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Oral anti-coagulants use in chinese hospitalized patients with atrial fibrillation

chinese Medical Journal 2024年第2期137卷 172-180页

作者： Jing Lin Deyong Long chenxi Jiang caihua Sang Ribo Tang Songnan Li Wei Wang Xueyuan Guo Man Ning Zhaoqing Sun Na Yang Yongchen Hao Jun Liu Jing Liu Xin Du Louise Morgan gregg c.fonarow Sidney c.Smith Jr Gregory Y.H.Lip Dong Zhao Jianzeng Dong changsheng Ma On behalf of ccc-AF investigators Department of cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China National clinical Research center for cardiovascular Diseases Beijing 100029 China Department of Epidemiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vessel DiseasesBeijing 100029China International Quality Improvement Department American Heart AssociationDallasTX 07076USA Division of cardiology Geffen School of Medicine at University of CaliforniaLos Angeles CA 90024USA Division of cardiology University of North CarolinaChapel HillNC 27599USA Department of cardiology Liverpool Centre for Cardiovascular ScienceUniversity of Liverpool and Liverpool Heart&Chest HospitalLiverpool L143PEUK Department of clinical Medicine Aalborg UniversityAalborg 9000Denmark 不详

Background:Oral anti-coagulants(OAc)are the intervention for the prevention of stroke,which consistently improve clinical outcomes and survival among patients with atrial fibrillation(AF).The main purpose of this study is to identify problems in OAc utilization among hospitalized patients with AF in ***:Using data from the Improving care for cardiovascular Disease in china-Atrial Fibrillation(ccc-AF)registry,guideline-recommended OAc use in eligible patients was ***:A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019,of whom 38,203 were at a high risk of stroke,9717 were at a moderate risk,and 4610 were at a low *** admission,only 20.0%(6075/30,420)of patients with a diagnosed AF and a high risk of stroke were taking *** use of pre-hospital OAc on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population(adjusted odds ratio:0.54,95%confidence interval:0.43-0.68;Pcharge,the prescription rate of OAc was 45.2%(16,757/37,087)in eligible patients with high stroke risk and 60.7%(2778/4578)in eligible patients with low stroke *** utilization in patients with high stroke risk on admission or at discharge both increased largely over time(all Pc utilization at discharge was positively associated with in-hospital rhythm control strategies,including catheter ablation(adjusted odds ratio[OR]11.63,95%confidence interval[cI]10.04-13.47;Pctronic cardioversion(adjusted OR 2.41,95%cI 1.65-3.51;Pc drug use(adjusted OR 1.45,95%cI 1.38-1.53;Pconclusions:In hospitals participated in the ccc-AF project,>70%of AF patients were at a high risk of *** poor performance on guideline-recommended OAc use was found in this study,over time the ccc-AF project has made progress in stroke prevention in the chinese AF ***

关键词： Atrial fibrillation Oral anti-coagulants OAc Stroke prevention contraindication

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The American Heart Association’s Get With the Guidelines(GWTG)-Stroke development and impact on stroke care

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Stroke & Vascular Neurology 2017年第2期2卷 94-105页

作者： cora H Ormseth Kevin N Sheth Jeffrey L Saver gregg c.fonarow Lee H Schwamm Neurology Yale University School of MedicineNew HavenConnecticutUSA Department of Neurology UCLA Medical CenterLos AngelesCaliforniaUSA Department of cardiology UCLA Medical CenterLos AngelesCaliforniaUSA Department of Neurology Massachusetts General HospitalBostonMassachusettsUSA

The American Heart Association’s Get With the Guidelines(GWTG)-Stroke programme has changed stroke care delivery in the USA since its establishment in *** is a voluntary registry and continuous quality improvement initiative that collects data on patient characteristics,hospital adherence to guidelines and inpatient *** of the programme saw increased provision of evidence-based care and improved patient *** review will describe the development of the programme and discuss the impact on stroke outcomes and transformation of stroke care delivery that followed its implementation.

