test case example的八卦，YOUTUBE和Yahoo名人娛樂都在討論

因為有不少朋友建議我，將日前臉書上“武漢肺炎發生率與致死率的國際比較”一文翻譯成英文，所以，就以英文版再次和大家分享，也謝謝大家的批評指教。

International Comparison of Incidence and Mortality Rates of COVID-19

In the statistics of the COVID-19 collected and published by the World Health Organization (WHO), only the numbers of confirmed cases and deaths of COVID-19 of affected countries are available, without taking the population of each country into consideration. It will result in a biased assessment of the COVID-19 risk for each country.
Better data for international comparison is incidence rates, which refer to the number of confirmed COVID-19 cases (numerator) divided by the number of the population (denominator) of a given country. As shown in Table 1. the incidence rate per 100,000 population was highest in Italy, Korean, Iran, and China (>5.0 per 100,000) and much lower in Japan, US and Taiwan (<0.5 per 100,000).



The number of confirmed COVID-19 cases in each country is not only related to its population but also dependent on the coverage rate of the COVID-19 virus test. The confirmed case number and incidence rate are relatively low for those countries where only the severe cases were tested for COVID-19 virus; and they are much higher for countries where severe, moderate and mild cases were tested for the virus.

Once a country changes its policy of virus testing, for example of testing only those who are seriously ill, the number of the confirmed cases and incidence rate will drop sharply in a short period of time, but its case fatality rate will rise accordingly.

The case fatality rate is the proportion (percentage) of confirmed COVID-19 cases who died from the disease. Its numerator is the number of confirmed cases who died from the disease, and its denominator is the total number of confirmed cases. It is for sure that the case fatality rate will be higher if the analysis is limited to severe cases, and it will drop dramatically if the analysis also includes moderate and mild cases.

As shown in Table 2, the case fatality rates are the same for severe (5%), moderate (0.5%) and mild (0.1%) COVID-19 confirmed cases in countries A, B, and C are the same, but
the overall case fatality rates per 1,000 confirmed cases are significantly different among the country A, where only test the severe cases (41 per 1,000), country B where both severe and moderate cases are tested (14 per 1,000), and country C where test all severe, moderate and mild cases (8 per 1,000).



Among the countries with more than 1,000 confirmed cases in Table 1, the overall case-fatality rates in Italy, China and Iran were all exceeded 3.5%. Obviously, the severe cases account for a relatively large proportion of confirmed cases. The overall case-fatality rate for South Korea and Germany was only 0.8% and 0.1%, respectively, where the moderate and mild cases account for a relatively large proportion.

When we see a rapid decline in the number of confirmed cases with a soared case fatality rate, we must first pay attention to the change in the country's virus testing strategy. The Director-General of WHO recently stated that all countries should be cautious for the case fatality rate of COVID-19 is rising! The conclusion that the Director-General was biasedly made without taking the change in the virus testing strategy into consideration. He made the matter worse by causing unnecessary panic!

In addition to the virus-detection strategy, some other factors such as age, chronic disease status, and quality of medical care also affect the case fatality rate. For examples, the fatality rate will be low if the patients in the hospital for isolation treatment are mostly young people, without chronic disease, and receiving good cares. If most patients are old, with chronic disease, and receiving inadequate cares due to limited hospital resources and manpower, the case fatality rate will become high.

