External volume expansion of the recipient site by suction has been proposed as a way of improving fat graft survival. The objective of this study was to present an innovative and simple intraoperative external expansion system to enhance small-volume autologous fat grafting (40–80 mL) and to discuss its background and its mechanism of action. In this system, expansion is performed using a complete vacuum delivery system known as the Kiwi VAC-6000M with a PalmPump (Clinical Innovations). The recipient site is rapidly expanded intraoperatively 10 times for 30 seconds each with a negative pressure of up to 550 mm Hg before autologous fat injection. During this repetitive stimulation, the tissues become grossly expanded, developing macroscopic swelling that regresses slowly over the course of hours following the cessation of the stimulus. The system sets various mechanisms in motion, including scar release, mechanical stimulation, edema, ischemia, and inflammation, which provide an environment conducive for cell proliferation and angiogenesis. In order to maintain the graft construct in its expansive state, all patients are encouraged postoperatively to use the Kiwi three times daily for one minute per session over the course of three days. The handling of this system is simple for both the patients and the surgeon. Satisfactory clinical outcomes have been achieved without significant complications.
Adipose Tissue ; Cell Proliferation ; Cicatrix ; Contracture ; Edema ; Graft Survival ; Humans ; Inflammation ; Ischemia ; Subcutaneous Tissue ; Suction ; Transplants* ; Vacuum

Objective To investigate the blood pressure change in relation to the evolution of impaired glucose tolerance (IGT). Methods From 1986 to 1992, 334 subjects with IGT were randomized to placebo, diet, exercise and diet plus exercise intervention groups. No anti-hypertension drug was given to these enrolled subjects. Blood pressure was measured at the beginning and the end of the six-year prospective study. In this analysis these subjects were stratified to seven subgroups based on 2 h plasma glucose (2hPG) level during OGTT at the end of the study: < 7.8,7.8~8.8,8.9~9.9,10.0~11.0,11.1~13.8,13.9~16.6 and≥16.7mmol/L. Blood pressure changes in relation to the evolution of glucose tolerance in these subgroups were compared by least square mean procedure. Results Changes of systolic blood pressure (SBP) in average in these seven groups were -2.4,0.6,7.7,4.3,1.7,-2.9and-6.9mm Hg (1mm Hg=0.133kPa), and changes of diastolic blood pressure (DBP) were-3.2,3.0,3.3,1.7,-0.7,-1.3 and-3.7mm Hg respectively after controlling for age, sex, BMI at baseline and Δ BMI during the follow-up period. In those subjects with IGT evolved into normal glucose tolerance (NGT) or diabetes, reductions in SBP and DBP were significantly greater than those who retained IGT with 2hPG between 8.9-9.9mmol/L (all P < 0.05 ). In 264 out of the 334 subjects with IGT and blood pressure≥130/80mm Hg at baseline, blood pressure changed more strikingly: changes of SBP in these groups were-5.2,-2.6,5.2,2.3,-2.3,-4.2,-7.6mm Hg, and DBP were -5.0, -3.7,1.5, -2.9, -4.3, - 4.0 and-6.0mm Hg respectively after the adjustment of age, sex, BMI, BMI variation. The reductions of SBP and DBP in subjects whose status of IGT was converted to NGT or diabetes were significantly greater than those with retained IGT and 2hPG between 8.9-9.9mmol/L. Conclusion Blood pressure is increased in the subjects with IGT who retained in the IGT group during the six-year follow-up period in Da-Qing Study. On the contrary, subjects with IGT evolved into NGT or diabetes demonstrate significant reduction of blood pressure.

Objective: Contact tracing has been used in China and several other countries in the WHO Western Pacific Region as part of the COVID-19 response. We describe COVID-19 cases and the number of contacts traced and quarantined per case as part of COVID-19 emergency public health response activities in China. Methods: We abstracted publicly available, online aggregated data published in daily COVID-19 situational reports by China’s National Health Commission and provincial health commissions between 20 January and 29 February 2020. The number of new contacts traced by report date was computed as the difference between total contacts traced in consecutive reports. A proxy for the number of contacts traced per case was computed as the number of new contacts traced divided by the number of new cases. Results: During the study period, China reported 80 968 new COVID-19 cases and 659 899 contacts. In Hubei Province, there were 67 608 cases and 264 878 contacts, representing 83% and 40% of the total, respectively. Non-Hubei provinces reported tracing 1.5 times more contacts than Hubei Province; the weekly number of contacts traced per case was also higher in non-Hubei provinces than in Hubei Province and increased from 17.2 in epidemiological week 4 to 115.7 in epidemiological week 9. Discussion: More contacts per case were reported from areas and periods with lower COVID-19 case counts. With other non-pharmaceutical interventions used in China, contact tracing and quarantining large numbers of potentially infected contacts probably contributed to reducing SARS-CoV-2 transmission.