Evaluation of Sysmex XN-3000 for Detection of Schistocyte / 中国实验血液学杂志

OBJECTIVE@#Compared with the method of optical microscopy, to evaluate the accuracy of fragmented red cells(FRC) detection by Sysmex XN-3000.@*METHODS@#A total of 111 samples were collected from patients diagnosed as thrombotic thrombocytopenic purpura, autoimmune disease, hematological disease, malignant tumor and health examination in our hospital from June 2019 to February 2021, including 74 cases in the case group and 37 cases in the healthy control group. All samples were detected by optical microscope and Sysmex XN-3000, respectively. ROC was used to evaluate the detection ability of Sysmex XN-3000 for schistocyte. Bland-Altman method was used to evaluate the consistency of the results of the two methods for detection of schistocyte, and Pearson correlation analysis was conducted for the difference of the results.@*RESULTS@#The area under the ROC curve was 0.890(95% CI: 0.828-0.952, P<0.01). Sysmex XN-3000 count did not quantitatively agree with schistocyte counts by microscopy in the case group(mean of difference:-1.53, 95% limits of agreement: -8.78~5.72). There was a weak positive correlation between platelet count and the difference of analyzer and microscopic results (r=0.32,P<0.05).@*CONCLUSION@#Sysmex XN-3000 can be used as a reference for qualitative determination of schistocyte. However, the sensitivity of Sysmex XN-3000 should be improved. It is still necessary to combine with manual microscopy. The quantitative results are not reliable now and cannot be used as a reference for monitoring the results of schistocyte in clinical patients after treatment.

Use of the reticulocyte channel warmed to 41 °C of the XN-9000 analyzer in samples with the presence of cold agglutinins

ABSTRACT Objectives The purpose of this study was to compare data obtained from the reticulocyte channel (RET channel) heated to 41 °C with those obtained from impedance channel (I-Channel) at room temperature in the samples with the mean corpuscular hemoglobin concentration (MCHC) < 370 g/L and in samples with the MCHC > 370 g/L, in the presence of cold agglutinins. Methods In this study, 60 blood samples (group 1) with the MCHC < 370 g/L (without cold agglutinins) and 78 blood samples (group 2) with the MCHC > 370 g/L (with cold agglutinins) were used to compare the two analytical channels of the XN-9000 analyzer in different preanalytical conditions. The parameters evaluated in both groups were the following: red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), mean cell volume (MCV), RBC-most frequent volume (R-MFV), mean hemoglobin concentration (MCH) and mean cellular hemoglobin concentration (MCHC). Results The results of this study showed an excellent correlation with both channels of the XN-9000 analyzer in samples with and without cold agglutinins, except for the MCHC. The bias between the values obtained in the I-channel and those obtained in the RET channel of both groups was insignificant and remained within the limits of acceptability, as reported by Ricos et al. for all considered parameters, except for MCHC. Conclusions The presence of cold agglutinins in blood samples can be detected by a spurious lowering of the RBC count and by a spurious increase in the MCHC. The RET channel represents a great opportunity to correct the RBC count in a rapid manner without preheating. However, neither methodology can completely solve the residual presence of cold agglutinins in all samples, despite the MCHC values being < 370 g/L.

Neutrophil scattering data driven pre-microscopic flagging of acute leukemic cases

ABSTRACT Background: The hematology analyzer, Sysmex XN-1000, generates white blood cell count with varying scattering intensities during a complete blood count (CBC) analysis. Objectives: The objectives of the study were to study the predictive role of median and coefficient of variation of neutrophil scattering items in blood samples for differentiation of leukemic subjects. Methods: We evaluated six neutrophil scattering parameters: neutrophil side scatter mean intensity, neutrophil side fluorescence light (SFL) mean intensity, neutrophil forward scatter mean intensity, neutrophil side scatter area distribution width (NE-WX), neutrophil SFL area distribution width (NE-WY), and neutrophil forward scatter area distribution width (NE-WZ), measured in white blood cell differential scattergram generated by the hematology analyzer (Sysmex XN-1000) at an academic medical center. Results: We collected 433 blood samples from acute myeloid leukemia (AML) and acute lymphoid leukemia (ALL) cases and normal controls. AML group showed highly significant differences in the mean values compared with the control group. Out of six neutrophil scattering items, NE-WX, NE-WY, and NE-WZ showed high efficiency, with area under the curve (AUC) values of 0.764, 0.748, and 0.757, respectively, to differentiate AML from ALL cases and control groups. When comparing combined acute leukemia cases (AML plus ALL) with the control group, NE-WX, NE-WY, and NE-WZ generated highly significant AUC values (0.840, 0.884, and 0.801, respectively). Conclusion: The neutrophil scattering parameters generated during CBC analysis provide a new tool for the prediction of acute leukemia and its lineage.

