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Xiaoliang Liu,1,* Kecheng Lou,2,* Yunmeng Zhang,3 Chuanxiao Li,1 Shenghong Wei,1 Shangzhi Feng1 1Department of Urology, Jiujiang University Clinic College/Hospital, Jiujiang, Jiangxi, People’s Republic of China; 2Department of Urology, Lanxi People’s Hospital, Jinhua, Zhejiang, People’s Republic of China; 3Department of Anesthesiology, Jiujiang College Hospital, Jiujiang, Jiangxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shangzhi Feng, Email 1131718266@qq.comAbstract: Botanical preparations for herbal medicine have received more and more attention from drug researchers, and the extraction of active ingredients and their successful clinical application have become an important direction of drug research in major pharmaceutical companies, but the complexity of extracts, multiple side effects, and significant individual differences have brought many difficulties to the clinical application of herbal preparations. It is noteworthy that extracellular vesicles as active biomolecules extracted from medicinal plants are believed to be useful for the treatment of a variety of diseases, including cancer, inflammation, regenerative-restorative and degenerative diseases, which may provide a new direction for the clinical utilization of herbal preparations. In this review, we sort out recent advances in medicinal plant extracellular vesicles and discuss their potential as disease therapeutics. Finally, future challenges and research directions for the clinical translation of medicinal plant extracellular vesicles are also discussed, and we expect that continued development based on medicinal plant extracellular vesicles will facilitate the clinical application of herbal preparations.Keywords: plant-derived extracellular vesicles, Chinese medicine preparation, nanoparticle, drug delivery nanoplatforms, nanotherapeutics

Introduction: Many patients with diabetes mellitus are not attaining optimal glycaemic control, although the rate is unknown in South Sudan. Maintaining adequate glycaemic control is the most effective means of preventing complications associated with diabetes. This record review assesses the proportion of patients with diabetes on follow-up not adequately controlled using glycated haemoglobin (HbA1c) and describes associated factors. Method: This is retrospective cross-sectional review of electronic patient records from a private for-profit health facility in Juba, South Sudan. The study assesses follow-up HbA1c levels of type I (T1DM) and type II (T2DM) patients with diabetes 18 years and older. An HbA1c value of less than 7% was regarded as reflecting adequate control. Logistic regression was used to assess factors associated with inadequate control. From an unadjusted analysis, variables were retained for the adjusted analysis that were significant at the 95% confidence level. Crude and adjusted odds ratios (AOR) were reported. Results: Of the 291 patients assessed, 62.2% were male, mean age was 54 (SD =12.6) years, and the median body mass index (BMI) was 27.2 (IQR=24.5-30). Those with hypertension were 28.5% and 35% had medical insurance. Overall, 60 patients (20.6%) achieved target HbA1c levels of 10%. Independent predictors of non-achievement of target HbA1c were female gender, adjusted prevalence ratio, PR (95% CI) =1.18 (1.01-1.32); normal BMI, adjusted PR (95% CI) =1.41 (1.07-1.83) and having no medical insurance cover, adjusted PR (95%CI) =1.13 (1.10-1.29). Conclusion: About 80% of patients did not attain target HbA1c levels. Diagnosis of diabetes, care and treatment of patients with diabetes is not well organised in South Sudan leading to poor outcomes even in private clinics. Women and those without medical insurance cover are at greater disadvantage. We recommend better diagnosis and classification of patients with diabetes as well as reorganisation of care and treatment. We also recommend initiatives that will increase coverage of services to women and putting more people on medical insurance cover.