หนึ่งในปัญหาคลาสิก เวลาเขียนโปรแกรมที่ทุกคนต้องเจอเลย
ก็คือการบวกลบเลขทศนิยมในภาษาโปรแกรม ของบางภาษา นี้แหละ
เช่น JavaScript, Python, Perl, C#, C, C++, Java, PHP, Fortran
(และอื่นๆ อีกหลายภาษาที่ไม่ได้กล่าวถึง)
.
หลายครั้งที่มันอาจเพี้ยนได้ เช่น
👉 0.1+0.2 ไม่ได้เท่ากับ 0.3
แต่ได้เป็น 0.30000000000000004
.
👉 หรือ 0.1 บวกกัน 10 ครั้ง ก็ไม่ได้เป็น 1
แต่ได้เป็น 0.9999999999999999
.
คนเขียนโปรแกรมเจอแบบนี้เข้าไป
ก็เหมือนมวยโดนหมัดน๊อคมึนงงในดงโค้ด
:
:
แต่ใช่ว่ามันจะเพี้ยนทุกครั้ง ซะเมื่อไร เช่น
0.5+0.5 = 1 (ถูกต้องเป๊ะ)
0.2+0.3 = 0.5 (บังเอิญไม่เพี้ยน)
.
สำหรับ กรณี 0.2 กับ 0.3 มันถูกตัดเศษเหลือเป็น
0.2000000000000000111022302462515654042363166809082031250
กับ
0.2999999999999999888977697537484345957636833190917968750
พอบวกกันจึงได้ 0.5 พอดี แบบฟลุ๊คๆๆ ซึ่งไม่ควรทำได้
(ตรงสอบดูได้ 0.2+0.3 == 0.5 ได้ค่าออกมาเป็น true)
:
:
สาเหตุที่เป็นเช่นนี้
ก็เพราะว่าคอมพิวเตอร์มันรู้จักแต่ เลขฐาน2 อะนะ
ต่อให้เราเขียนโค้ดใช้เลขฐาน10 ก็ตาม
สุดท้ายเวลาโค้ดมันถูกรัน ก็จะกลายเป็นเลขฐาน 2 อยู่ดี
.
😨 แล้วก็เป็นความซวยที่จะมาเยือนคนเขียนโปรแกรม
เพราะเวลาแปลงเลขฐาน10 ไปเป็นเลขฐาน 2
บางกรณีมันแปลงแล้ว ดันได้ตัวเลขที่ไม่รู้จบเสียด้วยซิ
จึงทำให้การเก็บทศนิยมผิดเพี้ยนไปได้
.
สำหรับรูปแบบการจัดเก็บเลขทศนิยม ในหลายภาษา
เขาจะนิยมใช้มาตรฐาน IEEE-754 floating point
เช่น 0.1 จะถูกมองว่าคือ 1/10
.
เมื่อเก็บเป็นเลขทศนิยมฐานสอง
ตามมาตรฐาน IEEE-754 floating point จะได้เป็น
0.0001100110011001100110011001100110011001100110011...
เป็นทศนิยมไม่รู้จบในรูปเลขฐานสอง ....นี้คือสิ่งที่คอมมองเห็น
.
พอคอมแปลงกลับมาเป็นทศนิยม เพื่อให้มนุษย์โลกอ่านเข้าใจ
ในรูปฐาน 10 ก็จะได้เป็น
0.1000000000000000055511151231257827021181583404541015625
ทว่าคอมมันจะตัดให้เหลือแค่ 0.1 (คนจึงเห็นแค่นี้)
:
🤔 ซึ่งความเพื้ยนแบบนี้
แน่นอนทำให้เกิดบั๊กเวลาคำนวณตัวเลข
- ยิ่งงานต้องการคำตอบที่ละเอียดมาก เช่น งานธนาคาร ก็จะประสบปัญหา เป็นต้น
- หรือเวลานำไปใช้ในเงื่อนไขเปรียบเทียบพวก if, while ฯลฯ ก็อาจมีบั๊กเกิดขึ้นได้ เป็นต้น
.
😀 แต่ไม่ต้องห่วง ในหลายๆ ภาษาเขาจะมีวิธีแก้ปัญหานี้อยู่ครับ
ป้องกันการคำนวณตัวเลข ไม่ให้คลาดเคลื่อน เช่น
- ใน Java ก็จะมีคลาส BigDecimal เอาไว้บวกลบคูณหาร สำหรับเลขทศนิยมโดยเฉพาะ
- ใน Python ก็จะมีคลาสคล้ายๆ กัน เช่น Decimal
- ส่วนใน JavaScript อาจใช้ไลบรารี่ ซึ่งมีให้เลือกเยอะเช่น
https://github.com/MikeMcl/decimal.js/
https://github.com/MikeMcl/bignumber.js/
https://github.com/MikeMcl/big.js/
- ภาษาอื่นที่เหลือลองไปศึกษาเองดูนะครับ
.
.
เรื่องบวกลบคูณหาร เลขทศนิยม ถือเป็นเรื่องสำคัญที่ไม่ควรมองข้าม
โดยส่วนตัวก็เคยเจอความเผลอเรอตรงนี้
ในระดับโปรเจคระดับธนาคาร ก็เคยพลาดมาแล้ว
สุดท้ายต้องมาไล่นั่งแก้โค้ดหลายบรรทัด
เสียเวลานั่งไล่ test ใหม่อีกรอบอีก
.
หมายเหตุเห็นคอมเมนต์สงสัยว่า
PHP กับ C# รอดชะตากรรมเดียวกันไหม ?
ก็บอกว่าไม่รอดครับ
.
// ลองดูตัวอย่างโค้ด C#
Console.WriteLine( ((0.1+0.2) == 0.3)); // False
Console.WriteLine( ((0.1+0.2) == 0.30000000000000004)); // True
// ลองดูตัวอย่างโค้ด PHP
echo number_format(0.1+0.2 , 17);
.
++++++
เขียนโดย โปรแกรมเมอร์ไทย thai programmer
อ่านเรื่อง IEEE-754 floating point ได้ที่
https://th.wikipedia.org/wiki/จำนวนจุดลอยตัว
One of those classic problems, programming that everyone needs to encounter.
It's positive to delete decimal numbers in some language.
เช่น JavaScript, Python, Perl, C#, C, C++, Java, PHP, Fortran
(and many other languages not mentioned)
.
Many times it can be crazy like
👉 0.1 + 0.2 is not equal to 0.3
But I got to be 0.30000000000000004
.
👉 or 0.1 plus 10 times. It's not 1
But I got to be 0.9999999999999999
.
The Programmer found this.
It's like boxing. I got hit by a punch. I'm confused in dong code.
:
:
But it's not that it's crazy every time like
0.5 + 0.5 = 1 (exactly correct)
0.2 + 0.3 = 0.5 (accidentally not crazy)
.
For Case 0.2 and 0.3 it was cut down.
0.2000000000000000111022302462515654042363166809082031250
With the.
0.2999999999999999888977697537484345957636833190917968750
When we are positive, we get 0.5 fit like fluke which you shouldn't be able to do.
(I can watch the exam. 0.2 + 0.3 == 0.5 get the value to be true)
:
:
The cause is like this
Because computers only know the base number 2
Even if we write code, use base number 10
In the end, when the code is run, it will become base number 2 anyway.
.
😨 and it's bad luck to visit the programmer.
Because time to convert base number 10 to base number 2
In some cases, it's converted and I get the number that I don't end.
So it makes the decimal picking wrong.
.
For the decimal number storage in multiple languages
He will be popular with IEEE-754 floating point standards
For example, 0.1 will be seen as 1/10
.
When keeping it as a decimal number, base two.
According to IEEE-754 floating point standards.
0.0001100110011001100110011001100110011001100110011...
It's a decimal. I don't finish in the second base picture.... this is what the computer can see.
.
When the computer converts back to decimal so that the world can read and understand.
In the picture of base 10 will be.
0.1000000000000000055511151231257827021181583404541015625
But the computer will cut to only 0.1 (so people see this)
:
🤔 this kind of being
Sure. It makes cuddle times to calculate numbers.
- the more jobs need detailed answers such as banking work, there will be problems, etc.
- or time to use in comparison terms. If, while etc. There may be cuddle baht.
.
😀 but don't worry. in many languages, there will be a solution to this problem.
Prevent calculation of numbers from inaccurate such as
- in Java, there will be bigdecimal class to delete multiplication for decimal numbers especially.
- in python, there will be similar classes such as decimal.
- Javascript may use a lot of libraries to choose from.
https://github.com/MikeMcl/decimal.js/
https://github.com/MikeMcl/bignumber.js/
https://github.com/MikeMcl/big.js/
- the rest of the other languages, try to study it yourself.
.
.
It's important to delete multiplication, divide the decimal numbers. It's important that you should not overlook.
Personally, I have met a burp here.
At Project Level, bank level has been missed.
Finally, I have to sit and fix many lines of code.
Wasting time to sit and chase the test again.
.
Note that I see the comments. I wonder if
Php and c #survive the same fate?
I said I wouldn't survive.
.
// check out the code C Sample #
Console.WriteLine( ((0.1+0.2) == 0.3)); // False
Console.WriteLine( ((0.1+0.2) == 0.30000000000000004)); // True
// check out the sample code php
echo number_format(0.1+0.2 , 17);
.
++++++
Written by Thai Programmer Thai programmer
Read about IEEE-754 floating point at
https://th.wikipedia.org/wiki/จำนวนจุดลอยตัวTranslated