Comparative study of urine sediment elements with fully automated analyzer and the bright field microscope method using Sternheimer Malbin dye / Эрүүл мэндийн лаборатори

Introduction@#The traditional microscopic method is to visually count the elements in the urine, but it is difficult to distinguish between the cells because they are not stained. Sternheimer Malbin staining, on the other hand, contains a variety of dyes that help to distinguish elements in urine sediment, improve the differentiation between cell nuclei and cytoplasm, provide more information about cell shape and image, and make it easier to differentiate kidney disease. @*Objective@#To study the results of the reading of a fully automatic urine sediment analyzer of compared with the Sternheimer Malbin stained bright field microscope method.@*Research materials and methods@#In this study included 150 people who served the MJTH of the MNUMS received permission to participate in the research. The urine sample collected in accordance with the standard operating instructions was counted by a fully automated analyzer and stained with Sternheimer Malbin dye and counted red cells (RBC), white blood cells (WBC), epithelial cells (EC), and renal epithelium (RTEC) under a microscope using a Fuchs-Rosenthal chamber.@*Results@#23.3% (n=35) of the respondents were male, 76.6% (n=115) were female, and the average age was 44.3±11.6. There 16.6% (25)/9.3% (14) of the RBCs were counted in excess of the reference volume when analyzed under an microscope stained with an automated urine sediment analyzer and Sternheimer-Malbin dye. For each WBC method, 45.4% (68)/41 (61)% and EC 24.7% (37)/23.3% (35) were counted above the reference volume. 90% (135)/32% (48) of the total samples were counted in excess of the RTEC reference volume. Comparing the performance of the automatic urine sediment analyzer with the light microscope method, the sensitivity and specificity were RBC-99.8%/99.1%, WBC-99.3%/99.6%, EC-99.7%/99.2, and RTEC-99.1%/99.2%. False-positive and false-negative results were rated for each RBC-99.9%/99.1%, WBC-99.3%/99.6%, EC 99.8%/99.2%, and RTEC-99.7%/99.9%, respectively. The positive likelihood ratio was RBC, WBC, RTEC 1.0, or the test was useless, while the negative likelihood ratio was RBC was very different, WBC was slightly different, EC was very different, and RTEC was very different. Positive and negative predictive value indicators RBC-99.3%/99.4%, WBC-99.4%/99.4%, EC-99.4%/99.5, RTEC-99.2%/99.1%, optimality for RBC, WBC, EC 99.4%, RTEC -99.1%.@*Conclusion@#</br> 1. The results of an automated urine sediment analyzer and a bright field microscope stained by Sternheimer Malbin were similar for red blood cells, white blood cells, and epithelial cells, but different for renal tubular epithelial cells. </br> 2. The resuls UF-5000 analyzer and bright field microscope analysis using Sternheimer Malbin dye were comparable.