关键词： impact programme

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Outcomes of Medicare beneficiaries hospitalised with transient ischaemic attack and stratification using the ABcD^(2) score

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Stroke & Vascular Neurology 2021年第2期6卷 314-318页

作者： Shreyansh Shah Li Liang Durgesh Bhandary Saga Johansson Eric E Smith Deepak L Bhatt gregg c.fonarow Naeem D Khan Eric Peterson Janet Prvu Bettger Department of Neurology Duke University School of MedicineDurhamNorth CarolinaUSA Duke clinical Research Institute DurhamNorth CarolinaUSA AstraZeneca UK Ltd CambridgeUK Hotchkiss Brain Institute and Department of clinical Neurosciences University of CalgaryCalgaryAlbertaCanada Division of cardiology Brigham and Women's HospitalBostonMassachusettsUSA Division of cardiology Ronald Reagan UCLA Medical CenterLos AngelesCaliforniaUSA

Background Long-term outcomes for Medicare beneficiaries hospitalised with transient ischaemic attack(TIA)and role of ABcD^(2) score in identifying high-risk individuals are not *** We identified 40825 Medicare beneficiaries hospitalised from 2011 to 2014 for a TIA to a Get With The Guidelines(GWTG)-Stroke hospital and classified them using ABcD^(2)s of mortality and rehospitalisation(all-cause,ischaemic stroke,haemorrhagic stroke,myocardial infarction,and gastrointestinal and intracranial haemorrhage)for high-risk versus low-risk groups adjusted for patient and hospital *** Of the 40825 patients,35118(86%)were high risk(ABcD^(2)≥4)and 5707(14%)were low risk(ABcD^(2)=0-3).Overall rate of mortality during 1-year follow-up after hospital discharge for the index TIA was 11.7%,44.3% were rehospitalised for any reason and 3.6%were readmitted due to *** with ABcD^(2) score≥4 had higher mortality at 1 year than not(adjusted HR 1.18,95%cI 1.07 to 1.30).Adjusted risks for ischaemic stroke,all-cause readmission and mortality/all-cause readmission at 1 year were also significantly higher for patients with ABcD^(2) score≥4 vs *** contrast,haemorrhagic stroke,myocardial infarction,gastrointestinal bleeding and intracranial haemorrhage risk were not significantly different by ABcD^(2) *** This study validates the use of ABcD^(2) score for long-term risk assessment after TIA in patients aged 65 years and *** efforts for community-based follow-up care after TIA are needed for ongoing prevention in Medicare beneficiaries who were hospitalised for TIA.

关键词： admitted score prevention

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Temporal trends and rural-urban disparities in cerebrovascular risk factors,in-hospital management and outcomes in ischaemic strokes in china from 2005 to 2015:a nationwide serial cross-sectional survey

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Stroke & Vascular Neurology 2023年第1期8卷 34-50页

作者： chun-Juan Wang Hong-Qiu Gu Xin-Miao Zhang Yong Jiang Hao Li Janet Prvu Bettger Xia Meng Ke-Hui Dong Run-Qi Wangqin Xin Yang Meng Wang chelsea Liu Li-Ping Liu Bei-Sha Tang Guo-Zhong Li Yu-Ming Xu Zhi-Yi He Yi Yang Winnie Yip gregg c.fonarow Lee H Schwamm Ying Xian Xing-Quan Zhao Yi-Long Wang Yongjun Wang Zixiao Li china National clinical Research center for Neurological Diseases Beijing Tiantan HospitalCapital Medical UniversityBeijingChina National center for Healthcare Quality Management in Neurological Diseases Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Vascular Neurology Department of NeurologyBeijing Tiantan HospitalCapital Medical UniversityBeiingChina center of Stroke Beijing Institute for Brain DisordersBeijngChina Beijing Key Laboratory of Translational Medicine for cerebrovascular Disease BeijingChina Duke clinical Research Institute Duke UniversityDurhamNorth CarolinaUSA Department of Neurology Duke Univeristy Medical CenterDurhamNorth CarolinaUSA Department of Epidemiology Harvard T H Chan School of Public HealthBostonMassachusettsUSA Neuro-intensive care Unit Department of NeurologyBeijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of Neurology Xiangya HospitalCentral South UniversityChangshaHunanChina Department of Neurology The First Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiangChina Department of Neurology The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina Key Laboratory of cerebrovascular Disease Prevention and Treatment National Health Commission(Province and Ministry Co-constructed)ZhengzhouHenanChina Department of Neurology The First Affiliated Hospital of China Medical UniversityShenyangLiaoningChina Department of Neurology The First Hospital of Jilin UniversityChangchunJilinChina Department of Global Health and Population Harvard T.H.Chan School of Public HealthBostonMAUSA Ahmanson-UcLA cardiomyopathy center Ronald Reagan-UCLA Medical CenterLos AngelesCAUSA Department of Neurology Massachusetts General HospitalHarvard Medical SchoolBostonMAUSA Department of Neurology The University of Texas Southwestern Medical CenterDallasTexasUSA Research Unit of Artificial Intelligence in cerebrovascular Disease Chinese Academy of Medical SciencesBeijingChina chinese Inst

