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Objective: To clarify the improvement of maintenance efficiency depending on digital diagnosis technology through the application of digital diagnosis tools for the new type blood cell analyzer in equipment maintenance. Methods: Combined with the actual case, to explore the application and expansion of digital diagnosis tool in maintenance for blood cell analyzer from different aspects, such as common cause analysis of partial absorption alarm, communication error, temperature control failure, the problem location of stepper motor encoder fault and other aspects. Results: By effective using digital diagnosis tool, the maintenance efficiency has been improved, the fault cause has been effectively analyzed, and this method can help technician to find fault phenomenon that would not normally be found by accidental fault in common maintenance and help them to locate accidental fault point. Conclusion: Digital diagnosis tools can fully use specialist data, find hidden danger of equipment fault in earlier, put forward judgment information for fault, and provide convenience for equipment maintenance.
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Objective To establish the re-examination criteria of the Sysmex XN-9000 automatic blood cell analyzer pipeline suitable for this laboratory for ensuring the accuracy of detection results .Methods A total of 2250 whole blood samples were se-lected from inpatients ,outpatients and subjects undergoing physical examination .The Sysmex XN-9000 blood cell analyzer was a-dopted to conduct the detection .With the manual microscopic examination as the golden standard ,26 items of re-examination criteria were performed the verification and evaluation .The positive predicting value ,negative predicting value ,false positive rate ,false neg-ative rate and re-examination rate were performed by the statistics .Results In compariing the instrument alarm information with the microscopic examination results ,the positive predicting value was 91 .59% ,the negative predicting value was 98 .64% ,the false positive rate was 2 .09% ,the false negative rate was 1 .02% and the re-examination rate was 24 .84% .Conclusion The formulated re-examination criteria of the Sysmex XN-9000 blood cell analyzer is in accord with the characteristics of our laboratory ,which in-creases the detection efficiency ,prevents the missing detection and false detection and has clinical guidance significance .
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Objective To evaluation the precision performance of XE-2100 Automatic Blood Cell Analyzer using EXCEL Mi-crosoft with reference to CLSI EP15-A3 .Methods According to CLSI EP15-A3 ,high level and low level (BIO-RAD company) of quality control materials were measured using XE-2100 Automatic Blood Cell Analyzer ,and analyzed by one-factor analysis of vari-ance of EXCEL 2003 and equation editor .The within-run coefficient of variation and within-laboratory coefficient of variation were calculated and compared with national industry standards and manufacturer statement .Results For high and low level of quality control materials ,the within-run coefficient of variation and within-laboratory coefficient of variation of white blood cell ,red blood cell ,hemoglobin and platelet were less than national industry standards and manufacturer statement .Conclusion The precision ver-ification scheme of CLSI EP15-A3 with EXCEL Microsoft has a relatively good maneuverability and statistical performance ,which could be used in verification of the precision performance of quantitative testing items in clinical laboratories .
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Objective To study application of the quality management of Blood Cell Analyzer according to the requirement of biological variation determination.Methods Collected the indoor imprecision value(CV％) from 8 items detected by blood cell analyzer during from April to Nov.of 2016,and the bias (Bias％) of 8 items of two EQA (external quality assessment) from the ministry of health in 2016.Then according to the 3 levels of the minium,appropriate and optimal quality specifications derived from the biological variability the rates of imprecision and bias were culculated.The pass rate of the imprecision and bias was calculated.By using mean bias and mean imprecision and biological variation 3 levels of total error (TEa) crite rion,and to calculate the corresponding σ and QGI value,so as to evaluate the performance of whole blood cell analyzer.Then improved the quality.Results For the imprecision value of 8 items,except the MCHC average value,all others were all 100 ％ meeting the appropriate level of quality requirements.For the bias value (Bias ％) from 8 items,except MCH,all others were over 80 ％ meeting the appropriate level of quality requirements.While for the calculated σ value,based on the best level of quality requirements,except the σ value of WBC was 4.6,the σ value of all other items were all＜3.Based on the appropriate level of quality requirements,except the σvalue of MCHC was 1.9,the value of σ of all other items were all＞ 3,and based on the minimal requirements,the σ value of all 8 items were all ＞3.After analysis,this blood cell analyzer,except that MCHC should use the minimal quality standard requirements,all other examination items could used the proper quality standard requirements,and the calculated QGI were all ＜0.8.Conclusion Based on the biological variation determination requirement and calculated σ and QGI value,this method could be used to more accurate quality evaluation of blood cell ana lyzer.Which is a higher levelof quality management,will be more conducive to quality improvement and better serve the clinical.