從非典到新冠肺炎

From SARS to Novel Coronavirus (COVID-19) - English version is in the second half

新冠肺炎，Novel coronavirus (2019-nCoV) 新型冠状病毒肺炎，疫情越來越嚴重，被證實可以人傳人，也在武漢以外的許多地方發現病例，造成世界各國及世界衛生組織（WHO）高度關切，當然也讓很多住在中國大陸及附近區域的華人非常緊張，就好像當年的非典肺炎疫情即將再一次大爆發一樣。

目前，現代醫學還沒有找到治療新冠肺炎的方法，只能針對某些症狀來處理，疫苗的研發更是遙遙無期。怎麼辦？每次遇到這種情況，中醫就會被搬出來，這次也不例外。新冠肺炎爆發後，網上馬上有許多中醫對付新冠肺炎的文章。當然，除非哪位中醫師看過、治好過大量的新冠肺炎病例，所有的討論都是猜想、假設。然而，有些猜想及假設值得參考，有些猜想及假設卻明顯在誤導大眾。

我還沒有治療過新冠肺炎，不能大肆評論。不過，我治好過很多禽流感、豬流感、及每年流感導致的嚴重肺炎及其它病變的病人。其中許多病人是被美國大型西醫院證實為嚴重肺炎，被要求醫院或居家隔離，偷偷溜出來找中醫看診的。也因此許多病人及討論中醫的網站，希望我能針對新冠肺炎發表一些意見。

我們以前就討論過，這些彪悍的流感病毒，經過那麼多年、那麼多次的變種（mutation），每年都不一樣，東漢時期傳下來的經典中醫，根本沒有遇到過現在的病毒，怎麼可能治療如此嚴重的肺炎呢？

中醫從來就不認識病毒，也不從病毒種類的角度來思考。中醫是探討人體受到外界因素破壞，失去平衡後，身體會有哪些現象、哪些反應，根據那些現象、那些反應來調整身體狀況，期待身體能恢復到平衡狀態，把外界因素帶來的破壞減到最小。我打個半開玩笑的比方，警匪槍戰時，我們注意到壞人哪個方向來的火力強大，造成我們部署在哪個位置的警員傷亡，這時我們會趕緊重新部署人員，或者想辦法增派警力，我們大概無暇去管壞人是用哪個牌子的槍、哪個工廠做的子彈！

雖然幾百年幾千年下來，病毒變種等等的外界因素改變了非常多，人體演化的改變卻非常有限。人體的功能，無論是怎麼被破壞的，某項功能被破壞而導致的症狀、反應、後續演變，卻依然有明顯的脈絡可循。也因為如此，在很多情況下，中醫以專注人體本身平衡狀態的治療方式，反而比西醫專注在外來敵人的治療方式來得有效許多。

依據多年累積大量的臨床病例觀察，無論是禽流感、豬流感、還是每年的流感，人體敗壞的進程依然如同傷寒雜病論探討的一樣，非常簡化的說，從一般桂枝湯證、葛根湯證等的表寒，轉變到小青龍湯證等的裡寒，津液不足、水道運化失調而化熱，變成比較嚴重的大青龍湯證，或者更嚴重肺臟的寒熱夾雜，金匮要略肺痿肺癰咳嗽上氣病脈證治第七篇中的射干麻黃證、葶藶大棗瀉肺湯證、澤漆湯證、小青龍加石膏湯證等等混雜出現，搞得亂七八糟，也不再是什麼簡單方劑可以對應的。