Chen Y, Zhang W, Huang Y, et al. Int J Nanomedicine. 2015;10:4043-4057. The Editor and Publisher of the International Journal of Nanomedicine wish to retract the published article. Concerns were raised regarding the alleged duplication of an image in Figure 10 with the same image from Figure 8B in Huang et al, 2016 ‘c(RGDyK)-decorated Pluronic micelles for enhanced doxorubicin and paclitaxel delivery to brain glioma’ (https://doi.org/10.2147/IJN.S104162). Specifically, Figure 10, Heart, F127/P105/MTX appears to have been duplicated with the same image from Figure 8B, Heart, Saline in Huang et al, 2016. The authors responded to our queries and explained that the animal experimental work for both studies was performed at the same time. It was possible an error was made during the arrangement of the H&E images for the respective figures from both articles. However, given the length of time that has passed since the completion of these studies the authors were no longer able to retrieve the original data. To help maintain the integrity of the scientific record the authors agreed with the decision to retract the article. We have been informed in our decision-making by our policy on publishing ethics and integrity and the COPE guidelines on retractions. The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as “Retracted”.

Abstract The ongoing coronavirus disease 2019 (COVID-19) pandemic has put a strain on health systems globally. Although Africa is the least affected region to date, it has the weakest health systems and an exponential rise in cases as has been observed in other regions, is bound to overwhelm its health systems. Early detection and isolation of suspected and confirmed COVID-19 cases are pivotal to the prevention and control of the pandemic. The World Health Organization (WHO) recommends that all laboratory-confirmed cases should be isolated and treated in a health care facility; however, where this is not possible due to the health system capacity, patients can be isolated in re-purposed facilities or at home. An already very apparent future challenge for Africa is facility-based isolation of COVID-19 cases, given the already limited health infrastructure and health workforce, and the risk of nosocomial transmission. Use of repurposed facilities requires additional resources, including health workers. Home isolation, on the other hand, would be a challenge given the poor housing, overcrowding, inadequate access to water and sanitation, and stigma related to infectious disease that is prevalent in many African societies. Conflict settings on the continent pose an additional challenge to the prevention and control of COVID-19 with the resultant population displacements in overcrowded camps where access to social services is limited. These unique cultural, social, economic and developmental differences on the continent, call for a tailored approach to COVID-19 case management strategies. This article proposes three broad case management strategies based on the transmission scenarios defined by WHO, and the criteria and package of care for each option, for consideration by policy makers and governments in African countries. Moving forward, African countries should generate local evidence to guide the development of realistic home-grown strategies, protocol and equipment for the management of COVID-19 cases on the continent .

Xiujuan Zhang,1 Dandan Liu,2 Yong He,3 Kai Lou,4 Dongmei Zheng,1 Wenxia Han1 1Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People’s Republic of China; 2Department of Respiratory and Intensive Care Unit, Shandong Provincial Chest Hospital, Jinan, People’s Republic of China; 3School of Management, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China; 4Department of Endocrinology, Jinan Central Hospital Affiliated to Shandong University, Jinan, People’s Republic of ChinaCorrespondence: Dongmei Zheng; Wenxia HanDepartment of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jing 5 Road, Jinan, Shandong Province 250021, People’s Republic of ChinaTel +86 531 6877 6375Email zhengdongmei1971@163.com; hanwx97@163.comAim: Branched-chain amino acids (BCAAs) have been reported owning curative effects in early diabetic nephropathy. However, the mechanisms of its action have not been elucidated. The aim of this study is to investigate the effect of possible mechanism(s) of BCAAs on cultured rat mesangial cells (RMCs).Methods: RMCs were treated with high glucose (30 mmol/L) and BCAAs (10 mmol/L) respectively. Cell proliferation was detected using an MTT assay. Expression of transforming growth factor (TGF)-β1 and gremlin mRNA was detected by semiquantitative reverse-transcription (RT) PCR. TGF-β1 and fibronectin (FN) protein levels were measured using enzyme-linked immunosorbent assays (ELISAs). Gremlin, bone morphogenic protein (BMP)-7, and Smad2/3 proteins were detected by immunofluorescence. Smad1/5/8 and phosphorylated (p)-Smad1/5/8 were detected by Western blotting.Results: The proliferation rate of the RMCs in the high glucose group alone was 1.45-times of cells in the CON group, and it was reduced by 32% upon co-treatment with BCAAs. The expression of TGF-β1, gremlin, p-Smd2/3 and FN mRNA or protein in the HG group was higher than that in the CON group. In the BCAAs group, the corresponding levels were lower than that in HG group. The expression of BMP-7 and p-Smad1/5/8 were significantly lower in the HG group than in the CON group. Moreover, the expression of BMP-7 and p-Smad1/5/8 were higher in the BCAAs group than in the HG group.Conclusion: BCAAs showed an antidiabetic effect via reducing TGF-β1-Smad2/3 pathway and Gremlin expression and upregulating BMP-7-Smad1/5/8 pathway in rat mesangial cells, consequently lessening ECM deposition in renal tissue.Keywords: diabetic nephropathy, branched chain amino acids, TGF-β1, BMP-7, Smad

