะเขาทำไม่เป็น
อย่าลืมว่าคนไม่เป็นไอที
ยังไงเขาก็ไม่เป็นจริงๆ เลยนะ
.
ด้วยเหตุนี้เขาจึงต้องจ้างเขียนโปรแกรม
ยิ่งเราเก่งด้านนี้
กล้าพูดได้เลยว่า
สามารถเรียกค่าตัวให้แพงได้
เพราะเราในสายตาลูกค้า หรือนายจ้าง
คือผู้เชียวชาญ เพราะเขาทำไม่ได้อย่างเรา
ดังนั้นเราไม่ใช่กระจอก
.
เพราะฉะนั้นถ้าเราไม่หมั่นตามเทคโนโลยี
ไม่หมั่นฝึกฝน
ไม่เป็นผู้เชียวชาญ
แล้วเราจะเก่งได้ไง
.
นี้แหละคือคุณสมบัติ 3 ข้อ
ในการเช็คว่าเราเป็นนักเขียนโปรแกรมได้หรือไม่
.
.
🧘♂ ++++++ 🧘♂
.
ทิ้งท้าย
ทุกอาชีพมันก็มีด้านมืดด้านสว่าง
ด้านสว่างทางสายนี้ คือเงินดี
.
ยิ่งเป็น เอาท์ซอร์ส หรือ contact
เงินเดือนเกินครึ่งแสน
เก่งจริงมีให้เห็นมาแล้ว
ยิ่งภาษาอังกฤษได้
โปรไฟล์จะเราจะหล่อสวย
มีแต่คนจ้องตามจีบ
.
ยิ่งรู้จักเก็บเงินดีๆ
ยิ่งรู้จักใช้เงินทำงานให้เป็น
รับรองได้เห็นเงินล้านก่อนอายุ 30 ไม่ยาก
.
แต่ถ้าเป็นพนักงานประจำ
ก็ต้องบอกตามตรงรายได้จะไม่สูงมาก
ยกเว้นไปทำต่างชาติ
หรือพวก startup บางเจ้า เขากล้าจ้างแพง
.
ส่วนด้านมืดคืองานเครียด
อาชีพนี้อยู่ได้เพราะเรา....
ต้องใช้สมองแก้ปัญหา ให้ลูกค้า
เพราะลูกค้า หรือนายจ้าง
เขาทำไม่ได้เหมือนเรา
จึงต้องมาจ้างเราเขียนโปรแกรมให้
.
สำหรับบทบาทอาชีพนี้
ถ้าเปรียบเป็นนักฟุตบอลคือ
ไม่ตำแหน่งกองหลัง ก็ผู้รักษาประตู
ทำงานปิดทองหลังพระเสียมากกว่า
เราไม่ใช่กองหน้า
.
พอไม่ใช่กองหน้าซุปเปอร์สตาร์
บางคนเลยเจอกดเงินเดือนลง
ทั้งที่ความรับผิดชอบเกินเงินเดือน
.
ถ้าใจไม่รักไม่ชอบอยู่ยาก
ยิ่งถ้าไม่มีพื้นฐาน 3 ข้อที่กล่าวมา
รับรองอยู่ได้ไม่นาน
ก็เบื่อลาออก
ไปทำอย่างอื่นกันหมด
.
อย่าลืมในโลกใบนี้
มันมีงานที่เงินดี
ที่ไม่ต้องใช้สมองแก้ปัญหา
เหมือนนักเขียนโปรแกรม
งานดีเงินดีมีเยอะมากมาย
.
เพียงแต่อาชีพไหน?
จะเหมาะกับตัวตนน้องๆ
ถูกจริตหรือไม่ ก็เท่านั้นเอง
.
งานที่ไม่ใช่ ยังไงก็ไม่ใช่
.
.
.
.
.
.
.
.++++++++++++++++++++++++++++
<ประชาสัมพันธ์ ขายหนังสือ/>
“โปรแกรมเมอร์ก็รวยได้ ด้วยเส้นทางเอาท์ซอร์สสายดำ”
ความยาว 176 หน้า กระดาษ A5 (≈ 41,002 คำ)
แบ่งเป็น 2 เวอร์ชั่น
.
👉 1) เวอร์ชั่นพิเศษเป็น PDF
ปรินต์ออกมานอนเกาพุงอ่านได้ ราคา 330 ฿
ติดต่อสั่งซื้อไดที่ไลน์ @269aibvq (เฉพาะ PDF)
.
👉 2) เวอร์ชั่นอีบุ๊กอ่านผ่านโปรแกรมของเว็บ mebmarket
ไม่มีแจก PDF ปรินต์ออกมาไม่ได้
ราคาถูกลงมาหน่อย 250 บาท ฿
กับ 279 บาท ฿ (ซื้อผ่านระบบ Apple)
ซื้อได้ที่ 👇
https://www.mebmarket.com/web/index.php…
.
สำหรับตัวอย่างหนังสือ ดาวน์โหลดได้ตามลิงก์ข้างล่าง 👇
https://drive.google.com/open…
.
✍ เขียนโดย โปรแกรมเมอร์ไทย thai programmer
Sisters asked me if I want to be a programmer.
.
So I made 3 lists for checking out.
Let's see if we qualify as a program.