然而，雖然進程很像，不同於一般外感的是，這些嚴重流感肺炎病情加重的改變速度快非常多，也來得猛烈頑強很多。一般的外感從桂枝湯證、葛根湯證等轉變到大青龍湯證或更複雜的病情，通常需要一兩週的時間。同時，還得病人自己非常不注意，或者醫生治療錯誤，一般感冒才會沒辦法自己好，反而變成嚴重的病症。這幾年的流感，從一開始覺得不太對勁，到嚴重複雜的病情，只需要三四天，而且有越來越快的趨勢。這大幅提高中醫師治療流感時，判斷功力及敏感度的要求，中醫師必須在許多症狀還沒有出現時，就得抓緊時間，趕緊行動，卻又不能預防過度，反而讓病情加重。換句話說，時機、劑量、藥材比例變得非常重要，稍有不慎，就無法反轉病情。

舉個例子，有些病人得了流感，咳嗽非常嚴重，痰非常多，呼吸困難。依照中醫的辨證，假如一致都是寒，舌苔白、小便清、怕冷等等，本來依照辨證論治，我們可能會開射干麻黃湯加減給病人。然而，因為流感的進程非常快速，中醫師得非常敏感，譬如看到舌苔白卻帶有一絲絲乾的感覺，就很可能得加上大寒的石膏來避免肺喪失津液，卻又不能加太多石膏，以免肺寒加重。又譬如聽到咳嗽聲音非常深沈，從肺的底部發出，又帶有膿痰的濁音，就很可能得加上瀉肺的葶藶來避免肺中水飲、痰飲大幅增加，卻又不能加太多葶藶，以免肺變得太虛弱。

我們回頭來看這次的新冠肺炎。根據有限的資訊，我們知道感染後有大約兩週的潛伏期，這段時間沒有什麼症狀，病人可能只會感到有些疲憊。剛開始發病時，很像一般的感冒，病人會發熱、乏力，並不嚴重，沒有什麼流鼻涕等上呼吸道的症狀，有的甚至沒有發熱。約一半的病人一週多後恢復，另一半的病人卻在一週後出現呼吸困難，有些病人會快速進展為急性呼吸窘迫綜合征、膿毒症休克、代謝性酸中毒、凝血功能障礙等等嚴重的問題，可能導致死亡。

從上面的敘述，我們不難發現，一開始很像一般中醫外感的桂枝湯證、葛根湯證，一半的病人也就自己恢復了，另一半的病人卻出現快速的入裡化熱現象，肺津液迅速流失，非常濃稠的痰飲沈積在肺部下方。同時，中醫認為肺為人體調節津液的源頭，肺金生水，好比天空下雨一般，而當肺的功能及津液調節出現嚴重障礙，很快就會拖累三焦水道、腎臟等的功能，導致上面提到的幾種嚴重病情。換句話說，新冠肺炎可以讓輕微的太陽證外感，迅速發展成嚴重的肺痿肺癰，再進一步瓦解人體其它功能的運作。

怎麼治療？在沒有直接治療武漢肺炎病人的情況下，我們也只能根據有限的資訊來推論，不過，以前大量的流感肺炎治療病例，可以讓我們比較有信心的面對新冠肺炎。當病人已經出現明顯新冠肺炎症狀時，大多已經入裡化熱，嚴重的肺痿肺癰。這個時候，得用大劑量的石膏清肺熱、加強肺津液運作。也得靠葶藶、大戟等把肺下方濃稠的痰飲及胸腔可能的積液去掉，痰飲積液不去，是無法修復肺家津液運作的。同時，肺氣不宣，就好像吸管上頭堵住了，吸管內的水無法上下，我們還得使用麻黃等宣肺、發陽的中藥來配合。另外，肺已經受損了，除了大動作急救外，比較穩定後，還得靠一些潤肺的藥來收尾，讓肺完全恢復。如果我們列一個可能加入的中藥單，大致有石膏、葶藶子、大戟、生半夏、麻黃、射干、紫菀 、款冬花、 生薑、炙甘草、紅棗、麥門冬、杏仁等等。當然，如前面所言，用藥的時機、劑量、藥材比例非常重要，每一個病人的差異也很大，嚴格考驗中醫師的功力與膽識，一旦判斷錯誤，不但沒有效果，反而可能會加重病情。

網上有些中醫師，說新冠肺炎或其它流感肺炎可以用板藍根清熱解毒來治好。也有些中醫師說可以用麥門冬湯等等的輕劑治好嚴重的肺炎。甚至還有些中醫師說多喝綠豆湯可以預防新冠肺炎！其實，真的遇過、治好過禽流感、豬流感等嚴重流感肺炎的中醫師，一看這些文章，就幾乎可以確定這些人根本沒有治療過嚴重肺炎的經驗，充其量只是在西醫治療下，在旁邊幫幫病人一些小忙而已。這樣的情況下，難怪中國政府平時大力推展中醫，真的有如同新冠肺炎這樣重大疫情爆發時，卻看不到中國政府大量使用中醫方法來治療病人、控制疫情。醫學是實戰的學問，沒有大量臨床病例，講得再好聽都是沒有用的，如果希望中醫真的在主流醫學裡站立起來，希望中醫真的能面對大規模的疫情，回歸最基本的臨床療效，才是最重要的，其它都只像是武術表演，而非實際作戰。