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We established age- and gender-specific reference ranges for the 36 routine complete blood cell (CBC) and 57 cell population data (CPD) items in the Sysmex XN-2000 (Sysmex, Japan). In total, 280 peripheral blood samples were obtained from an equal number of healthy adults. Values for 36 routine items and 57 CPD items were obtained for each sample, and the results were categorized into six subgroups (N>39 in each subgroup) according to patient age (20-40, 41-60, and >60 yr) and gender (male and female), and compared with respect to age and gender differences. The majority of data items (22 of 36 routine CBC items and 44 of 57 CPD items) exhibited significant differences (P< or =0.05) in their results with respect to age or gender, and several red cell-, lymphocyte-, and platelet-related data tended to decrease in women or older adults. These results provide a basis for establishing age- and gender-specific reference ranges for routine and CPD items in Sysmex XN-2000. Furthermore, these reference ranges could be used to determine clinical significance for new items of Sysmex XN-2000 in further studies.
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Adult , Aged , Female , Humans , Male , Middle Aged , Age Factors , Automation , Blood Cell Count/methods , Reference Values , Sex FactorsABSTRACT
Objective:To evaluate the performance for the Sysmex XN20 A1 automation blood cell analyzer.Methods: The precision, contaminative rate, linear range, blank, accuracy and various sample models were verified, and low values of blood platelet were compared with the methods of microscopy and dye.Results:The contaminative rate was lower than 0.4%. The linear arrange and precision were well for the analyzer. The values of RBC, HGB and PLT were within the range of 1±0.05 and the correlation coefficients were higher than 0.975. The bias of average and constant values by the accuracy verification samples test met the demands of accuracy. And the relative differences of various sample models meet the requirements of the comparability. The variable coefficient of low values of PLT was lower than 4% by the dye method.Conclusion: The Sysmex XN20 A1 automation blood cell analyzer has the characteristics of perfect precision, accuracy, low contaminative rate, broad linear arrange and good repeatability for the low level PLT. It can be applied in clinical laboratory.
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Objective To investigate and analyze the reference ranges of the common parameters of venous blood cell analysis a ‐mong healthy adults in Kunshan City .Methods The analytical results of venous blood cells from 2 456 healthy adults were selected and the ten indicators of red blood cell ,hemoglobin ,mean corpuscular volume ,mean corpuscular hemoglobin concentration ,mean corpuscular hemoglobin ,hematocrit ,white blood cell ,lymphocytes percentage ,neatrophilic granulocyte percentage ,blood platelet were statistically analyzed by adopting the SPSS 19 .0 software .Results The commonly used 10 parameters of blood cells showed a skewed distribution ,the Mann‐Whitney U tests showed that the gender difference in 10 parameters was statistically significant (P<0 .05) ;the WBC count was slightly higher than that reported by other literature ,the other 9 parameters were close to those reported by the majority of related literature .Conclusion The commonly used parameters of blood cell analysis are influenced by the region , gender ,environment ,living condition and detection instrument ,and it is necessary to establish the reference ranges for each labora‐tory .