Sysmex XN-9000 hematology analyzer in examining peripheral blood nucleated red blood cells: An evaluation of clinical application / 第二军医大学学报

[Abstract] Objective To evaluate the clinical value of Sysmex XN-9000 hematology analyzer for detecting peripheral blood nucleated red blood cells (NRBC). Methods A total of 16 273 peripheral blood samples were collected and examined by Sysmex XN-9000 hematology analyzer and microscopic manual detection. The sensitivity, specificity and positive prediction value and negative predictive value of NRBC were measured by manual measurement under microscope. The 248 specimens positive by both methods were used as subjects, and the correlation between the two methods for detecting NRBC was analyzed. The disease types of 277 patients positive of NRBC were analyzed by microscopic examination. Results The sensitivity of NRBC detected by Sysmex XN-9000 hematology analyzer was 89.5%, specificity was 99.6%, positive predictive value was 80.5%, and negative predictive value was 99.8%. There was a positive correlation between the percentages of NRBC detected by the two methods (rs＝0.813, P0.001). Among the 277 NRBC-positive patients, 173 had hematological diseases and 104 had no hematologic diseases, and there were significant differences in NRBC counts between the two groups (median: 0.38×109/L vs 0.16×109/L, P0.05), and the percentages of NRBC were not significantly different (median: 2.95% vs 3.60%, P＝0.835 1). Among patients with hematological diseases, NRBC was mainly present in patients with acute lymphoblastic leukemia (31 cases), acute myeloid leukemia (55 cases), malignant lymphoma (39 cases) and multiple myeloma (18 cases). Among patients without hematologic diseases, NRBC was mainly present in those with solid cancer (24 cases) and cirrhosis hemorrhage (36 cases). Conclusion The Sysmex XN-9000 hematology analyzer can detect NRBC with high accuracy, and it thus has a promising clinical application value.

Significance of lymphocyte structure parameters of Sysmex XN-9000 hematology analyzer in screening peripheral atypical lymphocytes / 第二军医大学学报

[Abstract] Objective To investigate the significance of lymphocyte structure parameters of Sysmex XN-9000 hematology analyzer in screening peripheral blood atypical lymphocytes when positive alarm of atypical lymphocytes occurs. Methods From Dec. 2017 to Dec. 2018, 370 blood samples with positive alarm of atypical lymphocytes, which were detected by XN-9000 hematology analyzer in outpatient and emergency department of Changhai Hospital, Naval Medical University (Second Military Medical University), were collected in this study. Six lymphocyte structure parameters were recorded, including lymphocyte complexity (L-X), lymphocyte fluorescence intensity (L-Y), lymphocyte size (L-Z), dispersion width of lymphocyte complexity (L-WX), dispersion width of lymphocyte fluorescence intensity (L-WY) and dispersion width of lymphocyte size (L-WZ). According to the atypical lymphocyte proportion detected manually under microscope, the 370 samples were divided into 2 groups: atypical lymphocyte positive group (100 samples with an atypical lymphocyte proportion5%) and atypical lymphocyte negative group (270 samples with an atypical lymphocyte proportion≤5%), and the significance of each lymphocyte structure parameter was evaluated by receiver operating characteristic (ROC) curve. Then the parameters with high accuracy for screening atypical lymphocytes were analyzed by logistic regression model to study the significance of their combination. Results The lymphocyte structure parameters L-WY, L-X and L-Z had high accuracies in screening atypical lymphocytes, with the ROC area under curve (AUC) being 0.927, 0.939 and 0.931, respectively. The combined predictor was generated using L-WY, L-X and L-Z by logistic regression analysis model, and the ROC AUC of combined predictor was 0.979. When 0.058 1 was selected as the cut-off value, the sensitivity was 100.0% and the specificity was 77.8%. Conclusion Lymphocyte structure parameters L-WY, L-X and L-Z detected by Sysmex XN-9000 hematology analyzer can effectively screen peripheral blood atypical lymphocytes when positive alarm of atypical lymphocytes occurs.

Comparison of Red Blood Cell, White Blood Cell and Differential Counts between UF-5000 System and Manual Method

BACKGROUND: Analysis of body fluids provides important information for assessing various medical conditions. We aimed to validate the analytical and diagnostic performance of the Sysmex UF-5000 (Sysmex, Japan) system for the analysis of different body fluids. METHODS: Eighty body fluid samples were analyzed using the UF-5000 system in the body fluid mode and light microscopy. Body fluids included ascitic, pleural, and cerebrospinal fluid (CSF), as well as other fluid samples. RESULTS: A comparison between the UF-5000 system and manual counting demonstrated good correlations with regard to red (r=0.6555) and white blood cell (r=0.9666) counts. The UF-5000 system also demonstrated good performance for differential cell counting (r=0.9028). CSF particularly showed a good correlation. CONCLUSIONS: The use of the UF-5000 system for cell counting and differential analysis of body fluid samples might be an effective and automated alternative to chamber counting in laboratory routine analysis, thereby enhancing laboratory workflow and clinical effectiveness.