From SARS to Novel Coronavirus (COVID-19)

Written in Chinese by Dr. Andy Lee, January 21, 2020
Translated to English by Dr. James Yeh and Dr. Andy Lee, March 28, 2020

The epidemic from Novel Coronavirus is becoming much more serious. Transmissivity among people has been proven. (Note: It's now named COVID–19. The term “Coronavirus” will be used here.) Cases were found in areas beyond Wuhan. It has caused serious attentions from the WHO (World Health Organization) and many countries around the world. The residents in China and the surrounding regions are quite worried and wonder whether it will break out like SARS (2003). (Note: The article was written on January 21, 2020, before Coronavirus became a global pandemic.)

So far, the modern medical field has not found a cure for Coronavirus, but resorts to treating patients’ symptoms only. Any vaccine to treat Coronavirus is still no way in the sight. What do we do? Every time such a situation happens, the topic of using Traditional Chinese Medicine (TCM) is raised (at least among the Chinese communities). There is no exception this time. Many articles related to using TCM on Coronavirus have been popping up on the web. However, unless some TCM doctors who have actually treated many Coronavirus cases, all the discussion would be hypotheses or assumptions. Some hypotheses are worth considering while many others could be quite misleading.

Personally I have not treated patients cases related to Coronavirus. (Note: Shortly after this writing, the author has directly and indirectly participated in treating patients of Coronavirus successfully, and has published other later blogs which included his involvement in treating those patients. Please refer to his medical blog http://www.DrLee.us.) However, I did treat and cure patients inflicted by other viruses in the past, such as the Bird Flu, Swine Flu, and other influenza. A good amount of those patients were diagnosed as severe pneumonia by large hospitals and were required for isolation or self-quarantine. Hence many of patients and online medical forums online are asking for my opinions about Coronavirus.

As we discussed before, all these viruses from the outbreaks are either newly found or mutated from previous strands. The strand can be different every year. Therefore, people always ask how one can say that the TCM knowledge developed in East Han Dynasty (25-220 AD) would be any useful for treating the modern diseases, let alone the severe ones.

It turns out that TCM does not recognize any virus and does not deal with the concept of which type of virus is microscopically at work. TCM looks at how human bodies would become out-of-balance and react to external stimuli. Once the body is out of balance, what symptoms will exhibit and what reactions will be to adjust the body conditions to regain the balance, hence to reduce the damage to the body to the minimum. Let me take an example to illustrate: when there is a gunfight between the police and bandits, we want to see which direction the shots are coming from, causing casualties of the police force, so that we are able to adjust or reinforce the police power. We have no time to think about which brand of the guns or bullets the bandits use.

Over thousands of years, the external viruses have changed and evolved quite a bit, but the evolution of human beings was quite limited. The human body function, no matter how it was damaged, the symptoms due to the damage of the function, the reactions, and the following progression of the disease still follow certain paths. For this very reason, TCM’s focus on the balance of the human body often surpasses the effectiveness of Western medicine, which focuses more on external treats and the microscopic aspect of how human body’s cells are impacted by the external treats.

From the accumulation of many years of clinical treatment and observations, no matter it is Bird Flu, Swine Flu or other influenza, the bodily ‘damage’ and its progression by the viral attack still follow the description of the classic TCM literature “Treatise on Cold Damage on Miscellaneous Disease” (傷寒雜病論). In short summary, the disease usually starts with “Exterior Deficiency or Weakness” (表虛) or “External Coldness” (表寒), for which is matched to one of the several syndromes named with the corresponding herbal remedies such as “Gui Zhi Tang” (桂枝湯) and “Ge Geng Tang” (葛根湯). Then, the disease moves onto the next stage “Interior Coldness” (裡寒) or “Lung Coldness” (肺寒), which shows the syndromes named as “Xiao Qing Long Tang” (小青龍湯), etc. When the respiratory system is “affected by the coldness”, the body fluid function of the respiratory system gets affected. The circulation function of the lung becomes “Dry and Overheated” (燥热). This would lead to a more serious stage “Heated Interior” (入裡化熱) and would often be matched to its herbal remedy “Da Qing Long Tang” (大青龍湯). Or, even worse, it becomes so-called “mixed coldness and heat” (寒熱夾雜) in the lung. Such a complex situation was extensively discussed in Chapter 7 of the classic literature “Synopsis of Prescriptions of the Golden Chamber” (金匮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.

However, even the disease progressions are similar, the more serious viral attacks like Coronavirus can and often do progress much faster with more severe consequences than the common flu. As described in the previous paragraph, normally the disease progression of the “External Coldness” stage to the more serious “Heated Interior” stage usually takes one to two weeks. It is also often due to the ignorance of the patient or misdiagnosis and treatment of the doctor, which prevents the patient from recovering from this “catching a cold”. In the recent several years though, the time period between the time that the patient did not feel well and the time that the patient is in a serious and complex situation can be as short as 3 to 4 days. We also see the trend that this period gets shorter and shorter. In other words, the disease progression is getting much faster. This phenomenon poses a much higher demand on TCM doctors’ ability to make a quick and proper judgment and sensitivity to the subject matter. TCM doctors must intercept the disease progression before it reaches to a more serious stage, even without obvious symptoms of the next stage. TCM doctors have to timely prescribe the proper herbal remedy in terms of the type of herbs and relative dosages of herbs. Too weak a dosage could not stop the progression while too strong a dosage could worsen the condition also. A misjudgment would not be able the turn the conditions around, but hurt the patient more.