Background Stroke is the leading cause of mortality in china,with limited evidence of in-hospital burden obtained from nationwide *** aimed to monitor and track the temporal trends and rural-urban disparities in cerebrovascular risk factors,management and outcomes from 2005 to *** We used a two-stage random sampling survey to create a nationally representative sample of patients admitted for ischaemic stroke in 2005,2010 and *** sampled participating hospitals with an economic-geographical region-stratified random-sampling approach first and then obtained patients with a systematic sampling *** weighed our survey data to estimate the national-level results and assess changes from 2005 to *** We analysed 28277 ischaemic stroke admissions from 189 participating *** 2005 to 2015,the estimated national hospital admission rate for ischaemic stroke per 100000 people increased(from 75.9 to 402.7,Ptrendce of risk factors,including hypertension,diabetes,dyslipidaemia and current smoking,*** composite score of diagnostic tests for stroke aetiology assessment(from 0.22 to 0.36,Ptrendcondary prevention treatments(from 0.46 to 0.70,Ptrendcrease was found in discharge against medical advice(DAMA)(from 15.2%(95%cI 13.7%to 16.7%)to 8.6%(8.1%to 9.0%);adjusted Ptrend=0.046),and decreases in in-hospital mortality(0.7%in 2015 vs 1.8%in 2005;adjusted OR(aOR)0.52;95%cI 0.32 to 0.85)and the composite outcome of in-hospital mortality or DAMA(8.4%in 2015 vs 13.9%in 2005;aOR 0.65;95%cI 0.47 to 0.89)were *** between rural and urban hospitals narrowed;however,disparities persisted in in-hospital management(brain MRI:rural-urban difference from−14.4%to−11.2%;cerebrovascular assessment:from−20.3%to−16.7%;clopidogrel:from−2.1%to−10.3%;anticoagulant for atrial fibrillation:from−10.9%to−8.2%)and in-hospital outcomes(DAMA:from 2.7%to 5.0%;composite outcome

关键词： admitted nationwide survey

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Patterns of antidepressant therapy and clinical outcomes among ischaemic stroke survivors

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Stroke & Vascular Neurology 2021年第3期6卷 384-394,I0018-I0032页

作者： Mark R Etherton Shreyansh Shah Xu Haolin Ying Xian Lesley Maisch Deidre Hannah Brianna Lindholm Barbara Lytle Laine Thomas Eric E Smith gregg c.fonarow Lee H Schwamm Deepak L Bhatt Adrian F Hernandez Emily c O'Brien Neurology Massachusetts General HospitalBostonMassachusettsUSA Neurology Duke University School of MedicineDurhamNorth CarolinaUSA Duke clinical Research Institute Duke UniversityDurhamNorth CarolinaUSA American Heart Association Inc DallasTexasUSA clinical Neurosciences University of Calgary Cumming School of MedicineCalgaryAlbertaCanada cardiology Ronald Reagan UCLA Medical CenterLos AngelesCaliforniaUSA cardiovascular Medicine Brigham and Women's HospitalBostonMassachusettsUSA cardiology Duke UniversityDurhamNorth CarolinaUSA Population Health Duke Clinical Research InstituteDurhamNorth CarolinaUSA

