ObjectiveTo observe the effects of Xiere Xingpi Yin （XRXPY） on the body mass and body fat distribution in patients with simple obesity， and to preliminarily explore whether the mechanism involves the regulation of specific obesity-related microRNAs （miRNAs）. MethodsA randomized controlled trial design was employed to recruit patients with simple obesity diagnosed with the traditional Chinese medicine （TCM） syndrome of dampness-heat accumulating in the spleen. Using a randomized controlled trial design， 95 patients with simple obesity of dampness-heat encumbering the Spleen syndrome were recruited， after 3 were excluded， 92 were randomly assigned in a 1∶1 ratio by means of a random number table. On the basis of lifestyle intervention， the observation group received XRXPY granules， while the control group received a placebo. Serum samples and TCM symptom scores were collected before and after the 12-week observation period. Differences in body mass loss， body composition， lipid metabolism， and TCM symptom scores were compared between the groups. An obesity-related miRNA dataset was constructed by searching the Human MicroRNA Disease Database. Library construction， sequencing， and quality control were performed on 6 selected patients from each group to screen the differentially expressed miRNAs. The intersection of these miRNAs with the obesity-related miRNAs was verified by bioinformatics and correlation analysis. ResultsBaseline characteristics were comparable between the two groups before treatment. A total of 86 patients completed the study （42 cases in the observation group and 44 cases in the control group）. The proportion of patients achieving ≥5% body weight reduction was significantly higher in the observation group than in the control group 81.0% （34/42） vs. 43.2% （19/44） （χ²=12.963， P<0.01）. Compared with baseline within the observation group， body weight， waist circumference， and TCM syndrome score were significantly decreased （P<0.01）， as were body fat percentage （P<0.01） and serum triglyceride level （P<0.05）. Compared with the control group after treatment， waist circumference and TCM syndrome score were significantly lower in the observation group （P<0.01）， and body weight showed a trend toward reduction. When changes from baseline were compared between the two groups， the magnitudes of decrease in body weight， waist circumference， and TCM syndrome score were all significantly greater in the observation group than in the control group （P<0.01）. With respect to safety， no serious adverse events occurred in either group and no participant discontinued the study because of adverse events. Compared with baseline， alanine aminotransferase levels decreased significantly in both the control and observation groups （P<0.01）， and urea decreased significantly in the observation group （P<0.01）， indicating a favorable safety profile. Sequencing identified nine differentially expressed miRNAs. After intersecting with the obesity-related miRNA dataset （187 miRNAs）， 3 miRNAs were identified： miR-221 （log₂FC=-6.62， P=0.009）， miR-29a （log₂FC=6.33， P=0.016）， and miR-10b （log₂FC=-5.91， P=0.029）. A total of 262 target genes of the 3 miRNAs were identified， which were significantly enriched in 67 pathways， including the lysine degradation pathway （P=0.001）. Correlation analysis revealed a positive correlation between miR-221 and triglycerides （r=0.46， P=0.027）， a negative correlation between miR-29a and waist-to-hip ratio （r=-0.41， P=0.047）， and positive correlations of miR-10b with body fat percentage （r=0.49， P=0.014） and waist circumference （r=0.44， P=0.032）. ConclusionXRXPY combined with lifestyle intervention can effectively reduce the body mass and improve body composition. The underlying mechanism may involve the regulation of the lysine degradation pathway via miR-221， miR-29a， and miR-10b， though further verification is required.

