Ceramide plays an important role in sphingolipid metabolic processes. It affects cell signaling pathways, regulates cell and body metabolism, and is related to the occurrence and development of a variety of diseases. In recent years, with the application and development of mass spectrometry technology in the detection of ceramides, ceramides or different combinations of ceramides are found to be potential valuable new biomarkers for clinical diagnosis, risk assessment and prognosis of a variety of diseases. This article reviews the biochemical characteristics, detection methods and clinical application of ceramide, and outlines its application value as biomarkers.

Cardiometabolic disease mainly refers to the cardiovascular disease caused by the increased metabolic burden, including hypertension, diabetes, dyslipidemia, coronary heart disease, stroke, and so on. In China, the incidence of this kind of disease is continuous rising, and cardiometabolic disease is more and more diagnosed in patients in younger age. Currently, continuous exploration of new biomarkers and detection methods, standardization of testing techniques, strengthening of clinical and laboratory communication and cooperation, and cultivation of interdisciplinary talents are the major focuses in term of promoting the development of laboratory medicine in the field of cardiovascular metabolism.

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death of urban and rural residents in China, and dyslipidemia is the most important pathogenic risk factor for the occurrence and development of ASCVD. Faced with the increasing ASCVD burden in China, there is an urgent need to improve the lipid management in China. Clinical blood lipid testing is an important component of lipid management, and the accurate test results are a fundamental requirement for effective lipid management. The "China guidelines for clinical lipid profile testing" and "China guidelines for lipid management (2023)" are newly published. With the continuous updating of concepts on clinical lipid profile testing and lipid management, it is essential to further strengthen the communication and cooperation between clinical medicine and laboratory medicine, widely promote and apply the new concepts of updated guidelines, in order to better guide clinical practice, comprehensively improve the level of clinical lipid profile testing and lipid management in China, and assist in the standardized prevention and treatment of ASCVD in China and the early arrival of the turning points.

Objective:To establish and validate a reliable and sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the detection of 12 ceramides in human plasma.Methods:From October 2021 to October 2022, 438 apparently healthy individuals were enrolled in the Affiliated Hospitals of Zunyi Medical University for reference intervals of 12 ceramides in this population. Plasma samples were collected, and separated using the ACQUITY UPLC BEH C18 (2.1×50 mm, 1.7 μm) column, deuterated isotopes were used as internal standards. The mobile phase is water (containing 0.1% formic acid) and isopropanol: acetonitrile (1∶1, v/v, containing 0.1% formic acid) at a flow rate of 0.4 ml/min with gradient elution. The detection method was established using the Qlife Lab 9000 Plus triple quadrupole mass spectrometer. The performance of the method was evaluated in terms of linearity, the lower limit of quantification, precision, recovery, and stability.Results:The method passed the performance evaluation in terms of linearity, the lower limit of quantification, recovery, precision, and stability. The intra-and inter-batch precision of the 12 ceramides ranged from 1.3% to 14.3%, the correctness was verified by spiked recovery experiments, and the recoveries ranged from 91.9% to 111.0%. The lower limit of quantification ranged from 0.001 to 0.100 μmol/L. Standard curve showed good linearity (correlation coefficient r>0.990). Stability tests showed that the 12 ceramides were stable in the biological matrix and after processing under different conditions for a specified period of time. The corresponding biological reference intervals were established for each of the 12 ceramides: 0.103-0.326 μmol/L for Cer(d18∶1/16∶0), 0.018-0.098 μmol/L for Cer(d18∶1/18∶0), 0.933-3.919 μmol/L for Cer(d18∶1/24∶0), 0.243-1.072 μmol/L for Cer(d18∶1/24∶1), 0.001-0.007 μmol/L for Cer(d18∶1/14∶0), 0.022-0.095 μmol/L for Cer(d18∶1/20∶0), 0.185-0.835 μmol/L for Cer(d18∶1/22∶0), 0.003-0.022 μmol/L for Cer(d18∶0/16∶0), 0.001-0.016 μmol/L for Cer(d18∶0/18∶0), 0.017-0.156 μmol/L for Cer(d18∶0/24∶0), 0.008-0.074 μmol/L for Cer(d18∶0/24∶1), and 0.106-0.721 μmol/L for LacCer(d18∶1/24∶1). Conclusion:Our study shows that the newly established LC-MS/MS method for the determination of 12 ceramides in human plasma is reliable, and suitable for clinical application.