Background and purpose Depression is common after stroke and is often treated with antidepressant medications(AD).ADs have also been hypothesised to improve stroke recovery,although recent randomised trials were *** investigated the patterns of in-hospital AD initiation after ischaemic stroke and association with clinical and readmission *** All Medicare fee-for-service beneficiaries aged 65 or older hospitalised for ischaemic stroke in participating Get With The Guidelines-Stroke hospitals between April and December 2014 were eligible for this *** measures included days alive and not in a healthcare institution(home time),all-cause mortality and readmission within 1-year *** score(PS)-adjusted logistic regression models were used to evaluate the associations between AD use and each outcome *** also compared outcomes in patients prescribed selective serotonin reuptake inhibitors(SSRIs)AD versus those prescribed non-SSRI *** Of 21805 AD naive patients included in this analysis,1835(8.4%)were started on an AD at *** started on an AD had higher rates of depression and prior ischaemic stroke,presented with higher admission National Institutes of Health Stroke Scale score and were less likely to be discharged ***,patients started on an SSRI had lower rates of discharge to *** for stroke severity,patients started on an AD had worse all-cause mortality,all-cause readmission,major adverse cardiac events,readmission for depression and decreased ***,AD use was also associated with an increased risk for the sepsis,a falsification endpoint,suggesting the presence of residual *** Patients with ischaemic stroke initiated on AD therapy are at increased risk of poor clinical outcomes and readmission even after PS adjustment,suggesting that poststroke depression requiring medication is a poor prognostic *** research is needed to explore

关键词： prescribed admission founding

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clay preference and particle transport behavior of Formosan subterranean termites （Isoptera： Rhinotermitidae）＂ A laboratory study

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Insect Science 2014年第6期21卷 785-795页

作者： cai Wang gregg Henderson Department of Entomology Louisiana State University Agricultural Center Baton Rouge LA 70803 USA

Although preference and utilization of clay have been studied in many higher termites, little attention has been paid to lower termites, especially subterranean termites. The Formosan subterranean termite, coptotermes formosanus Shiraki, can modify its habitat by using clay to fill tree cavities. Here, the biological significance of clay on c. formosanus was investigated. choice tests showed that significantly more termites aggre- gated in chambers where clay blocks were provided, regardless of colony group, observation period, or nutritional condition （fed or starved）. No-choice tests showed that clay had no observable effect on survivorship, live or dry biomass, water content, and tunneling activity after 33-35 d. However, clay appeared to significantly decrease filter paper consumption （dry weight loss）. Active particle （sand, paper, and clay） transport behavior was observed in both choice and no-choice tests. When present, clay was preferentially spread on the substrate, attached to the smooth surfaces of the containers, and used to line sand tunnels. Mechanisms and potential application of clay attraction are discussed.

关键词： aggregation clay coptotermesformosanus filter paper consumption particle transport behavior

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Application of anti-cD103 immunotoxin for saving islet allograft in context of transplantation

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chinese Medical Journal 2010年第24期123卷 3644-3651页

作者： ZHANG Lei gregg A. Hadley Department of General Surgery the Second Affiliated Hospital of Harbin Medical University Harbin Heilongjiang 150086 China Division of Transplantation Department of Surgery the Ohio State University Medical Center Columbus OH 43210 USA

Background Previous studies using knockout mice document a key role for the integrin cD103 in promoting organ allograft rejection and graft-versus-host disease. However, a determination of whether blockade of the cD103 pathway represents a viable therapeutic strategy for intervention in these processes has proven problematic due to the lack of reagents that efficiently deplete cD103＋ cells from wild type hosts. To circumvent this problem, in the present study, we invented an anti-cD103 immunotoxin （M290-SAP）. We investigated whether M290-SAP has capacity to eliminate cD103-expressing cells in vivo and protect transplanted islets from destroying by host immune *** Flow cytometry was used to analyze the efficacy of M290-SAP in depleting cD103-expressing cells in *** using allogenic islet transplantation models as well as NOD mice with recent onset type 1 diabetes, the therapeutic efficacy of cD103-expressing cell depletion was *** M290-SAP dramatically reduces the frequency and absolute numbers of cD103-expressing leukocytes in peripheral lymphatic tissues of treated mice. Balb/c islets transplanted into streptozotocin-induced diabetic c57BL/6 mice under single M290-SAP treatment showed an indefinite survival time compared with untreated mice, M290-treated mice and IgG-SAP treated mice （mean survival time, ＞100 days vs. ＜20 days）. c57BL/6 islets transplanted into hyperglycemic NOD mice under single M290-SAP treatment showed a pronounced delay in allograft rejection compared with untreated mice （mean survival time 12-13 days vs. ＜7 days）. Immunological analysis of mice with long-term islet allograft survival revealed an obvious atrophy thymus and severe downregulation of alloimmunity of cD8 subpopulation response to allogenic *** Regardless of the underlying mechanisms, these data document that depletion of cD103-expressing cells represents a viable strategy for therapeutic intervention in islet allograft rejection.

