实验室自动化和信息化的发展、建设、应用及管理初探

本文介绍了实验室自动化系统(laboratory automation system,LAS)和实验室信息系统(laboratory information system,LIS)的发展、组成和功能,论述了实验室自动化建设及应用中的注意事项,旨在介绍自动化实验室的管理理念.     

临床检验自动化流水线的发展现状及展望

介绍了实验室自动化系统的基本构成、概念和工作流程,论述了目前国内外实验室自动化流水线的进展和系统的选择方案,分析了各医院组建该系统需考虑的因素.     

西门子实验室自动化系统实时双向通讯功能的实现

目的：构建西门子实验室自动化系统实时双向通讯功能。方法：利用实验室自动化系统提供的标本接收应答信息,通过改造检验信息系统联机通讯系统,进行标本检测的实时双向控制。结果：实现了实验室自动化系统标本自动签收、自动获取检验项目等实时双向功能。结论：实时双向通讯功能的实现,优化了工作流程,提高了工作效率。     

实验室自动化系统问题与展望

介绍了国内实验室自动化系统应用中存在的问题,分析归纳了自动化系统在场地规划、前期评估、仪器整合、人员配备等方面需要注意的细节,从控制软件升级、后处理模块改进、增加连接仪器种类等方面对自动化系统的发展与改进提出建议,为国内各个应用自动化系统的临床实验室提供参考.     

实验室自动化系统运行评估

目的:对实验室自动化系统运行数据进行评估,为自动化系统参数设置提供依据。方法:在自动化系统满负荷运转情况下,应用音量计对自动化实验室7个采样点进行音量检测;通过自动化系统验证10份阴阳性间隔样本携带污染情况;抽取1 732例标本运行数据进行统计,分析标本检测超时原因;对64个单项、16个分杯组合、32个项目组合进行血清用量评估。结果:自动化实验室采取减噪措施后,减少了噪声对工作人员的影响;10份标本间未发现相互污染,携带污染实验合格;1 732份标本在自动化系统中平均周转时间为65 min,标本通过前处理模块平均时间为24 min,各种因素导致检测失败是标本周转时间延长的主要原因;5 ml全血每管平均分离血清量2 012.7μl,免疫项目、分杯项目较多标本需增加抽血管数。结论:通过实验室自动化系统运行数据分析,可改进自动化系统运行流程,提高工作效率。     

荷兰利用因特网自动化实验室系统监测疾病爆发

疾病爆发的快速检测是采取有效控制措施的关键。电子实验室数据的自动化分析使得疾病爆发或有共同临床特征的病原体爆发得到迅速检测。荷兰已经发展了一个以现有电子实验室为基础并与因特网联网的疾病监测系统,即传染病监测系统(ISIS)。该自动化监测系统能针对所有类型的病原体,作者描述了ISIS的发展情况。荷兰的76个微生物实验室中,90％以上设在公立医院,     

微生物自动鉴定系统——VITEK-AMS

<正>70年代后由于计算机广泛应用,在微生物学家和工程技术人员的密切合作下发明了许多自动化微生物检测仪,如Automicrobic(AMS)、Abbott(MS-2)、Autobac(IDX)等.目前在世界上应用最广泛、自动化程度最高、功能最齐全的鉴定系统为VITEK-AMS.我国已有60多个实验室,世界上有3000多个实验室应用这一系统.     

自动化生化免疫流水线应用体会

本文介绍自动化流水线应用体会,从模块构成、应用优势与存在问题等几方面对自动化流水线应用中具体问题进行分析,为准备引进和正在使用自动化流水线系统的临床实验室提供参考.     

基于Net的卫生检验实验室信息管理系统自主开发与应用

实验室信息管理系统(Laboratory Information ManagementSystem,LIMS),是利用计算机网络技术、数据库技术等来对实验室进行规范管理的计算机软硬件系统[1],通过LIMS实验室可以达到自动化运行、信息化管理和无纸化办公的目的,对实验室提高工作效率、降低运行成本起到重要的作用。LIMS作     

实验室自动化检验操作系统工作原理与结构

介绍了实验室全自动化检验流水线操作系统的原理和结构，阐述了此系统各模块的功能和技术结构，以及系统模块信息交流控制的模式和流程。     

Strengthening national laboratory health systems in the Caribbean region

Abstract

The President's Emergency Plan for AIDS Relief (PEPFAR) programme for the Caribbean Region was established in 2008 to address health system challenges, including fragile laboratory services and systems. The laboratory component of this programme consisted of several phases: assessment of laboratory needs of all 12 countries engaged in the programme; addressing gaps identified during the assessment; and monitoring and evaluation of the progress achieved. After one year of PEPFAR collaboration with national governments and other partners, laboratory services and systems greatly improved. Some of the milestones include: (1) the accreditation of a public laboratory; (2) improved access to HIV diagnosis with faster turnaround time; (3) establishment of capacity for platforms for DNA PCR, viral load and HIV drug resistance; (4) development of the laboratory workforce; and (5) establishment of a framework for implementation of sustainable quality management systems for laboratory accreditation. The progress recorded in strengthening laboratory health systems after one year of initiating this collaboration shows that with a rigorous initial assessment, programme design and intervention and strategic partnership, national laboratory health systems can be greatly enhanced to support programme implementation. Continued collaboration and country leadership is critical to create an integrated and sustainable laboratory network in the Caribbean.     