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Objective To study the value of clinical application of leukocyte classification alarm system (Q‐Flag ) for Sysmex XT‐1800i blood cell analyzer .Methods 394 blood samples with alarm system (Q‐Flag) and 190 ones without abnormal alarm infor‐mation detected by the Sysmex XT‐1800i blood cell analyzer were performed to observe the quantity and morphology of blood cells by manual differentiation ,and the results were compared between them .Results The alarm system of Sysmex XT‐1800i blood cell analyzer in detecting cell morphologic abnormalities was 100 .0% for sensitivity ,62 .3% for specificity ,70 .8% for positive predic‐tive value and 100 .0% for negative predictive value .Based on thegold standardof manual differentiation ,no abnormal cells were observed in those blood samples without Q‐Flag alarm information and the coincidence rate was 100% .The coincidence rate of leu‐kocyte classification was from 0 .0% to 75 .0% for blood cell analyzer when the alarm system (Q‐Flag) was between 100U and 200U ,and that was from 66 .7% to 95 .6% when the alarm system (Q‐Flag) was between 200U and 300U .Conclusion The alarm system sensitivity of leukocyte classification alarm system (Q‐Flag) is high for Sysmex XT‐1800i blood cell analyzer ,and it is nec‐essary to manually differentiate the samples with abnormal Q‐Flag in order to provide accurate and reliable clinical diagnostic infor‐mation .
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Objective To evaluate the performance of XE‐5000 automated blood cell analyser for detecting nucleated red blood cell (NRBC) in peripheral blood and investigate its clinical application value .Methods The intra‐assay imprecision ,carryover rate , and linear range of the analyser were evaluated .The absolute NRBC count and percentage of NRBC of 137 blood specimens (NRBC‐positive according to the DIFF channel of the analyser) were determined in the NRBC channel of the analyser ,and the percentage of NRBC of these blood specimens were determined by using microscope method as well .Differences between the two methods were analysed by using SPSS18 .0 statistic software .Results The intra‐assay imprecision of the analyser for detecting absolute NRBC count in specimens with high ,moderate ,and low Q‐flag values were 2 .10% ,3 .26% and 11 .62% ,respectively ,and the imprecision for detecting percentage of NRBC were 3 .79% ,5 .80% and 13 .33% ,respectively .The carryover rates of the analyser for detecting absolute NRBC count and percentage of NRBC were 0 .51% and 0 .26% ,respectively .At the range of (0~18)× 109/L ,the absolute NRBC count detected by using the analyser showed good linearity :Y=1 .048 6X+0 .189 6(r=0 .999 1) .There were no statistically significant differences between the analyser and microscope for detecting percentage of NRBC(P=0 .716) ,and showed good corre‐lation:Y=1 .150 2X+0 .626 1(r=0 .967 0) .Conclusion The XE‐5000 automated blood cell analyser could completely replace the traditional microscope for clinically classifying and counting NRBCs .
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Objective To compare the body fluid count results detected by Sysmex XE-5000 automatic blood cell analyzer and manual method .Methods A total of 300 cases of body fluid specimens (including cerebrospinal fluid and fluid of serous cavity ) were analyzed .RBC ,WBC counting and classification were respectively detected by XE-5000 and manual method of improvement Neubauer counting plate .Results The fresh specimens without contain a large number of cell clusters ,which RBC counts(RBC-BF)(100-10 000)× 106/L ,and WBC counts(WBC-BF) (9-50)× 106/L ,showed there were a linear relationship between the in-strument method(r=0 .998 5 ,0 .986 3) .In the range ,there was no significant difference between XE-5000 and manual method(t=9 .96 ,P>0 .05) .Also in this range the results of instrument correlated with those of manual method(r= 0 .989 3 ,0 .971 7 , 0 .924 9) .For those specimens which contain a large number of cell clusters ,RBC-BF and WBC-BF were a badly linear relationship between the instrument method(r=0 .564 8 ,0 .456 1) .Conclusion Body fluid specimens which are fresh and do not contain a large number of cell clusters ,in the range of RBC-BF (100 -10 000) × 106/L ,WBC-BF (9 -50) × 106/L ,Sysmex XE-5000 automatic blood cell analyzer could ensure the results have good accuracy .