关键词： immunotoxin saporin cD8 T lymphocytes pancreatic islets transplantation thymus

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Formation of fine crystalline dolomites in lacustrine carbonates of the Eocene Sikou Depression, Bohai Bay Basin, East china

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Petroleum Science 2016年第4期13卷 642-656页

作者： Yong-Qiang Yang Long-Wei Qiu Jay gregg Zheng Shi Kuan-Hong Yu School of Geosciences China University of Petroleum Department of Geology Oklahoma State University

The genesis of the fine crystalline dolomites that exhibit good to excellent reservoir properties in the upper fourth member of the Eocene Shahejie Formation（Es4s）around the Sikou Sag, Bohai Bay Basin, is uncertain. This paper investigates the formation mechanisms of this fine crystalline dolomite using XRD, SEM, thin section analysis and geochemical data. The stratigraphy of the Sikou lacustrine carbonate is dominated by the repetition of metre-scale, high-frequency deposition cycles, and the amount of dolomite within a cycle increases upward from the cycle bottom. These dolomite crystals are 2–30 μm in length, subhedral to anhedral in shape and typically replace both grains and matrix. They also occur as rim cement and have thin lamellae within ooid cortices. Textural relations indicate that the dolomite predates equant sparry calcite cement and coarse calcite cement. The Sr concentrations of dolomites range from 900 to 1200 ppm. Dolomite δ18O values（-11.3 to-8.2 ‰ PDB） are depleted relative to calcite mudstone（-8.3 to-5.4 ‰ PDB） that precipitated from lake water, while δ13c values（0.06–1.74 ‰ PDB） are within the normal range of calcite mudstone values（-2.13 to 1.99 ‰ PDB）. High87Sr/86Sr values（0.710210–0.710844） indicate that amounts of ca2＋ and Mg2＋have been derived from the chemical weathering of Palaeozoic carbonate bedrocks. The high strontium concentration indicates that hypersaline conditions were maintainedduring the formation of the dolomites and that the dolomites were formed by the replacement of precursor calcite or by direct precipitation.

关键词： Dolomite Lacustrine carbonate Eocene Sikou Sag Bohai Bay Basin

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Protective effect of hydroxychloroquine on rheumatoid arthritis-associated atherosclerosis

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Animal Models and Experimental Medicine 2019年第2期2卷 98-106页

作者： Na Shi Shuangyue Zhang gregg Silverman Mengtao Li Jun cai Haitao Niu NHc Key Laboratory of Human Disease comparative Medicine (The Institute of Laboratory Animal Sciences CAMS&PUMC) Key Laboratory of Human Diseases Animal Model State Administration of Traditional Chinese Medicine Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases Beijing China Department of Rheumatology Langone Medical Center New York University New York City New York Peking Union Medical college Hospital Beijing China Fuwai Hospital Chinese Academy of Medical Sciences Beijing China