Objective To investigate the effect of NAIF1 in gastric cancer cell lines MKN45. Methods We constructed pLVX-Tight-Flag-NAIF1-puro plasmid with Tet-on system. DOX was added to induce NAIF1 expression in MKN45 cells. The cells were collected at 0, 6, 12 and 24 hours after DOX addition for gene expression microarray detection and biological analysis of differentially expressed genes. qRT-PCR and Western blot were used to verify the changes in mRNA and protein levels of the selected target differential genes. Results The biological analysis of gene microarray hybridization results showed that IFIT1, IFIT2 and IFIT3 expression significantly increased at 24h, qRT-PCR also showed this change, and Western blot further verified the change in protein level. However, IFIT5 showed no significant change in mRNA and gene expression. Conclusion Over-expression of NAIF1 in gastric cancer cells can promote the expression of some immune system-related IFIT family proteins.

Phytosterolemia is a rare, severe autosomal recessive sterol storage disorder caused by homozygous or compound heterozygous mutations in one of the ABCG5 and/or ABCG8 adenosine triphosphate binding cassette (ABC) genes. The most prominent features of phytosterolemia are the significantly increased serum content of plant sterols. Present review focused on the laboratory diagnosis of phytosterolemia, briefly described the metabolism of phytosterols, and introduced the latest research progress on phytosterolemia diagnosis, its relationship with ASCVD and laboratory diagnostic methods (including the detection of serum concentrations of phytosterols, ABCG5/G8 gene mutation). We hope this article could improve readers′ awareness and attention on this disease.

Objective:To investigate the relationship between T/N take-up value and the clinic feature of breast cancer, and explore the predictive ability of T/N take-up value for breast cancer prognosis.Methods:Breast cancer patients treated at Zhongshan Hospital, Fudan University and undergoing BSGI examination before surgery from Jan 2014 to Nov 2018 were collected. The relationship between T/N take-up value and the clinical features of breast cancer and DFS was analyzed.Results:A total of 419 breast cancer patients were collected. The median follow-up time after operation was 34 months. At the end of the follow-up, 43 cases relapsed and 376 cases did not. The average T/N values of CC position and MLO position before surgery were 2.74 and 2.58. The T/N value of CC is related to tumor stage (χ 2=22.077, P<0.05), lymph node metastasis ( Z=2.138, P<0.05) and degree of invasion ( Z=3.371, P<0.05). The T/N value of MLO is related to tumor stage (χ 2=23.091, P<0.05), lymph node metastasis ( Z=2.531, P<0.05) and degree of invasion ( Z=2.99, P<0.05). The best cut-off values of CC position and MLO position calculated by ROC curve are 2.59 and 2.97. Univariate analysis showed that tumor staging ( HR: 2.039, 95% CI: 1.404-2.962, P=0.001), T/N value at CC position ( HR: 4.349, 95% CI: 2.141-8.883, P<0.001) and T/N value at MLO position ( HR: 2.767, 95% CI: 1.520-5.039, P<0.001) is an independent risk factor for the prognosis of breast cancer. Multivariate COX regression analysis showed that tumor stage ( HR: 1.959, 95% CI: 1.302-2.946, P=0.001) and T/N value at MLO position ( HR: 3.498, 95% CI: 1.531-7.992, P=0.003) are independent risk factor of breast cancer prognosis. Conclusion:The BSGI T/N value has a certain correlation with breast cancer DFS.