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Objective To investigate the consistency of the results detected by different types of blood cell analyzer in the blood center .Methods On the basis of the calibration in each analyzer ,with the analyzer obtaining the excellent result in participating the external laboratory quality assessment hosted by the Ministry of Health as the reference ,the fresh blood samples were adopted to analyze other analyzers .Results For the analyzers after conducting the comparison ,the consistency and accuracy of the detection results were ensured .Conclusion After calibration in different types of blood cell analyzer ,the differences exist in the detection re‐sults .Periodically conducting the comparison among different types of instrument has very practical significance .
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Objective To explore the clinical application of humoral mode of the Sysmex XE-5000 automatic blood cell analyzer in the count and differential count of hydrothorax and ascites white blood cell(WBC).Methods The 196 clinical specimens of hy-drothorax and ascites from the hospitalized patients were collected and conducted the WBC count and differential count by the hu-moral mode of the Sysmex XE-5000 automatic blood analyzer (streaming technology with semiconductor laser-instrument method) and the artificial microscope counting method (manual method).The specimens were divided into two groups according to the in-strument counting results,the group A:(0 -1 500)× 106/L and the group B:>1 500 ×10 6/L and the correlation between two methods was analyzed.Results The data analysis demonstrated that the two kinds of methods for detecting the WBC count and dif-ferential count of hydrothorax and ascites had good correlation,and the difference had no statistical significance (P >0.05).Conclu-sion The humoral mode of the Sysmex XE-5000 automatic blood cell analyzer has a good application value for detecting WBC count and differential count of hydrothorax and ascites.
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Objective To explore the causes of accidental instability of SYSMEX XS-800i blood cell analyzer for WBC testing and their countermeasures.Methods Totally 10 pieces of specimen with high deviation were analyzed retrospectively, and the changes of DIFF-Y values of WBC were observed. Sysmex detergent was used to clean the pipelines including 4DL, 4DS and EPK pipes. Fluid path electromagnetic valve was checked and then repaired or replaced. Results It's proved that the results at the first time were not reliable, and there was significant differences between the results at the first and second times for DIFF-Y value, with P<0.01. The failures were eliminated after the above countermeasures were carried out.Conclusion WBC testing pipelines and electromagnetic valve of fluid path have to be cleaned periodically to eliminate the influence on DIFF-Y value of WBC and false increase of WBC counting.
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Objective To investigate the application value of the XT-4000i blood cell analyzer in body fluid cell count.Methods 113 cases of body fluid specimen were collected in the hospitalized patients from September 2013 to February 2014.Then RBC and WBC counts in the collected specimens were detected whitin 1 h by XT-4000i blood cell analyzer and the manual detection method, the RBC count values were divided into 3 levels:L1 100~1 000 ×106/L,L2 1 001 ×106 ~100 000 ×106/L and L3 > 100 000 × 106/L;WBC count values were divided into 2 levels:L1 1~50×106/L and L2 >50×106/L.The correlation between the two kinds of test methods was analyzed.Results The results of RBC and WBC counts detected by the XT-4000i blood cell analyzer and the manual method had a higher correlation.The correlation coefficients were 0.931,0.996,0.865,0.942 and 0.988.Conclusion The XT-4000i blood cell analyzer can be applied in clinical fluids cell count.
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Objective To evaluate whether the comparability of 3 automatic blood cell analyzers meet the clinical requirements by conducting the comparative study on the detection results of these instruments.Methods With the Sysmex 2100 automatic blood cell analyzer as the reference instrument,Sysmex 1000i and Abbott 1800 as the experimental instrument,the original quality control provided by the instrument factory and the patient′s fresh anticoagulant blood samples in the laboratory were adopted to monitor for continuous 40 d by these three instruments and the detection results of WBC,RBC,HGB,HCT and PLT were analyzed.Results The detection results of these 3 instruments were statistically tested by the F test,the differences showed no statistical significance (P >0.05)and the bias was in 1/2 of the maximum permissible error range in America department clinical test revised regulations (CLIA′88).Conclusion The detection results by these 3 instruments are comparable and can meet the clinical requirements.