Binghui Wei,1,2 Muye He,1,2 Xiaoran Cai,1,2 Xinyu Hou,1,2 Yujie Wang,1,2 Jiaojiao Chen,1,2 Minbo Lan,1 Yanzuo Chen,1,2 Kaiyan Lou,2,3 Feng Gao1,2,41Shanghai Key Laboratory of Functional Materials Chemistry, East China University of Science and Technology, Shanghai 200237, People’s Republic of China; 2Department of Pharmaceutics, School of Pharmacy, East China University of Science and Technology, Shanghai 200237, People’s Republic of China; 3State Key Laboratory of Bioengineering Reactor, Shanghai Key Laboratory of New Drug Design and Shanghai Key Laboratory of Chemical Biology, School of Pharmacy, East China University of Science & Technology, Shanghai 200237, People’s Republic of China; 4Shanghai Key Laboratory of New Drug Design, East China University of Science and Technology, Shanghai 200237, People’s Republic of ChinaCorrespondence: Feng Gao; Kaiyan LouEast China University of Science and Technology, 130 Meilong Road, Shanghai 200237, People’s Republic of ChinaTel +86 21 6425 2449; +86 21 6425 3299Fax +86 21 6425 8277Email fgao@ecust.edu.cn kylou@ecust.edu.cnAim: To determine whether the use of a mixed polymeric micelle delivery system based on vitamin E succinate (VES)-grafted-chitosan oligosaccharide (CSO)/VES-grafted-chitosan (CS) mixed micelles (VES-g-CSO/VES-g-CS MM) enhances the delivery of C-DMSA, a theranostic fluorescent probe, for Hg2+ detection and detoxification in vitro and in vivo.Methods: Mixed micelles self-assembled from two polymers, VES-g-CSO and VES-g-CS, were used to load C-DMSA and afforded C-DMSA@VES-g-CSO/VES-g-CS MM for cell and in vivo applications. Fluorescence microscopy was used to assess C-DMSA cellular uptake and Hg2+ detection in L929 cells. C-DMSA@VES-g-CSO/VES-g-CS MM was then administered intravenously. Hg2+ detection was assessed by fluorescence microscopy in terms of bio-distribution while detoxification efficacy in Hg2+-poisoned rat models was evaluated in terms of mercury contents in blood and in liver.Results: The C-DMSA loaded mixed micelles, C-DMSA@VES-g-CSO/VES-g-CS MM, significantly enhanced cellular uptake and detoxification efficacy of C-DMSA in Hg2+ pretreated human L929 cells. Evidence from the reduction of liver coefficient, mercury contents in liver and blood, alanine transaminase and aspartate transaminase activities in Hg2+ poisoned SD rats treated with the mixed micelles strongly supported that the micelles were effective for Hg2+ detoxification in vivo. Furthermore, ex vivo fluorescence imaging experiments also supported enhanced Hg2+ detection in rat liver.Conclusion: The mixed polymeric micelle delivery system could significantly enhance cell uptake and efficacy of a theranostic probe for Hg2+ detection and detoxification treatment in vitro and in vivo. Moreover, this nanoparticle drug delivery system could achieve targeted detection and detoxification in liver.Keywords: micelles, C-DMSA, mercury poisoning, detection and detoxification, drug delivery system

Zhang X, Liu D, He Y, Lou K, Zheng D, Han W. Diabetes Metab Syndr Obes. 2019;12:2433– 2440. The authors of this paper have advised of an error with affiliation 1.Read the original paper here