Objective To compare the function recovery of multiple injuries combined with floating knee joint injury and simple knee joint injury,and to analyze the risk factors.Methods A retrospective case control study was conducted to analyze the clinical data of 41 patients with multiple injuries combined with Blake and McBryde Ⅱ A floating knee injury admitted to Xijing Hospital of Air Force Medical University from June 2011 to June 2017.There were 26 males and 15 females,aged 18-76 years,with an average of 34.5 years.There were 25 patients with simple knee joint injury and and 16 patients with multi-joint combined injury involving knee joint and ipsilateral hip joint or ankle joint injury.Surgical fixation was performed in different parts by external fixation,intramedullary nail and plate screw fixation.According to the Kalstr(o)m and Olerud functional evaluation criteria,the excellent and good rate of postoperative functional recovery was compared between the two groups.The surgical fixation methods of the two groups were compared.Logistic regression analysis was performed on the influencing factors of functional recovery.Results The patients were followed up for 1-7 years,with an average of 3 years.The excellent and good rate of overall functional recovery in the two groups was 68％,and the rate was 84％ in simple knee injury group and 44％ in multi-joint combined injury group (P ＜ 0.01).There was no significant difference in the ratio of intramedullary nail and plate screw fixation between the two groups (P ＞ 0.05),while the proportion of the external fixation in the multi-joint combined injury group [31％ (5/16)] was significantly higher than that in the simple knee joint injury group [16％ (4/25)] (P ＜ 0.05).Logistic regression analysis showed that the rate of external fixation was an independent factor affecting the postoperative function (OR =0.15,P ＜ 0.01).Conclusions The postoperative function in multi-joint injury patients is poorer than in the single joint injury patients.The higher rate of using external fixation in multi-joint injury patients is a risk factor.For Blake and McBryde Ⅱ A floating knee injury combined with multi-joint injury,less external fixation should be used,so as to improve the postoperative function.

Objective To investigate the clinical effect of Gamma 3 intramedullary nails for the treatment of unstable intertrochanteric fractures in the elderly. Methods A total of 36 elderly patients (aged over 70 years)with unstable intertrochanteric fractures (Evans type Ⅲ or above)treated with Gamma 3 intramedullary nails from January 2013 to December 2016 were followed up and analyzed. Results All patients were followed up for 6 to 12 months ,with an average of (9.4 ± 2.6) months. The fractures were healed in all patients ,and the healing time was between 10 and 18 weeks , with an average of 14 weeks. A mild type of coxa varus was found in 2 cases. According to the Harris hip score ,the curative effect was excellent in 24 cases ,good in 7 cases ,fair in 3 cases and poor in 2 cases. The excellent and good rate was 86.1% . Conclusions The gamma 3 intramedullary nail is an outstanding internal fixation tool for the treatment of unstable intertrochanteric fractures in the elderly ,with such advantages as minimal trauma ,short operation time ,firm fixation and few postoperative complications.

Objective: To investigate the clinical value of combined detection of serum miR-378 and miR-21 in gastric cancer (GC). Methods: Eighty-seven patients with GC and 78 patients with colorectal cancer(CRC) from National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences were selected, 83 individuals undergoing healthy physical examination were selected as the healthy controls. The levels of serum miR-378 and miR-21 were detected by quantitative real-time PCR (RT-qPCR) (result data were transformed as log2 for analysis). Results: Relative expression levels of miR-378 in the serum were -1.24, -3.25 and -2.73 in healthy controls, GC and CRC patients, respectively. Compared with the healthy controls, the levels of serum miR-378 were significantly decreased in GC and CRC patients (both P<0.05). Relative expression levels of miR-21 in the serum were 0.11, 2.34 and 2.47 in healthy controls, GC and CRC patients, respectively. Compared with the healthy controls, the levels of serum miR-21 were significantly up-regulated in GC and CRC patients (both P<0.05). Moreover, the serum level of miR-378 in GC patients was inversely associated with tumor clinical stage (P<0.05). However, the level of miR-21 showed no significant differences among patients with different clinical and pathological characteristics (all P>0.05). The area under the receiver operating characteristic curve (AUC), sensitivity and specificity of miRNA-378 to diagnose GC was 0.770, 82.0% and 66.0%, respectively, and were 0.900, 85.0%, and 88.0% of miR-21, respectively. The AUC, sensitivity and specificity of combined detection of serum miR-378 and miR-21 to diagnose GC were 0.930, 92.0% and 87.0%, respectively, while the AUC of combined detection of serum CEA and CA-199 was 0.767, the AUC of combined all of the four factors was 0.946. Conclusion The combined detection of serum miR-378 and miR-21 have a certain effect on diagnosis of GC.