.
😍 1) An inventor must be
Programming must be built all the time.
Build web games, mobile application, create programs in the computer world.
.
Easy to say. It's built software on computer.
This is an invention that was all caused by keyboard.
Where the virtual programmers cast their spells.
.
Let's think about the scientists, the innovators, the world.
Like Thomas Alva Edison (Thomas Alva Edison)
If these days, it's me, Mark sạkh, the creator of Facebook.
Bill Gate, the founder of Microsoft.
Stiff Jopp, founder of Apple Company.
.
Let's give a celebrity example.
If you don't know, try these guys.
Let's get your name in a while. Let's go through the history.
.
What if I like it?
Feel like these people are idols
I want to ask for a signature.
Wanted to take a picture
I want to shake my hand to read this article until the end.
.
Let's just say that I want you to ask your heart.
If the sisters love creating invention
Happy to create something with our own two hands.
The more it's done we'll feel shiny
It's cool. It's great. Jeaw garlic.
And more people use what we create.
.
Let's think about the brothers and sisters. Created Facebook with their hands.
Are you proud that there are billions of people around the world?
If the sisters are feeling very proud and happy.
Seeing our invention out of the world.
Congratulations, this is the first step of the programming path.
.
😍 2) must be a problem solver
Think of the programming people.
They will always have obstacles to solve.
.
✔ from customers who throw us trouble
✔ or our program that sticks to the buck but doesn't get stuck waiting for the heart.
✔ error or error program error
✔ Working time, not working, not working on purpose.
✔ Programme, I have to come to sit and check and wash.
.
Programmers career. They need to sit and think.
Maybe problems don't end at work
I have to sit and think about it.
Such as eating, taking shower, sitting and filming in the toilet, I have to sit and think.
.
Because sometime in the working hours are over
But our head is not over yet.
I still feel like I want to solve my problem.
.
Some people even when they sleep, they take it to dream.
I can think of solving problems when I sleep.
Our head is a fighter.
Fighting here means fighting to fix the problem.
When I can solve the problem, I feel like I'm cool. I'm great.
It's me. The best that I can solve problems.
.
Think about game time, chow problems like
Catching the wrong thing in the photo
Or guess the vocabulary puzzle
Or play Rubik, etc.
.
If you feel like it, try to fight.
Trying to solve these chao problems
I can't solve it. I can't fix
.
The more I can solve, the more I can jump and dance.
If you have feelings like this, congratulations.
This is the second step of the path to programming.
.
😍 3) Must be interested and follow technology.
Programming
Most jobs are in computer IT.
The basics can be a program writer.
Need to be interested and follow technology
Very candid.
I want to forget that technology is changing fast.
Some of them come and kill other technologies.
.
✔ This single film camera is a digital camera.
✔ Mobile phone used to be white, black, black, normal pressing button.
Currently, it's Tuspicious. The touch screen is a smartphone.
.
The way a programmer needs to learn
Adapt to the technology trend.
Will make outsiders think that we are experts
Why did he hire us?
.
Because he can't do it.
Don't forget that people are not IT.
He's not really real at all
.
That's why he has to hire to program.
The more we are good at this.
I dare to say that
Can be charged to be expensive
Because we are in the eyes of customers or employers.
I'm an expert because he can't do it like me.
So we are not shoddy
.
So if we don't stand by technology
No practice.
I'm not an expert
How can I be good at it?
.
Here are 3 qualifications.
In check if we can be programmers
.
.
🧘♂ ++++++ 🧘♂
.
Backing up.
Every career has a dark side, bright side.
The bright side this line is good money
.
The more outsource or contact
Salary is over half hundred thousand
Really good. I have seen it.
The more English I get.
My profile will be handsome, beautiful.
There are many people who follow me.
.
The more you know how to save good money.
The more you know how to spend money to work.
I guarantee that it's not difficult to see a million before 30
.
But if it's a full time employee.
I have to be honest. The income won't be very high.
Except to go foreign.
Or some startups. They dare to hire expensive people.
.
The dark side is stressful work
This career lasts because of us....
Need brain to solve problems for customers.
Because of a customer or an employer.
He can't do it like us
So you have to hire us to program it.
.
For this career role.
If it's like a footballer, it's
No defender position, goalkeeper.
Working to close gold after monk's back is more broken.
We are not a striker
.
Enough is not a superstar striker.
Some people found that they pressed their salary down.
Responsibility is beyond salary
.
If you don't love, you don't like
If you don't have the 3 basics that you say.
Guaranteed it won't last long
I'm bored to quit.
Let's go do something else
.
Don't forget in this world
It has a job that pays well
That doesn't need brain to solve problems.
Like a program writer.
Good work, good money, lots of them.
.
Just what profession is this?
I will be suitable for the younger ones.
Right or not. That's all.
.
A job that is not a job is not a thing.
.
.
.
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.
.
.
.++++++++++++++++++++++++++++
< Public relations book sale />
′′ Programmers can also be rich with black outsource routes
Length 176 pages h̄n̂ā paper (≈ 41,002 words)
Divided into 2 versions
.
👉 1) Special version as PDF
Princess came out to sleep and scratch my belly. Read it. Price is 330 ฿
Contact Line s̄ạ̀ng sụ̄̂x 269 aibvq (PDF only)
.