The above can be illustrated by a simple example. A patient caught flu and has symptoms such as heavy coughing, lots of sputum, and difficulty in breathing. From the TCM dialectics, with observations of white tongue coating, clear urine, and feeling chilly, etc., it is clearly caused by “Coldness”. Such a patient typically should be prescribed with “She Gan Ma Hung Tang” (射干麻黃湯) or its variations. However, due to the fast progression of the modern flu, the TCM doctor would need to pay attention to much subtle details such as the dryness of the tongue although it still shows the white coating. In this case, Sheng Shi Gao (Gypsum, 生石膏) might need to be added to the herbal remedy to make sure that the lung would not suffer dryness. Given that Sheng Shi Gao (Gypsum, 生石膏) itself is an ingredicient that is “very cold” in nature, the dosage could not be too strong to make the lung too chilly. At the opposite end of the spectrum, if the sound of the coughing is very ‘deep’, like dense sputum coming from the bottom of the lung, the herbal remedy might need to add Ting Li (Sisymbrium indicum, 葶藶) to clear up the lung to avoid too much mucus in the lung. And again, the dosage of葶藶 could not be too much to weaken the lung. (Note: Handling the proper timing and proper remedy can be a real test to the ability and experience of the TCM doctor.)

Let’s go back to the discussion on Coronavirus. From the limited information available so far, we know that there are about two weeks of incubation period after the infection. There are little symptoms during this period and the patient may just feel more tired than usual. More obvious symptoms will start like those of common flu with fever, fatigue but not too serious. Upper respiratory symptoms like running nose are less common. Some patients may not even exhibit fever. About half of the patients infected will recover over a week or so. The other half of the patients will experience difficulty in breathing, or rapid progression to acute respiratory distress syndrome, septic shock, metabolic acidosis, coagulopathy, etc. Some patients had died due to these severe conditions.

From the above description, this Coronavirus, in the beginning, is very much like the common flu and will stay in stages of “Exterior Deficiency or Weakness” (表虛) or “External Coldness” (表寒). Half of the patients infected will recover by themselves as in common cold. The other half of the patients may exhibit situations of rapid penetration into inner organs and excess ‘heat’, which causes loss of fluidity of respiratory system and accumulation of dense sputum at the lower part of the lung. In the TCM theory, the lung serves as the initial “gating factor” of body fluids. When the lung fails to serve the proper function, other organs like the kidney will be adversely affected also. In other words, Coronavirus can turn a light “External Coldness” to extremely severe “Lung Atrophy” (肺痿) and “Lung Abscess” (肺癰), which in turn will impair the function of other organs.

How to treat? Without direct experience of treating Coronavirus patients, we can only postulate from our limited information available in hand. (Note: Shortly after this writing, the author has directly and indirectly participated in treating patients of Coronavirus successfully. The treatments were exactly as outlined in this article.) From the ample experience of dealing pneumonia cases caused by flu, we are confident that we can also treat Coronavirus successfully. When patients are showing the obvious Coronavirus symptoms, most of them would have entered the stage of “Heated Interior” (入裡化熱) with “Lung Atrophy” (肺痿) or “Lung Abscess” (肺癰) to a certain degree. At this stage, we will need large dosages of Sheng Shi Gao (Gypsum, 生石膏) to clear the heat to ensure the proper fluidity function of the lung. Also, we will rely on Ting Li (Sisymbrium indicum, 葶藶), Da Ji (Euphorbia pekinensis Rupr., 大戟), etc. to clear up the dense mucus at the lower part of the lung and to remove the edema of the chest chamber. Without getting rid of the excess mucus and fluid, the lung cannot properly function. We need to use Ma Huang (Ephedra sinica Stapf., 麻黃), etc. to enhance the lung function (宣肺、發陽) and restore proper breathing. When the lung is damaged as in fibrosis, after the conditions stabilize, we need to “moisturize” the lung (润肺) to help the lung to recover fully. In other words, we will most likely use the herbal ingredients such as Sheng Shi Gao (Gypsum, 生石膏), Ting Li (Sisymbrium indicum, 葶藶), Da Ji (Euphorbia pekinensis Rupr., 大戟), Sheng Ban Xia (Pinellia ternate, 生半夏), Ma Huang (Ephedra sinica Stapf., 麻黃), She Gan (Belamcanda chinensis, 射干), Zi Wan (Aster tataricus, 紫菀), Kuan Dong Hua (Tussilago farfara flower, 款冬花), Sheng Jiang (Ginger, 生薑), Zhi Gan Cao (processed Glycyrrhiza uralensis Fisch., 炙甘草), Hong Zao (Ziziphus jujube, 紅棗), Mai Men Dong (Ophiopogon japonicas, 麥門冬), Xing Ren (Prunus armeniaca, 杏仁), and others. As we discussed in previous paragraphs, the timing, dosage, the relative ratios of different herbal ingredients are very critical. Given that there are quite some variations in patient conditions, the challenges on TCM doctors’ comprehensive knowledge, judgment and courage are unprecedented.