ObjectiveTo observe the effects of Xiere Xingpi Yin （XRXPY） on the body mass and body fat distribution in patients with simple obesity， and to preliminarily explore whether the mechanism involves the regulation of specific obesity-related microRNAs （miRNAs）. MethodsA randomized controlled trial design was employed to recruit patients with simple obesity diagnosed with the traditional Chinese medicine （TCM） syndrome of dampness-heat accumulating in the spleen. Using a randomized controlled trial design， 95 patients with simple obesity of dampness-heat encumbering the Spleen syndrome were recruited， after 3 were excluded， 92 were randomly assigned in a 1∶1 ratio by means of a random number table. On the basis of lifestyle intervention， the observation group received XRXPY granules， while the control group received a placebo. Serum samples and TCM symptom scores were collected before and after the 12-week observation period. Differences in body mass loss， body composition， lipid metabolism， and TCM symptom scores were compared between the groups. An obesity-related miRNA dataset was constructed by searching the Human MicroRNA Disease Database. Library construction， sequencing， and quality control were performed on 6 selected patients from each group to screen the differentially expressed miRNAs. The intersection of these miRNAs with the obesity-related miRNAs was verified by bioinformatics and correlation analysis. ResultsBaseline characteristics were comparable between the two groups before treatment. A total of 86 patients completed the study （42 cases in the observation group and 44 cases in the control group）. The proportion of patients achieving ≥5% body weight reduction was significantly higher in the observation group than in the control group 81.0% （34/42） vs. 43.2% （19/44） （χ²=12.963， P<0.01）. Compared with baseline within the observation group， body weight， waist circumference， and TCM syndrome score were significantly decreased （P<0.01）， as were body fat percentage （P<0.01） and serum triglyceride level （P<0.05）. Compared with the control group after treatment， waist circumference and TCM syndrome score were significantly lower in the observation group （P<0.01）， and body weight showed a trend toward reduction. When changes from baseline were compared between the two groups， the magnitudes of decrease in body weight， waist circumference， and TCM syndrome score were all significantly greater in the observation group than in the control group （P<0.01）. With respect to safety， no serious adverse events occurred in either group and no participant discontinued the study because of adverse events. Compared with baseline， alanine aminotransferase levels decreased significantly in both the control and observation groups （P<0.01）， and urea decreased significantly in the observation group （P<0.01）， indicating a favorable safety profile. Sequencing identified nine differentially expressed miRNAs. After intersecting with the obesity-related miRNA dataset （187 miRNAs）， 3 miRNAs were identified： miR-221 （log₂FC=-6.62， P=0.009）， miR-29a （log₂FC=6.33， P=0.016）， and miR-10b （log₂FC=-5.91， P=0.029）. A total of 262 target genes of the 3 miRNAs were identified， which were significantly enriched in 67 pathways， including the lysine degradation pathway （P=0.001）. Correlation analysis revealed a positive correlation between miR-221 and triglycerides （r=0.46， P=0.027）， a negative correlation between miR-29a and waist-to-hip ratio （r=-0.41， P=0.047）， and positive correlations of miR-10b with body fat percentage （r=0.49， P=0.014） and waist circumference （r=0.44， P=0.032）. ConclusionXRXPY combined with lifestyle intervention can effectively reduce the body mass and improve body composition. The underlying mechanism may involve the regulation of the lysine degradation pathway via miR-221， miR-29a， and miR-10b， though further verification is required.

【Objective】 To investigate the clinical application of self-developed magnetic anchoring device for assisting thoracoscopic pulmonary resection. 【Methods】 Eleven patients underwent thoracoscopic pulmonary assisted with resection magnetic anchoring technique at the Department of Thoracic Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, from March to May 2019. Their clinical data were retrospectively analyzed. The operation time, blood loss, blood transfusion volume, postoperative hospital stay, and postoperative complications were recorded. 【Results】 There were seven male and four female patients, with the average age of (51.6±13.9) years (range from 22 to 69 years). Three single-port and eight single-utility-port thoracoscopic surgeries were performed. Magnetic instruments provided good surgical field exposure in all operations. Among 11 surgeries, one was converted to thoracotomy and one to three-hole surgery due to enlargement and adhesion of hilar lymph nodes. The operation time was (107.8±63.1) minutes (range of 27-182 minutes). The blood loss was 50 (10-50)mL (range of 5-1 000 mL). No blood transfusion was needed during the operation. The postoperative hospital stay was (5.0±1.8) days (range of 3-9 days). No postoperative complications occurred in all the patients. 【Conclusion】 Magnetic anchor technique can effectively alleviate the "chopstick effect" in thoracoscopic surgery. Magnetic anchor technique is safe and feasible in assisting thoracoscopic pulmonary resection.