👉 2) Ebook version read through the program of mebmarket web.
There is no PDF giving away. Can't print.
The price is cheaper. 250 baht ฿
With 279 Baht ฿ (Buying via Apple System)
Buy it at 👇
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.
For the book preview, download the link below 👇
https://drive.google.com/open?id=1tAnMozeYd63dcbBGTQmT_ZrpSaamZS3e
.
✍ Written by Thai programmer thai coderTranslated
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expert system example 在 沃草 Watchout Facebook 的最讚貼文
#獨家 世界衛生組織將台灣問題相關聲明稿下架!
世界衛生組織(WHO)在台灣時間今(6)日凌晨以 "How the World Health Organization works with all people, everywhere" 為題發了一篇聲明稿,試圖為排除台灣參與 WHO 辯解。不過這篇聲明卻在不到 24 小時內就被 WHO 網站下架,直至晚間6時30分仍呈現「找不到網頁」(This page cannot be found),《沃草》透過世衛網站暫存紀錄,獨家為大家揭露該篇聲明內容。
聲明中,WHO仍稱與台灣相關的事務為「中國台灣事務」( Taiwan, China issues),針對全球的種種批評,WHO 仍稱之為誤解(misunderstandings),並聲稱是有些人將「技術性的維護全球公共健康任務」與「決定 WHO 會員資格的權限」混淆,似乎打算以此來回應國際要求讓台灣加入 WHO 的呼聲。
聲明中多處重申 WHO 在 3 月 29 日公布的聲明(https://waa.tw/Qsu21N),認為 WHO 與台灣設有聯絡點、台灣專家曾參與 WHO 會議等,並表示台灣參與世界衛生大會的觀察員資格是在一次次的會員國投票中遭到否決,以及提起讓中華人民共和國取代中華民國聯合國席位的聯合國 2758 決議文,表示世界衛生大會遵循此決議及其中的一中原則。
似乎是為回應全球對 WHO 應對流行病能力的質疑,WHO 在聲明中表示「有些人可能認為 WHO 成員組成影響我們維護世界安全的能力,但更重要的是要了解我們的治理方式和實踐方式。」
暫存檔網址:https://waa.tw/dohkIm
聲明截圖:https://drive.google.com/file/d/1VP-KMgP4wb6Oy8jQkOjoSu-DWGS3Xqkb/view
原新聞稿網址:https://waa.tw/lFKd8M
(以下為世界衛生組織聲明原文)
標題:Update: How the World Health Organization works with all people, everywhere
發表時間:5 April 2020 Statement
內文:
In recent months we have seen misunderstandings in social media and the news media about how WHO manages global public health issues. In particular, there are a lot of questions about Taiwan, China issues. Some people are confusing WHO’s technical global public health mandate, with the mandate of countries to determine WHO’s membership. Countries decide this. The WHO Secretariat focuses on keeping the world safe.
WHO works to promote the health of all people, everywhere. Indeed, one of our overarching goals is Universal Health Coverage. #healthforall. We are an organization with a staff of physicians, scientists, researchers and public health experts who are committed to serving all people regardless of nationality, race, ethnicity, religion, gender.
This includes the people of Taiwan. We serve them through regular interactions with their experts and authorities on vital public health issues. This has been the case over many years, including during the COVID-19 pandemic.
It is understandable that some people might think that the composition of WHO’s membership affects our ability to keep the world safe. But it is important to understand both how we are governed and how we operate in practice.
WHO is part of the United Nations, whose membership is the mandate of countries. In 1971, countries of the world participating in the United Nations General Assembly recognized the People’s Republic of China as “the only legitimate representative of China,” in effect, a one-China policy. That is contained in UNGA Resolution 2758. In 1972, the World Health Assembly decided in WHA Resolution 25.1 to follow that.
Every year, members have a chance to discuss important proposals during the World Health Assembly, where rules and policies governing WHO are decided. For example, at different times, some countries have proposed giving Taiwan’s authorities a special status – that of observing the annual World Health Assembly.
There have been 14 times over the last 22 years (1997-2006; and in 2008, 2017, 2018, 2019) when countries discussed whether a delegation from Taiwan could attend the World Health Assembly as an observer. Each time the countries decided against it by consensus – except in 1997 and 2004 when there were votes: (by 128 votes to 19 in 1997; and by 133 votes to 25 in 2004). In 2007, the issue wasn’t observer status, but membership, and countries decided against considering that by a vote of 148 to 17.
There have been occasions when it was clear that there was general support among WHO countries for Taiwan to take an observer seat at the World Health Assembly. Between 2009 and 2016, it did so under the name “Chinese Taipei.”
But having a seat at the WHA, or not having a seat at the WHA, does not affect, in any way, whether an area or population benefits from WHO expertise and guidance. WHO helps all people, everywhere.
WHO and Taiwan’s health experts interact throughout the year on vital public health and scientific issues, according to well-established arrangements.
During the current COVID-19 pandemic, interactions have been stepped up, both through existing channels and new ones as well.