Selection of Unnecessary Urine Culture Specimens Using Sysmex UF-5000 Urine Flow Cytometer / 대한임상미생물학회지

BACKGROUND: Urine culture is one of the most frequently requested tests in microbiology. Automated urine analyzers yield much infection-related information. The Sysmex UF-5000 analyzer (Sysmex, Japan) is a new flow cytometry urine analyzer capable of quantifying urinary particles, including bacteria, WBCs, and yeast-like cells (YLCs) and can provide a Gram stainability flag. In this work, we evaluated how many unnecessary urine cultures could be screened out using the UF-5000. METHODS: We compared the culture results of 126 urine samples among 453 requested urine cultures (from sources other than the Urology and Nephrology departments) with urinalysis results. Urine cultures were considered positive if bacterial or YLC growth was ≥104 CFUs/mL. RESULTS: We used urinalysis cut-off values of 50/µL and 100/µL for bacteria and YLC, respectively. Forty eight of the 126 (38.1%, or 10.6% of 453 requested) cultures were below these cut-off values and did not contain any culture-positive samples. CONCLUSION: Bacteria and YLC counts generated using the UF-5000 analyzer could be used to screen out negative cultures and reduce urine culture volume by ~10% without sacrificing detection of positive cultures.

Dilution validation of high level D-dimer samples in Sysmex CS5100 instrument / 国际检验医学杂志

Objective To investigate the necessity of dilution in samples with high concentrations of D-Dimer and optimum dilution multiple.Methods Quality control products and calibration were detected by using Sysmex CS5100 for precision evaluation,including within-batch and between-run precision.Calibration were detected for validation of linear range and clinical reportable.Samples with D-Dimer5 mg/L and FDP>20 μg/mL were also serially diluted and detected to calculated recovery rate.Results Within-batch and between-run coefficients of variation were both less than 3%.Within the scope of 0.207-5.170 mg/L,the linear distribution was fine.The clinical reportable range was 0.207-165.440 mg/L.For samples with D-Dimer5 mg/L and FDP>20 μg/mL,there was obvious antigen excess phenomenon,and gradient dilution was required.Conclusion For samples with D-Dimer>5 mg/L and FDP>20 μg/mL,dilution should be performed to ensure the accuracy of detected results.

Comparing the tested results of QBC Star and Sysmex XP-100 hematology analyzers and analyzing their operational performance / 国际检验医学杂志

Objective Both QBC Star and Sysmex XP-100 hematology analyzers are convenient to carry,which can be used nor-mally under the condition of the field(emergency).This study would compare their test results and operating performance,so to provide guidance for rational use of the instruments.Methods 100 fresh blood samples of 100 health soldiers anti-coagulated by EDTA-K2 were detected by QBC Star and Sysmex XP-100 haematology analyzers respectively,the results of two analyzers were comparatively analyzed and their test time and operating convenience were analyzed.Results There was no significant difference in the results of hemoglobin concentration (HGB),hematocrit (HCT)tested by the two methods (P >0.05).There were significant difference of the mean corpuscular hemoglobin concentration (MCHC),the sum of lymphocyte percent and middle type cells (LYM%+MID%),neutrophil percentage(NEUT%),white blood cell count(WBC),platelet count(PLT)tested by the two meth-ods(P <0.05).The values of MCHC and LYM%+MID% tested by the QBC Star were significantly lower than that detected by Sysmex XP-100(P <0.05),while the rest indicators tested by the former were higher than that of the latter.It took about 5 minutes to complete a blood sample analysis with QBC Star,while about 1 min was needed for Sysmex XP-100.Conclusion The test results of QBC Star and Sysmex XP-100 hematology analyzers couldn′t exchanged except for that of HCT and HGB.Under the condition of field(emergency),QBC Star hematology analyzer is suitable for individual medical examination,and Sysmex XP-100 hematology an-alyzer can be used for the batch medical examination.