In those articles online, some TCM doctors claimed that Coronavirus can be cured by Ban Lan Gen (Isatis tinctoria root, 板藍根), which is believed to have natural antibiotic chemicals to “clear up the heat and toxics”. Some TCM doctors suggested using a simple mild herbal remedy “Mai Men Dong Tang” (麥門冬湯), which mainly relies on the ingredient Mai Men Dong (Ophiopogon japonicas, 麥門冬). Some people even suggested that having the green bean soup could prevent Coronavirus. In fact, those TCM doctors who have good experience of treating Bird Flu, Swine Flu, and pneumonia caused by other influenza would know that the people making those claims never had the real experience of treating severe pneumonia. They at most helped in a minor way the patients under Western medicine treatments. Under such conditions, it is not a surprise that the China government has not used TCM as the primary method of treating Coronavirus, despite its big promotion of TCM in the recent years. (Note: After this writing, Coronavirus epidemic became so severe in China that the China government changed its strategy and started to use TCM extensively in treating many mild Coronaviurs cases.)

Medicine is the science based on real treatment results. Without a good amount of successful cases in clinical treatments, it is useless to promote any fancy idea of treating patients. If we would like TCM to be respected in the mainstream medicine and to be meaningfully used in a severe epidemic like Coronavirus, it is critical to focus on the most fundamental. That’s the clinical results. Like the martial arts, unless you can fight off the bad guys, it’s just a show of fancy movements.

（http://andylee.pro/wp/?p=7169）
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When you see a buildup form at resistance or support, you want to know THIS strategy.

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1:25 KEY Tips for Trading Breakouts #1
The reason I'm looking for a buildup is very simple, it tells you one thing. For example, in this case, it is formed at resistance and has a buildup form at resistance. What it's telling you is that buyers are willing to buy at these higher prices, right?

1:44 KEY Tips for Trading Breakouts #2
Think about this, resistance is an area where traders are looking to get in the market. Where you expect the price to come down. The fact that the price cannot come down and is hovering at these higher prices, for quite a while in fact, it's about like, what? 20, 25 candles? It's telling you that the buyers are just willing to buy at these higher prices. And this is a sign of strength. Traders are buying at such higher prices because they think that the price is about to breakout higher. So this is a sign of strength and whenever you see a buildup form at resistance, it's a sign of strength. And, the market could possibly breakout from here.

2:16 KEY Tips for Trading Breakouts #3
Opposite of this is what we call the descending triangle. It's simply lower highs into support where you notice that the price is actually making lower highs into support. Telling you that the sellers are willing to sell at this lower price. And so they're just the inverse. Okay?

2:24 KEY Tips for Trading Breakouts #4
The fourth technique I wanna share with you is what I call the re-test. So when the price breaks out, there are times where it comes back and re-test the level previous resistance tested support. So here's an example, price breakout of this height re-test the previous resistance now it can support, price breaks out of it again, re-test previous resistance now it can support. Price then breaks out of this swing high retest previous swing high now it can support. Price breaks out of this swing high or resistance re-test so that it can support. So you can see that, this area in the chart where the price breaks out off in time to come in the future it could potentially act as a level where the buying pressure could come in.

3:26 KEY Tips for Trading Breakouts #5
This is what we call the re-test. So this is useful when the prices breakout and you miss the train you don't have to chase the market because if you're a patient enough, more often than not the market could do a re-test and give you a much more favorable entry price instead of chasing the market and the highs. Okay, and the last technique that I wanna share with you is what I call the strong trend. So this is when the trend is strong and typically is when the price is above the 20MA and in this case is below the 20MA.

If you have enjoyed this video so far, you can go down to my website for free trading strategies and techniques to improve your trading results. Just go to my website, tradingwithryner.com over here the link's at the top. Just scroll down to the bottom depending what you want. Even learn how to write massive trends. To learn about trading your stop loss exists where you can download this ultimate Trend Following guidelines where I will share with you different techniques to actually trade your stop-loss to big trends in the market.

Now, if you wanna learn how to better time your entries, maybe you wanna learn more than breakout. Maybe you wanna learn pullback support resistance, go and download the ultimate guide to PriceAction Trading because that's where I cover that in more details. These two guides are completely free so just go down to my website tradingwithryner.com click this blue button and I'll send it to your email address for free. All right? So with that said, I've come towards the end of this video if you've enjoyed, please see the like button. Any feedback or comment, let me know below I would really appreciate it. And if you wanna stay up to date, subscribe to my YouTube channel and you'll always be updated whenever I publish a new video.

รีวิว Casio Pro Trek F20A นาฬิกาที่แข็งแรงที่สุดจาก Casio ผ่านการทดสอบระดับเกรดทหาร

Casio Pro Trek F20A เปิดราคาเมืองไทย 14900 บาท เท่านั้น สามารถไปชมตัวจริงได้ที่งาน International Watch Fair วันที่ 21 สิงหาคม 2561 - 30 กันยายน 2561 นี้ ที่เซนทรัลชิดลม กรุงเทพมหานคร