Here are examples of WHO-Taiwan interactions around the coronavirus pandemic:
-- There is an established International Health Regulations (IHR) Point of Contact (POC) for Taiwan. Taiwan’s POC receives IHR (2005) communications, provides IHR information updates from Taiwan directly to WHO Headquarters, and has access to the IHR Event Information Site (EIS) system. The EIS system is a password-protected database and information exchange platform supporting the IHR. It is the well-established platform for all IHR communications, back and forth, between WHO and IHR contacts.
-- Health experts from Taiwan participate in two of the key WHO networks set up in January 2020 to support WHO work in the global COVID-19 response. Three experts from Taiwan are part of the WHO Infection Prevention and Control Network: two are part of the WHO Clinical Network. Every week, they join some 60 to 80 other experts from around the globe through a WHO-hosted teleconference, working to advance our knowledge and guidance in this response.
-- Two public health experts from Taiwan participated in the Global Research and Innovation Forum organized by WHO on 11-12 February 2020. They took part, alongside other world scientists, in considering critical research questions and in finding ways to work together to advance the response.
-- Taiwan’s Field Epidemiology Training Program is a member of the Training Programs in Epidemiology and Public Health Interventions Network (also known as “TEPHINET”). WHO shares Global Outbreak Alert and Response Network alerts and requests for assistance with TEPHINET, and those messages are cascaded to the TEPHINET members.
-- WHO, through its technical lead, has directly briefed health authorities from Taiwan and has offered again.
--Taiwan’s health experts and authorities have open access to developments, guidance and other materials through the WHO’s website (www.who.int) and other digital platforms.
--They can access the www.OpenWHO.org platform, which hosts open online courses for decisionmakers and responders around the world. During the COVID-19 pandemic, OpenWHO usage has reached more than 1 million.
--WHO has a designated contact point with their office in Geneva. Through this channel, general questions are handled and when technical concerns arise, WHO technical responses are coordinated.
--WHO also interacts with Taiwan’s health authorities through the European Centre for Disease Prevention and Control.
Importantly, the COVID-19 caseload in Taiwan is low relative to population. We continue to follow developments closely, and WHO is taking lessons learned from all areas.
Interactions with Taiwan during the response to the pandemic is not exceptional. Here are some examples of regular interactions with Taiwan’s health authorities and WHO, over many years, through well-established arrangements, and across many different global health concerns:
Over the course of 2019, Taiwan’s experts were invited to attend 9 WHO technical meetings. They attended 8 of these meetings, contributing to WHO expert processes on issues including immunization, drug-resistant TB, assistive technologies, vaccine safety and SDG targets on NCDs and Mental Health. Prior to the Covid-19 emergency, work was underway for more expert participation from Taiwan in 2020.
On influenza, Taiwan vaccine manufacturer Adimmune contributes to the WHO Pandemic Influenza Preparedness Framework (PIP Framework) and preparations are underway for concluding an agreement between WHO and Adimmune under the PIP Framework for pandemic influenza vaccine products;
In the fight against cancer, experts from Taiwan have contributed to key publications issued by the WHO International Agency for Research on Cancer;
In support of the International Health Regulations, an expert from Taiwan has been appointed to the IHR Expert Roster; and
On a range of other issues, from WHO pre-qualification practices for pharmaceutical manufacturers to malaria, there are exchanges with WHO on practical and technical issues.
It is fair to say that the contribution of Taiwan’s health experts to WHO, and their interactions with us, are well-developed and broad-based. And these interactions add value to the work of WHO and to global health.
expert system example 在 當張仲景遇上史丹佛 Facebook 的最讚貼文
TCM Treatments of COVID-19
Written in Chinese by Dr. Andy Lee, March 7, 2020 (http://andylee.pro/wp/?p=7660)
Translated to English by Dr. James Yeh, March 13, 2020
I published an essay “From SARS to Novel Coronavirus” in Chinese on January 21, 2020 (http://andylee.pro/wp/?p=7169). At that time, I tried to discuss possible Traditional Chinese Medicine (TCM) treatments of Novel Coronavirus based on my clinical experience of treating many severe cases of pneumonia caused by various influenza and other diseases. Since then, I have directly and indirectly participated in treating patients of Novel Coronavirus successfully, had discussions with many doctors fighting the epidemic at the front line and many researchers conducting related researches, and read many reports on this subject. Although the “Novel Coronavirus Pneumonia” has been renamed to “COVID-19” (coronavirus disease 2019) and the name of the virus has officially named from “2019-nCoV” to “SARS-CoV-2”, I now firmly believe that my original judgment, views, and interpretations are correct. For the sake of easiness for people to read and share, in this essay, I am reorganizing my previous discussions and including some explanations on certain confusions as well.
First, there are numerous provinces and cities in China using TCM to fight the “COVID-19” (I will use the term “Coronavirus” from now on.) No matter whether the treatments were primarily using TCM or the combination of TCM and the methods of Western medicine, there have been a significant amount of positive outcomes. On the other hand, the views of how to use TCM to treat and the use of corresponding herbal formulas vary quite a bit. Even when TCM remedies were effective, why did some patients fully recover and were discharged from the hospitals but other patients still could not get the virus-free “negative confirmation” from virus DNA tests?