Clinical performance evaluation of HBV serological biomarkers using SYSMEX HISCL5000 chemiluminescence analyzer / 医疗卫生装备

Objective To assess the detection performance of SYSMEX HISCL5000 automatic chemiluminescence immunoassay analyzer for serum hepatitis B virus (HBV) biomarkers.Methods Serological HBV biomarkers,including HBsAg,HBsAb,HBeAg,HbeAb and HbcAb,were measured by HISCLS000 analyzer.Further,a panel of parameters were analyzed,including precision,cross contamination rate,linear range,concordance rate,biological reference interval and limit of detection.According to the guideline from Clinical & Laboratory Standards Institues (CLSI) EP system,the potential clinical application of using HISCL5000 analyzer to measure serum HBV biomarkers were evaluated.Results A panel of five serum HBV biomarkers was measure by using HISCLS000 analyzer.The coefficient of variation (CV) value of the within-run imprecision was from 0.60％ to 4.17％,and CV value of the between-run imprecision was from 0.04％ to 5.35％.Linear verification showed that r2 was between 0.980 5 and 0.998 7,and a was between 0.970 9 and 1.022 6.The ratio of cross contamination was 0.00％.The coincident rate of HISCL5000 analyzer with other methods was between 96.00％ and 100.00％.Biological reference interval and limit of detectionderived from this analyzer were also proved qualified.Conclusion HISCL5000 analyzer can be used clinically to detect HBV biomarkers.

Clinical performance evaluation of HBV serological biomarkers using SYSMEX HISCL5000 chemiluminescence analyzer / 医疗卫生装备

Objective To assess the detection performance of SYSMEX HISCL5000 automatic chemiluminescence immunoassay analyzer for serum hepatitis B virus (HBV) biomarkers.Methods Serological HBV biomarkers,including HBsAg,HBsAb,HBeAg,HbeAb and HbcAb,were measured by HISCLS000 analyzer.Further,a panel of parameters were analyzed,including precision,cross contamination rate,linear range,concordance rate,biological reference interval and limit of detection.According to the guideline from Clinical & Laboratory Standards Institues (CLSI) EP system,the potential clinical application of using HISCL5000 analyzer to measure serum HBV biomarkers were evaluated.Results A panel of five serum HBV biomarkers was measure by using HISCLS000 analyzer.The coefficient of variation (CV) value of the within-run imprecision was from 0.60％ to 4.17％,and CV value of the between-run imprecision was from 0.04％ to 5.35％.Linear verification showed that r2 was between 0.980 5 and 0.998 7,and a was between 0.970 9 and 1.022 6.The ratio of cross contamination was 0.00％.The coincident rate of HISCL5000 analyzer with other methods was between 96.00％ and 100.00％.Biological reference interval and limit of detectionderived from this analyzer were also proved qualified.Conclusion HISCL5000 analyzer can be used clinically to detect HBV biomarkers.

Evaluation on performance of Sysmex CS2000i Automatic Blood Coagulation Analysis System / 国际检验医学杂志

Objective To systematically evaluate the performance of the Sysmex CS2000i Automatic Blood Coagulation Analysis System .Methods According to the standards of the Clinical and Laboratory Standards Institute (CLSI) ,the precision ,accuracy ,lin‐earity ,biological reference interval and carry‐over rates of the Sysmex CS2000i Automatic Blood Coagulation Analysis System were detected ,meanwhile the detections of 5 clinical specimens were compared between this system and the Sysmex CA 1500 Automatic Blood Coagulation Analysis System .Results The intra‐assay precision coefficient of variation (CV) ,inter‐day precisions CV carry‐over rate ,accuracy and linearity of plasma prothrombin time ,activated partial thromboplastin time ,fibrinogen and D‐dimmer detec‐ted by the Sysmex CS2000i Automatic Blood Coagulation Analysis System were all consistent with the quality target requirements of our laboratory .Conclusion The Sysmex CS2000i Automatic Blood Coagulation Analysis System has better performance in vari‐ous aspects ,the detection results could be used for the clinical diagnosis and treatment of related diseases .