Objective:To explore the surgical experience of high speed rotary excision combined with multi-technology in the treatment of adult nape-fat-pad.Methods:A total of 83 patients with nape-fat-pad in our department from March 2016 to September 2019 were selected for the study. In this marked area, 0. 2 percent lidocaine with 1∶10 000 epinephrine was used for local tumescent anesthesia, then a skin incision of about 0.5 cm was made directly under the fat pad and/or about 2 cm from it. First, use a fork knife to separate the fat pad at multiple planes and angles, then cut off with a rotary excision and sucked out thoroughly. Second, use a thin liposuction tube to pump the transition area between the nape-fat-pad and normal fat until the transition is natural and smooth. Finally, fix the skin in the separation area with oil nail, apply pressure with "8-form" bandage and sleep on the rice pillow for 1 week after surgery. The appearance of the neck, postoperative complications and patient satisfaction were followed up 3-6 months after the operation.Resuts:83 patients had varying degrees of pain and swelling for 1-2 months after operation, 76 cases(91.57%) of the patients had complete disappearance of swelling in about 1 month, 12 cases(14.46%)had cyanosis and ecchymosis, which improved in about 3 weeks, 5 cases(6.02%) had a sense of subcutaneous cord or induration, and recovered completely in 2-3 months. Subcutaneous effusion was found in 2 patients(2.41%) in the early stage of operation and absorbed about 1 week.4 cases (4.82%) had a slight "sense of step" in the operative and normal fat transition area about 1 month after operation. 3 cases (3.61%)had poor wound healing, and the other 80 cases (96.39%)were grade A healing. There was no abnormal skin sensation in the operation area in all the 83 cases.No serious complications such as skin necrosis infection and important vascular injury occurred in all the patients 3 to 6 months after the operation. In the patient satisfaction survey, 70 patients were satisfied, 9 were satisfied, 4 were average, the satisfaction rate of the patients was 95.18%.Conclusions:The high speed rotary excision combined with multi-technology in the treatment of nape-fat-pad has short operation time, good curative effect, few complications and high patient satisfaction.

Objective:To explore the surgical experience of high speed rotary excision combined with multi-technology in the treatment of adult nape-fat-pad.Methods:A total of 83 patients with nape-fat-pad in our department from March 2016 to September 2019 were selected for the study. In this marked area, 0. 2 percent lidocaine with 1∶10 000 epinephrine was used for local tumescent anesthesia, then a skin incision of about 0.5 cm was made directly under the fat pad and/or about 2 cm from it. First, use a fork knife to separate the fat pad at multiple planes and angles, then cut off with a rotary excision and sucked out thoroughly. Second, use a thin liposuction tube to pump the transition area between the nape-fat-pad and normal fat until the transition is natural and smooth. Finally, fix the skin in the separation area with oil nail, apply pressure with "8-form" bandage and sleep on the rice pillow for 1 week after surgery. The appearance of the neck, postoperative complications and patient satisfaction were followed up 3-6 months after the operation.Resuts:83 patients had varying degrees of pain and swelling for 1-2 months after operation, 76 cases(91.57%) of the patients had complete disappearance of swelling in about 1 month, 12 cases(14.46%)had cyanosis and ecchymosis, which improved in about 3 weeks, 5 cases(6.02%) had a sense of subcutaneous cord or induration, and recovered completely in 2-3 months. Subcutaneous effusion was found in 2 patients(2.41%) in the early stage of operation and absorbed about 1 week.4 cases (4.82%) had a slight "sense of step" in the operative and normal fat transition area about 1 month after operation. 3 cases (3.61%)had poor wound healing, and the other 80 cases (96.39%)were grade A healing. There was no abnormal skin sensation in the operation area in all the 83 cases.No serious complications such as skin necrosis infection and important vascular injury occurred in all the patients 3 to 6 months after the operation. In the patient satisfaction survey, 70 patients were satisfied, 9 were satisfied, 4 were average, the satisfaction rate of the patients was 95.18%.Conclusions:The high speed rotary excision combined with multi-technology in the treatment of nape-fat-pad has short operation time, good curative effect, few complications and high patient satisfaction.