Many TCM doctors participating in the treatments and discussions often look at the Coronavirus issue from a single “Point” or the condition of the patient at that specific moment. Some interpreted the disease as “Dampness” (濕), “Dryness” (燥), “Cold” (寒), or “Heat” (熱). (Translator’s note: These interpretations are often the opposite ends of the spectra, like Dampness is opposite to Dryness; and Cold is opposite to Heat.) From the clinical practice point of view, those treatments based on such conflicting interpretations all had positive effects to some degrees. Then, which interpretation is the “correct one”? In fact, those simple interpretations all have some merits but don’t fully cover the subject in hand. Although TCM is based on “Dialectical Treatment” (辯證論治), i.e. treatment is derived from “observation and diagnosis” of patients’ complex symptoms, the most important thing is that disease shouldn’t be viewed as an isolated problem at a specific time, but the whole development of symptoms along a timeline. Not only we need to observe and diagnose the current ailment but also we have to understand the development history of the disease and to project how the disease will develop in the future. For a single patient, we might be able to focus on the clinical results of this patient. But for epidemics, we have to look at a bigger picture and take into account how this Coronavirus develops health issues inside the human body from TCM’s perspective. And, in clinical treatments, we also need to consider many variants caused by each patient’s preconditions and one’s strength to fight off the disease.
From my experience of curing many patients who were inflicted with flu-induced pneumonia and complications, and the recent participation in treating and curing Coronavirus patients, it is proper to summarize that no matter whether the virus is Coronavirus, bird flu, swine flu, or the “common” flu, we found that the bodily deterioration caused by the virus, in general, follows the description from the TCM theory first covered in the ancient literature “Treatise on Cold Damage on Miscellaneous Disease ” (傷寒雜病論). However, the progressions of the disease from such special viruses are much faster, more severe, and/or more persistent than that of the common flu. Patients’ own original “health” condition also complicates the progression. (Translator’s note: For example, the infliction rate of young children is much smaller than that of adults for Coronavirus.)
As I explained before, the TCM theory discussed that for the common flu or “catching a cold”, the disease starts with “Exterior Deficiency or Weakness” (表虛). That is, the “exterior” of the body is invaded by the “External Pathogen” (外邪), like virus, and has adverse reactions. (Translator’s note: Here the exterior doesn’t mean just the outside surface of the body like the skin, but all the surfaces topologically exposed to the outside like lining of throat, nose, and bronchus of the body.) This is the first stage of the whole episode and often can be effectively treated with the herbal prescriptions such as “Gui Zhi Tang” (桂枝湯). If the patient is not properly treated, the body fluids within the surface and muscles could not function properly. It will cause the transition to the next stage “Exterior Excess” (表實). (Translator’s note: The word Excess has various meanings: excessive reactions all the way to neoplasm, excessive wasteful things, etc.) Viral infection at this stage is matched to one of the several syndromes named with the corresponding herbal remedies such as “Ge Geng Tang” (葛根湯), “Ma Huang Tang” (麻黃湯證), and others. The TCM theory calls this stage “Exterior Coldness” (表寒). In history, many TCM doctors considered this stage as the body being hurt by outside coldness (傷於寒) or in plain words “Catching Cold”. However, that is a misunderstanding. While outside coldness is one of the causes leading to the stage “Exterior Coldness”, it is not the only cause. When the body fluids could not function properly, the normal body fluids which had proper fluidity to circulate and to fulfill vital functions (活水) became a pot of “Dead Water” (死水), i.e. wasteful water which can’t fulfill vital functions. In other words, the ancient literature “Treatise on Cold Damage on Miscellaneous Disease” (傷寒雜病論) is much beyond the simple interpretation of how to treat the ailment caused by “cold damage”, but a classical literature of explaining both the physiology and pathology of human body functions.
Normally, the ailment or symptoms of the common flu would be limited at this stage of “Exterior Coldness”. Even without any treatment, the human body often could fight off the virus with an immune response and fully recover. But when the effects of Exterior Coldness started to penetrate into the interior of the body, the first common organs to be affected will be the organs that have a short path to the outside. (Translator’s note: Topologically, trachea and lung are only a membrane distance away from the outside air.) Then the Exterior Coldness gets transformed into the next stages such as “Interior Coldness” (裡寒) and “Lung Coldness” (肺寒). (Translator’s note: Here “Lung” means the whole respiratory system, not only the lung organ.) Clinically, the patients start to show symptoms of the syndrome named after its herbal remedy “Xiao Qing Long Tang” (小青龍湯). At this stage, the patients have serious coughing and running nose. When the respiratory system is “affected by the coldness”, the body fluid function of the respiratory system gets affected. Just like when the cooling system of a car malfunctions, the engine would overheat. The circulation function of the lung becomes “Dry and Overheated” (燥热). This would lead to the next stage of “Heated Interior” (入裡化熱) and often be matched to its herbal remedy “Da Qing Long Tang” (大青龍湯). At this stage, it does not mean that the whole lung is “dry and heated”. In fact, many pneumonia patients exhibit “mixed coldness and heat” (寒熱夾雜) in the lung. For example, while the upper part of the lung is “dry and heated”, the lower part of the lung might suffer excessive mucus of a high density. Pleural effusion and hydronephrosis might start to develop quickly.