Wear OS by Google™
4 GB internal memory
512 MB RAM
512 MB of RAM available.
Wi-Fi (IEEE 802.11 b/g/n)
Bluetooth® Smart
Super-Illuminator
MIL-STD-810G compliant
The MIL-STD-810 is a U.S. military technical standard that specifies environmental test conditions for military equipment. The standard defines tests for the compatibility of equipment and devices with extreme temperatures and air pressures, solar radiation, humidity, chemicals, acceleration forces and vibrations.
Smartphone time
Double LCD (320 x 300)
Touchscreen
Sunrise/sunset display
Fishing Timer
A special sensor measures the air pressure (measuring range: 260/1100 hPa) and presents this on the display in the form of a symbol. This enables early detection of weather trends.
Digital-compass
A built-in direction sensor detecs the magnetic north.
10,000 m Altimeter
A pressure sensor detects changes in the air pressure and converts the result into an altitude up to 10,000 m.
Altimeter data memory
Depending on the model, up to 40 sets of elevation data can be stored in the watch's data memory and re-accessed at any time. Each of these data sets consists of a measured altitude as well as the date and time. In addition to the individual altitudes, the maximum and minimum altitudes during a measurement are also stored.
Moon Phase Indicator
The moon phase indicator shows the current moon phase based to the earth
Tide indicator
Once the high tide time has been entered for a selected location, the watch can display the low and high tide phases at this location on any given date. This can be quite useful, for example, if you want to know the patterns of the tides at your destination in advance.
Gyrometer
Ideal for outdoor activities: The gyro sensor shows you every little change in direction during navigation, ensuring you always reach your destination. The sensor detects the smallest movements of the watch and acts against this by supporting optical image stabilisation or the alignment of the display.
Acceleration sensor
The motion sensor responds to acceleration and shows this as a speed on the display. The sensor also supports the auto rotation function of the watch, ensuring that the image is always displayed the right way up on the display.
GPS function
Measures your current position using artificial satellites circling the globe.
World time function
Displays the current time in major cities and specific areas around the world.
Daily alarm
The daily alarm reminds you of events that recur every day, by emitting an audible signal at the set time.
Snooze feature
Each time you stop the alarm, it sounds again after a few minutes.
Vibration alert
The vibration alarm discreetly reminds you of important appointments, without emitting a loud signal.
Airplane Mode (Offline Mode)
At the touch of a button, the watch switches to offline mode. This means that you can disable the wireless or GPS receiver when in the air for the duration of the flight.
Microphone
Make your daily life easier using practical voice commands spoken directly into the microphone on your watch. For example, you can start a Google search by saying "OK Google" — without the need to touch the display, or even take your smartphone out of your pocket. Many actions can be performed via the microphone using voice commands.
Mineral glass
The tough mineral glass resists scratching.
Resin case
Resin band
Synthetic resin is the ideal material for wrist straps thanks to its extremely durable and flexible properties.
Battery level indicator
An indicator shows the current battery level.
Water resistance classification (5 bar)
This watch can be worn when showering and bathing - it is tested for water resistance up to 5 bar according to ISO 22810.
Dimensions (H x W x D)
61,7mm x 57,7mm x 15,3mm
Weight
approx. 90 g
Availability of models and/or lineups may differ depending on the country or region.
Technical amendments and errors excepted. The sizes in figures do not correspond to the original sizes.
The colours may differ slightly from the original.
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Munich. Long bonnet, short overhangs, low centre of gravity, soft top: the sporty two-seater doing its laps at the BMW test centre in Miramas in the south of France is instantly recognisable as a purebred roadster. The new BMW Z4 is currently undergoing another particularly important stage of the process towards serial production maturity, in this case involving driving dynamics testing of a heavily disguised prototype. This will provide key insights into the performance properties of the new model, whose genuine roadster characteristics, pure driving pleasure and captivating sporty flair will soon go out on public roads.

Trials at the Autodrome de Miramas are focusing on fine-tuning of all drive and suspension systems – the basis for the sporty driving experience offered by the new BMW Z4. The most intense form of new dynamic roadster performance is embodied by the BMW Z4 M40i. A new, extremely powerful in-line 6-cylinder engine, a lowered sports suspension with electronically controlled dampers, a newly developed front axle, M light alloy wheels with mixed tyres, an M sports brake system and an electronically controlled lock in the rear axle differential create an overall package that sees the BMW M Performance model setting a whole new benchmark for driving pleasure in the roadster segment.

"The vehicle concept of the new BMW Z4 is geared consistently towards agility and driving dynamics," explains Jos van As, Head of Application Suspension. "The high level of body stiffness and the very rigid suspension attachment provide the perfect basis for a set-up that guarantees the performance qualities of a genuine sports car in terms of steering precision as well as longitudinal and transverse acceleration."

Like the Nürburgring-Nordschleife, the Miramas test centre offers perfect conditions for the new BMW Z4 to demonstrate its driving dynamics potential. Used by BMW to develop and test new models for more than 30 years, the centre comprises a long asphalt oval and a motorway ring road for high-speed tests as well as slalom, serpentine and circular tracks and a number of handling courses and circuits featuring highly diverse types of surface. These are currently being used for detailed analysis and optimisation of the roadster's acceleration, steering and brake response. For example, the final form of the adaptive M suspension as it interacts with the rear axle limited-slip differential is developed on a circuit that is also used for testing purposes by BMW Motorsport.

This intense testing process already indicates that the new version of the roadster concept will offer a tangible increase in sporty flair in the new BMW Z4. The new generation will particularly introduce effective enhancements in terms of agile handling, spontaneity and precision when changing direction and accelerating in dynamic style out of bends – without losing out in the comfort disciplines.