Background: Patients with rheumatoid arthritis (RA) have an increased risk for cardiovascular disease. We examined the effect of gut microbiota in a mouse model of RA that develops atherosclerosis. Methods: We created three groups of K/BxN female mice that were positive for the anti‐glucose‐6‐phosphate isomerase (GPI) antibody: control diet (cD), high fat diet (HFD), and HFD with hydroxychloroquine (HFD + HcQ). Serological tests were used to detect the serum levels of total cholesterol (TcHO), low‐density lipoprotein cholesterol (LDL‐c), triglyceride (TG), high‐density lipoprotein cholesterol (HDL‐c), anti‐ GPI antibody titers, and serum cytokines. Atherosclerotic plaque was determined by histological analysis, and gut microbiota were determined by 16sV4 sequencing. Results: Relative to mice given the cD, those receiving the HFD had increased serum levels of LDL‐c, TcHO, and TG, decreased serum levels of HDL‐c, increased atherosclerotic lesions in the aortic root, and altered gut microbiota. Addition of HcQ to HFD decreased the serum levels of LDL‐c, TcHO, and TG, increased serum levels of HDL‐c, and decreased the atherosclerotic lesions in the aortic root. Mice receiving HFD + HcQ also had the greatest bacterial diversity among the three experimental groups. Moreover, HcQ treatment significantly increased the abundance of Akkermansia and Parabacteroides, and decreased the abundance of clostridium sensu stricto cluster 1, and therefore may be responsible for the reduced RA‐associated atherosclerosis and dyslipidemia. conclusion: Our mouse model of RA indicated that HFD increased ankle width and aggravated a therosclerosis a nd d yslipidemia, a nd t hat H cQ a lleviated t he d yslipidemia and atherosclerosis, but had no effect on ankle width.

关键词： atherosclerosis autoimmunity hydroxychloroquine intestinal microbiota rheumatoid arthritis

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Assembly of JAZ–JAZ and JAZ–NINJA complexes in jasmonate signaling

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Plant communications 2023年第6期4卷 296-312页

作者： X.Edward Zhou Yaguang Zhang Jian Yao Jie Zheng Yuxin Zhou Qing He Javier Moreno Vinh QLam Xiaoman cao Koichi Sugimoto Leidy Vanegas-cano Leena Kariapper Kelly Suino-Powell Yuanye Zhu Scott Novick Patrick R.Griffin Feng Zhang gregg A.Howe Karsten Melcher Department of Structural Biology Van Andel InstituteGrand RapidsMI 49503USA Key Laboratory of Pesticide College of Plant ProtectionNanjing Agricultural UniversityNanjingChina MSU-DOE Plant Research Laboratory Michigan State UniversityEast LansingMI 48824USA Department of Molecular Medicine UF Scripps Biomedical ResearchJupiterFL 33458USA Plant Resilience Institute Michigan State UniversityEast LansingMI 48824USA Department of Biochemistry and Molecular Biology Michigan State UniversityEast LansingMI 48824USA Present address:Institute of Botany Jiangsu Province and Chinese Academy of SciencesNanjing 210014China Present address:Tsukuba-Plant Innovation Research center University of TsukubaTsukubaIbaraki 305-8572Japan

Jasmonates(JAs)are plant hormones with crucial roles in development and stress *** activate MYc transcription factors by mediating the proteolysis of MYc inhibitors called JAZ *** the absence of JA,JAZ proteins bind and inhibit MYc through the assembly of MYc–JAZ–Novel Interactor of JAZ(NINJA)–TPL repressor ***,JAZ and NINJA are predicted to be largely intrinsically unstructured,which has precluded their experimental structure *** a combination of biochemical,mutational,and biophysical analyses and AlphaFold-derived colabFold modeling,we characterized JAZ–JAZ and JAZ–NINJA interactions and generated models with detailed,high-confidence domain *** demonstrate that JAZ,NINJA,and MYc interface domains are dynamic in isolation and become stabilized in a stepwise order upon complex *** contrast,most JAZ and NINJA regions outside of the interfaces remain highly dynamic and cannot be modeled in a single *** data indicate that the small JAZ Zinc finger expressed in Inflorescence Meristem(ZIM)motif mediates JAZ–JAZ and JAZ–NINJA interactions through separate surfaces,and our data further suggest that NINJA modulates JAZ *** study advances our understanding of JA signaling by providing insights into the dynamics,interactions,and structure of the JAZ–NINJA core of the JA repressor complex.

关键词： JAZ protein NINJA AlphaFold colabFold MYc hydrogen-deuterium exchange

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