Such a complex situation was extensively discussed in Chapter 7 of the ancient literature “Synopsis of Prescriptions of the Golden Chamber” (金匱要略肺痿肺癰咳嗽上氣病脈證治第七篇). At this complex stage, the illness development varies significantly among patients of different preconditions and other variants. It is no longer the situation that a simple herbal remedy can be applied to all the situations. The TCM theory illustrates various treatments by those herbal remedies such as “She Gan Ma Hung Tang” (射干麻黃湯), “Ting Li Da Zao Xie Fei Tang” (葶藶大棗瀉肺湯), ”Ze Qi Tang” (澤漆湯), “Xiao Qing Long Jia Shi Gao Tang” (小青龍加石膏湯), and others. It doesn’t mean that one of the herbal remedies should be selected to treat a patient directly. Instead, the TCM Theory used these herbal remedies to teach its practitioners how to “think” and create a proper herbal remedy based on the conditions of a specific patient.
For example, the Coronavirus has quite a puzzling situation that many Western medicine doctors haven’t yet fully understood. Some severely affected patients exhibited fibrosis of the lung like the SARS phenomenon. Other severely affected patients did not have SARS-like lung fibrosis but had massive liquid cumulated in the lung, which even “drown” some patients to death. From the TCM point of view, it is not strange at all. Fibrosis of the lung is the typical following stage of Heated Interior matching to “Da Qing Long Tang” (大青龍湯). It was named as “Lung Atrophy” (肺痿) in the TCM theory. And the situation that one suffers from massive dense liquid accumulation is matched to symptoms of severe development after the stages matched to “She Gan Ma Hung Tang”( 射干麻黃湯) , “Ting Li Da Zao Xie Fei Tang” (葶藶大棗瀉肺湯), and others as discussed earlier. The TCM theory called it “Lung Abscess” (肺癰). In the TCM theory, Lung Atrophy and Lung Abscess are two progression paths of this virus depending on which path develops faster or even simultaneously. From the past and current reports, SARS virus tilts toward the path of Lung Atrophy, while the Coronavirus tilts a little more toward Lung Abscess.
The above explained the progression of flu and other epidemic virus infections. Now you might understand how different TCM doctors had different views or treatment methods, but all of the treatments had some partially positive effects. If a TCM doctor’s diagnosis at one particular moment was slight hotness of the lung, some mild herbs to “clean up the heat” (清熱解毒輕劑), often used by the “Southern School” doctrine (溫病派), might relieve the patient’s symptoms. But if a TCM doctor’s diagnosis at a different point of the progression was massive mucus accumulation, heavy dosage of strong herbs, often used by the “Northern or Classic School” doctrine (經方派) might be needed to treat Lung Abscess (肺癰). That is why we saw some reports that the “Pneumonia Formula One” (肺炎一號) used in Guangzhou city, which was based on mild herbs to reducing the “heat”, had some positive effects in Guangzhou but not so effective in Shanghai. In Shanghai, many TCM doctors had to switch to stronger herbal ingredient often found in “Da Qing Long Tang” (大青龍湯) and “She Gan Ma Hung Tang”( 射干麻黃湯) as discussed earlier. This was due to different weather patterns and different patients, i.e. different progression paths described in the previous paragraphs. In other words, from the specific moment of the doctor’s diagnosis, both views were correct. But neither of them grasped the progression timeline of this severe illness.
Another point raised earlier was why did some patients fully recover while others did not? According to the information given by the doctors on the front line, there were so-called “Western medicine and TCM combined treatments” in which Western medicine drugs were continuously given to the patients and TCM herbs were used as supplements. When adding TCM herbs had a positive effect and made a speedier recovery, it was all goodness. But when adding TCM herbs did not have positive results, then what? According to the doctors on the front line, the medical team did not really think through the stages of disease progression as discussed earlier and switch to different TCM remedies, but only increased the dosage of Western medicine drugs such as Interferon (干擾素), Chloroquine phosphate (磷酸氯喹) used to treat malaria (抗瘧疾藥物), Arbidol (阿比多爾) used to treat influenza (抗流感藥物), and others. Heavy dosages of such drugs had severe side effects and sequelae. In those “combined” treatments, the medical teams didn’t have enough TCM expertise to make sound decisions on herbal remedies. Instead, they simply used TCM herbs as “extra help”.