Evaluation for the performance of Sysmex XN 20 A1 automation blood cell analyzer / 中国医学装备

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.

Establishment of Age- and Gender-Specific Reference Ranges for 36 Routine and 57 Cell Population Data Items in a New Automated Blood Cell Analyzer, Sysmex XN-2000

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.

Causes and their countermeasures for accidental instability of WBC testing by Sysmex XS-800i blood cell a3nalyzer / 医疗卫生装备

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.

Establishment and evaluation of Sysmex XE-5000 hematology analyzer review criteria / 国际检验医学杂志

Objective To establish and evaluate the review criteria of blood routine detection by the Sysmex XE‐5000 hematolo‐gy analyzer in our hospital for improving the effectiveness of the measurement results .Methods 606 blood samples were collected from the outpatients and inpatients during 2014 and performed the microscopic examination by 2 technologists‐in‐charge with the double‐blind method .The average value of these results was used as the judging criteria .According to the 41 items of rule formula‐ted by the international expert group and combining with the patients characteristics of infectious disease hospital and instrument features in this hospital ,20 items of review criteria for blood routine test of our hospital was formulated .Results With the micro‐scopic examination results as the criteria ,among 606 detected samples ,116 samples were in line with the rules and the review rate was 19 .14(116/606) ,in which the true positive rate was 6 .93% (42/606) ,the false positive rate was 12 .21% (74/606) ,the false negative rate was 2 .64% (16/606) ,the true negative rate was 78 .22% (474/606) ,the sensitivity was 72 .41% and the specificity was 86 .5% .The expected values of positive and negative results were 36 .21% and 96 .73% respectively .The total effective rate was 85 .15% .Conclusion The review criteria formulated by this laboratory are reasonable and effective ,which has an important significance in the clinical application for increasing the detection speed of blood routine ,improving the laboratory reports quality , without missed true blood patients and accurately providing the valuable information for clinicians .

Application of CellaVision DM96 in nucleated cells classification of serous cavity effusion / 国际检验医学杂志

Objective To explore the capacity of the Sweden CellaVision DM96 automatic digital cell morphology analysis sys‐tem (DM96) in nucleated cell classification of serous cavity effusion .Methods 36 specimens of serous cavity effusion were selected from the inpatients of Second Affiliated Hospital of Xi′an Jiaotong University in March 2015 and performed the Wright staining by the two kinds of method ,the Japanese Sysmex SP‐1000Ⅰ automatic smearing machine and manual smearing ,after staining ,the smear was performed the nucleated cells classification by DM96 .The consistency and relevance of the classification results by DM 96 with those by the Sysmex XT‐4000i were calculated .Results The classification results by DM96 had better consistency with the results by XT‐4000i ,moreover the cell images taking by DM96 were clear with high automatic degree .Conclusion The DM96 auto‐mated digital nucleated cell morphology analysis system is reliable and effective ,and has a significance for improving the cellular morphological analysis of serous cavity effusion specimen .

The value of clinical application of leukocyte classification alarm system (Q-Flag) for Sysmex XT-1800i blood cell analyzer / 国际检验医学杂志

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 .

Performance evaluation of Sysmex XN-9000 automated hematology analyzer / 国际检验医学杂志

Objective To evaluate the performance of Sysmex XN‐9000 automated hematology analyzer .Methods According to international and domestic standards ,performance of analyzer was evaluated .Results The within‐batch and between‐batch preci‐sion ,carryover pollution rate ,linearity range and the accuracy of Sysmex XN‐9000 analyzer were all conform to related require‐ments .Leukocyte classification results compared with manual classification ,the correlation of neutrophil ,lymphocyte ,monocyte and eosinophil were fine ,but correlation of basophil was not very ideal .Conclusion The performance of Sysmex XN‐9000 analyzer could be satisfying ,could meet the needs of clinical inspection and diagnosis and treatment .