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Objective To evaluate the clinical application value of influence of chylemia specimen before and after blood plasma exchange on the detection results of hematological analyzer.Methods 22 chylemia specimens were collected,then the hematological analyzer was used to test the chylemia specimens before and after blood plasma exchange,and the results were compared with those detected by the manual microscopic counting.Results The detection results of WBC,NEU,LY,MO,RBC,HGB and PLT in the non-chylemia specimens and the original blood specimens before blood plasma exchange had no statistically significant differences (P >0.05);in 22 cases of chylemia specimens,the WBC count and classification,and the mean value of HGB and PLT before and after blood plasma exchange in the chylemia specimens had statistically significant differences (P <0.05),the WBC count and clas-sification,and PLT mean value after blood plasma exchange in the chylemia specimens by the hematological analyzer had good corre-lation with those detectd by the microscopic counting method(r2 =0.936,r2 =0.918).In the triglyceride interference test,the WBC count and classification,and the mean value of HGB and PLT could be changed with the increase of the triglyceride concentration. Conclusion Adopting the blood plasma exchange method could obviously improve the influence of chylemia specimens on the detec-tion results by the hematological analyzer and provide the accurate results for clinic.
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BACKGROUND: Automated blood cell analyzers often read leukemic blasts as normal cells. In this study, we evaluated the 5-part differential patterns of blasts using automated analyzers to determine if they can differentiate among blast types. METHODS: Blood samples containing 10% or more blasts were collected from patients with acute leukemia (N=175). The 5-part differential count was conducted using DxH 800 (Beckman Coulter, USA) and XE-2100 analyzers (Sysmex Co., Japan), and the results were compared with manual differential counts, which was used as a reference method. RESULTS: The DxH 800 reported the 5-part white blood cell differential count in 98.9% of the cases. The XE-2100 provided an invalid automated differential count in 72% of the cases. Both analyzers counted most lymphoblasts as lymphocytes and most myeloblasts as monocytes. In 11 cases, the DxH 800 reported a 5-part differential count without a blast flag. CONCLUSIONS: Some automated analyzers are able to recognize and count blasts according to their characteristic cell types. Therefore, complete blood counts obtained automatically can provide valuable data for making provisional decisions regarding the lineage of leukemia cells before further investigation.
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Humans , Acute Disease , Automation , Blood Cell Count/instrumentation , Leukemia/blood , Leukemia, Monocytic, Acute/blood , Leukemia, Myeloid, Acute/blood , Leukemia, Promyelocytic, Acute/blood , Precursor Cell Lymphoblastic Leukemia-Lymphoma/bloodABSTRACT
Objective To study the pathological characteristics of leukocyte myeloperoxidase (MPO) deficiency and clinical laboratory diagnostic strategy for this disease. Methods The Bayer ADVIA 120 blood cell analyzer differentiate leukocyte and detect myeloperoxidase index (MPXI) . The leukocyte morphology and differentiating count on blood smear by Wright’s stain were finished. The peroxidase positive cell percentage and score were counted by peroxidase stain. The expressive levels of leukocyte MPO antigen were measured by flow cytometric monoclonal antibodies method.Results The prevalence of mild neutrophil MPO deficiencies was 2.61%, and partial neutrophil MPO deficiencies was 0.39% in 5 761 in-patients. The significant changes in the dot plot from ADVIA 120 blood cell analyzer were seen in 3 patients with MPO deficiencies, and MPXI,MPO activities and MPO antigen levels of the patient’s neutrophils and monocytes decteased remarkably,but there were normal levels in eosinophils.Conclusion Neutrophil MPO deficiencies were not a rare disorder,but the mild deficiency cases were seen usually.The low activity of MPO is an important evidence for MPO deficiencies diagnosis.The Bayer ADVIA 120 blood cell analyzer can be used simply and fleetly for screening MPO deficiencies in routine hematology laboratory.The peroxidase stain of blood smear is an improtant diagnostic method for MPO deficiencies.