How about treatments primarily with TCM remedies? The chief Western medicine expert who leads the fight against the Coronavirus, Dr. Nanshan Zhong, admitted under political pressure that TCM was useful against light or even medium threat situations of Coronavirus but insisted that TCM could not cure severe cases. His statement was based on his belief that there is no ingredient in TCM herbs that could kill Coronavirus. I am sorry to say that Dr. Zhong is incorrect in this aspect. With solid patient cases as proof, TCM can actually cure severe cases of Coronavirus infection and other flu-related infections. When it did not, it is the particular TCM doctors who had not mastered the whole theory and methodology of TCM. But one thing that Dr. Zhong said correctly was that no ingredient in TCM herbs can “kill” the virus. However, the TCM treatment isn’t based on the ability to kill the virus. (Translator’s note: Western medicine drugs could not kill the virus either.) Many people still have the level of limited understanding that TCM can only improve the immunization ability or some herbs such as the root of Isatis tinctoria (板藍根) has some natural antibiotic chemicals. Such understanding is unfortunately poor and very limited. Although modern medical science still could not fully comprehend TCM theory and its clinical outcome, against Coronavirus, the better explanation is that TCM remedies can “improve the internal environment of the human body”. (Translator’s note: So that the patient would not fall into the adverse conditions that the organs fail to function.) In plain words, when the virus causes more mucus, TCM remedies reduce the mucus. When the virus causes fibrosis, TCM remedies reduce the “heat level” of the lung. TCM remedies tend to push the body and organs back to the original healthy states. Once the environment is unfriendly for the virus to keep replicating, the patients will have higher chances to eradicate the virus by themselves and recover. One can probably say that this explanation and method is similar to the idea of using Western medicine Interferon but without severe side effects. That is, TCM can cure not because it has the ability to “kill” virus by some ingredients but to help to restore patients’ “internal environment” to healthier conditions that prevent the virus from replicating quickly. (Translator’s note: If one buys the same argument made by Dr. Zhong that a medication needs to have ingredients to kill the Coronavirus, then all the medications used today would not qualify. Then do we give up? In fact, why TCM was not selected to treat severe cases was because those stronger and less commonly used herbs were not applied properly or the TCM doctors at hand had less confidence for doing so. )
Now, we can go back to discuss how clinically TCM can treat and cure Coronavirus patients. For light to mild cases, most of the different TCM treatment methodologies could help. For medium to severe cases, as I discussed in my previous essay, we need to utilize the strength of certain herbs:
- Sheng Shi Gao (Gypsum, 生石膏): To reduce heat inside the lung (清肺熱) and enhance the liquid circulation in the respiratory system (加強肺津液運作)
- She Gan (Belamcanda chinensis, 射干)、Zi Wan (Aster tataricus, 紫菀) 、Kuan Dong Hua (Tussilago farfara flower, 款冬花)、Sheng Ban Xia (Pinellia ternate, 生半夏)、Ting Li (Sisymbrium indicum, 葶藶)、Da Ji (Euphorbia pekinensis Rupr., 大戟), etc.: To reduce accumulation of excessive mucus and wasteful fluids inside the respiratory system (去肺下方濃稠痰飲、肺積水、胸腔積液等)
- Ma Huang (Ephedra sinica Stapf., 麻黃), etc.: To enhance the lung function (宣肺、發陽)
- Mai Men Dong (Ophiopogon japonicas, 麥門冬)、Xing Ren (Prunus armeniaca, 杏仁): To moisturize the lung (潤肺)
That is, we need to combine the theory and targeted responses of the various herbal remedies such as “Da Qing Long Tang” (大青龍湯), “She Gan Ma Hung Tang” (射干麻黃湯) , “Ting Li Da Zao Xie Fei Tang” (葶藶大棗瀉肺湯), ”Ze Qi Tang” (澤漆湯)“, etc. as discussed earlier, and properly adjust the dosages and ratios of ingredients to fit the requirements of individual patients based on their conditions. In addition, if the patients have other ailments, those conditions need to be taken into account also, such as:
- For “Coldness and Wetness of the Middle and Lower Abdomen“ (中下焦寒濕) or “Deficient Kidney Function” (腎陽不足): Add Bao Fu Zi (processed Aconitum carmichaelii Debx root, 炮附子)、Xi Xin (Asarum sieboldii, 細辛), etc.
- When the liver function is weak or damaged by heavy dosages of Western medicine drugs such as interferon: Add Chai Hu (Bupleuri Radix, 柴胡)、Huang Qin (Scutellaria baicalnsis Geprgi root, 黃芩), etc.
There is no question that it is very challenging to fight off the Coronavirus. The clinical treatments will seriously test TCM doctors’ thorough understanding of TCM and their ability and courage to call the right shots under a great amount of pressure. On the other hand, it is also a good time to prove that TCM can be effectively used to fight various viruses in a superb and speedy fashion with little sequelae and at a much lower cost.
For fighting such a new and aggressive virus epidemic, there is no single TCM herbal formula that can treat all situations. One must have deep knowledge of the stages of the disease, along with close examinations on patients’ preconditions, so one can use the most effective prescription to intercept and turn the symptoms around. On the other hand, many provinces and cities in China provided TCM guidelines on Coronavirus treatments and pre-fixed herbal formulas to address people’s demands on a herbal remedy for “common usage”. Among them, I found the current recommendation from the Chinese National TCM Administration the most appropriate for a good percentage of Coronavirus patients. The herbal remedy was recently named as “Qing Fei Pai Du Tang” (清肺排毒湯), which could probably be translated to “clean up the lung and get rid of the toxic”. In line with the discussion above, this specific herbal formula includes Ma Huang (Ephedra sinica Stapf., 麻黃), Zhi Gan Cao (processed Glycyrrhiza uralensis Fisch., 炙甘草)、Xing Ren (Prunus armeniaca, 杏仁)、Sheng Shi Gao (Gypsum, 生石膏)、Gui Zhi (Ramulus Cinnamom, 桂枝)、Ze Xie (Alisma orientalis, 澤瀉)、Zhu Ling (Polyporus umbellatus, 豬苓)、Bai Zhu (Atractylodes macrocephala Koidz., 白朮)、Fu Ling (Poria, 茯苓)、Chai Hu (Bupleuri Radix, 柴胡)、Huang Qin (Scutellaria baicalnsis Geprgi root, 黃芩)、Jiang Ban Xia (Pinellia ternate, 薑半夏)、Sheng Jiang (Ginger, 生薑)、Zi Wan (Aster tataricus, 紫菀)、Kuan Dong Hua (Tussilago farfara flower, 款冬花)、She Gan (Belamcanda chinensis, 射干)、Xi Xin (Asarum sieboldii, 細辛)、Shan Yao (Dioscorea oppositifolia, 山药)、Zhi Shi (Citrus aurantium, 枳實)、Chen Pi (Citrus reticulata Blanco, 陳皮)、and Huo Xiang (Pogostemon cabin, 藿香). Since such an herbal remedy was designed for “common usage”, it has to consider all degrees of disease severity. Therefore, the dosages can’t be too heavy, as the majority of the patient cases are light to mild. As the result, “Da Qing Long Tang” (大青龍湯) discussed earlier became a lighter herbal formula named as “Ma Xing Gan Shi Tang” (麻杏甘石湯). The stronger herbal ingredients such as Ting Li (Sisymbrium indicum, 葶藶) and Da Ji (Euphorbia pekinensis Rupr., 大戟) to treat pleural effusion and hydronephrosis are not included. Hence, for severe cases, the herbal remedy from the Chinese National TCM Administration needs to be enhanced with additional ingredients and larger dosages.
In summary, as long as the TCM doctors have sufficient knowledge and clinical experience, by applying the proper methodology, TCM alone is capable of dealing with severe Coronavirus infections. (Translator’s note: There is much to do to develop a comprehensive diagnostic and treatment methodology which can help many TCM doctors to pinpoint the patient’s condition and stages of the infection to make the proper decision, especially when fully qualified TCM doctors are of short supply.) At this moment, there is no “special drug” in Western medicine to cure Coronavirus, but to resort to cortisone, antibiotics, interferon, anti-malaria, anti-flu drugs to maintain the lives of patients and passively wait and hope that the patients’ bodies can find their own way to turn the situation around. Even then, the Western medicine drugs mentioned above all potentially have significant side effects and sequelae. Patients with severe cases might be able to get out of the deathbed but most likely live with some permanent damages to the body. Dr. Zhong, China’s chief Western medicine expert on the Coronavirus epidemic, also warned that the current path of developing the “special drug” would most likely lead to severe sequelae to the patients. Given that is the case, why don’t we put much more effort to fully develop the TCM treatment of viral infection, not just for Coronavirus but also for future viruses which will bound to happen in the future?
(Translator’s note: As China is getting good control of the virus spread and gradually recovers from this epidemic, the knowledge learned will be invaluable to the rest of the world. Europe and the United States are on the exponential rise of new cases as of the writing on 3/14/2020. Various models predict that in the US alone Coronavirus infections can reach millions, as discussed in the Opinion Column of New York Times, “How Much Worse the Coronavirus Could Get, in Charts” by Nicholas Kristof and Stuart A. Thompson, March 13, 2020. China should continue to put efforts to develop TCM diagnostic and treatment methodology so that millions of people in the rest of the world can be helped and saved. TCM is not just for science, it is for humanity.)
(http://andylee.pro/wp/?p=7729)
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ขั้นตอนการผลิต All-New 2019 BMW 3-Series Sedan (G20) production โฉมใหม่ล่าสุด (โดยละเอียด)
The BMW 3 Series Sedan represents the heartbeat of the BMW brand and the epitome of sporty driving pleasure in the premium midsize segment. The Mondial de l’Automobile 2018 is the venue for the world premiere of the seventh generation of the sports sedan. The new-edition 3 Series sees BMW building above all on the sporting tradition of the best-selling car. New powertrain technology and a body and chassis design geared squarely to maximising agility and dynamics create an ideal platform for an enthralling driving experience. The new BMW 3 Series Sedan comes as standard with a newly developed lift-related damper control system, which plays a significant role in giving the car its successful blend of sporting prowess and ride comfort. Options include an M Sport differential with electronically controlled locking function in the rear differential.
Precisely drawn lines and strikingly contoured surfaces mark out the exterior of the new BMW 3 Series Sedan, which showcases the brand’s new design language. The interior also has a clear, modern and sophisticated design.
Other features of the car that highlight its innovative character are BMW Operating System 7.0 and the BMW Intelligent Personal Assistant. Presented here for the first time, the Intelligent Personal Assistant responds to the prompt “Hey BMW”. The driver and passengers can speak with “him”, he is capable of learning and he gets better at his job all the time. The Intelligent Personal Assistant opens up a whole new avenue of interaction between the driver and car. It is a digital vehicle expert, knows the most important functions of the car and can explain them; if the driver wants to access navigation, office or entertainment functions, the BMW Intelligent Personal Assistant is there to help. One unique feature over other digital assistants is that drivers can give him a name, so they can activate him by saying “Hey Charlie”, for example, and therefore give him an even more defined personality. The Intelligent Personal Assistant awaits the driver’s every command and is always there to assist them. BMW is also taking a leading role in progress towards automated driving in the midsize class, thanks to a significantly extended range of driver assistance systems.