Strengthening national laboratory health systems in the Caribbean Region

The President's Emergency Plan for AIDS Relief (PEPFAR) programme for the Caribbean Region was established in 2008 to address health system challenges, including fragile laboratory services and systems. The laboratory component of this programme consisted of several phases: assessment of laboratory needs of all 12 countries engaged in the programme; addressing gaps identified during the assessment; and monitoring and evaluation of the progress achieved. After one year of PEPFAR collaboration with national governments and other partners, laboratory services and systems greatly improved. Some of the milestones include: (1) the accreditation of a public laboratory; (2) improved access to HIV diagnosis with faster turnaround time; (3) establishment of capacity for platforms for DNA PCR, viral load and HIV drug resistance; (4) development of the laboratory workforce; and (5) establishment of a framework for implementation of sustainable quality management systems for laboratory accreditation. The progress recorded in strengthening laboratory health systems after one year of initiating this collaboration shows that with a rigorous initial assessment, programme design and intervention and strategic partnership, national laboratory health systems can be greatly enhanced to support programme implementation. Continued collaboration and country leadership is critical to create an integrated and sustainable laboratory network in the Caribbean.     

DIAL: A Platform for real-time Laboratory Surveillance

Laboratory information systems fulfill many of the requirements for individual result management within a public health laboratory. However, access to the systems by data users, timely data extraction, integration, and data analysis are difficult tasks. These difficulties are further complicated by often having multiple laboratory results for specific analytes or related analytes per specimen tested as part of complex laboratory algorithms requiring specialized expertise for result interpretation. We describe DIAL, (Data Integration for Alberta Laboratories), a platform allowing laboratory data to be extracted, interpreted, collated and analyzed in near real-time using secure web based technology, which is adapted from CNPHI’s Canadian Early Warning System (CEWS) technology. The development of DIAL represents a major technical advancement in the public health information management domain, building capacity for laboratory based surveillance.     

二级生物安全实验室建设及生物安全管理

目的 为了建立规范化的二级生物安全实验室,更好地加强实验室生物安全管理,防范实验室意外事件发生.方法 根据WHO编写的《实验室生物安全守则》,结合参与设计二级生物安全实验室及从事生物安全管理的经验,回顾性总结二级生物安全实验室建设方案及生物安全管理方法.结果 实验室应严格分区,配备必须的设备、设施,建立完整的生物安全管理体系、实验室风险评估及控制措施、生物安全管理制度.结论 二级生物安全实验室在按照基本要求进行设计及软硬件建设后,还应通过安全自查及奖惩来保证制度的实施,方能防范或减少实验室意外事件及医院感染事件的发生.     

Implementing a network for electronic surveillance reporting from public health reference laboratories: an international perspective.

Electronic data reporting from public health laboratories to a central site provides a mechanism for public health officials to rapidly identify problems and take action to prevent further spread of disease. However, implementation of reference laboratory systems is much more complex than simply adopting new technology, especially in international settings. We describe three major areas to be considered by international organizations for successful implementation of electronic reporting systems from public health reference laboratories: benefits of electronic reporting, planning for system implementation (e.g., support, resources, data analysis, country sovereignty), and components of system initiation (e.g., authority, disease definition, feedback, site selection, assessing readiness, problem resolution). Our experience with implementation of electronic public health laboratory data management and reporting systems in the United States and working with international organizations to initiate similar efforts demonstrates that successful reference laboratory reporting can be implemented if surveillance issues and components are planned.     

Assessing the potential for algae and macrophytes to degrade crop protection products in aquatic ecosystems

Rates of pesticide degradation in aquatic ecosystems often differ between those observed within laboratory studies and field trials. Under field conditions, a number of additional processes may well have a significant role, yet are excluded from standard laboratory studies, for example, metabolism by aquatic plants, phytoplankton, and periphyton. These constituents of natural aquatic ecosystems have been shown to be capable of metabolizing a range of crop protection products. Here we report the rate of degradation of six crop protection products assessed in parallel in three systems, under reproducible, defined laboratory conditions, designed to compare aquatic sediment systems which exclude macrophytes and algae against those in which macrophytes and/or algae are included. All three systems remained as close as possible to the Organisation for Economic Co-operation and Development (OECD) 308 guidelines, assessing degradation of parent compound in the total system in mass balanced studies using ((14) C) labeled compounds. We observed, in all cases where estimated, significant increases in the rate of degradation in both the algae and macrophyte systems when compared to the standard systems. By assessing total system degradation within closed, mass balanced studies, we have shown that rates of degradation are enhanced in water/sediment systems that include macrophytes and algae. The contribution of these communities should therefore be considered if the aquatic fate of pesticides is to be fully understood.     

Computer technology of the not-too-distant future

In summary, I think we have all seen great strides made in the practice of laboratory medicine and in the sophistication of laboratory computer systems. Now we find ourselves in an era of increasing regulatory scrutiny and decreasing reimbursement, and face new data and information challenges. But I believe that laboratorians have been and will continue to be pioneers in the incorporation of information systems technology into their profession.     

Laboratory reporting and disease surveillance.

Disease surveillance is an important tool which is used to identify diseases that are hazardous to public health. Historically, surveillance systems were created to capture physician reports of notifiable diseases. However, state evaluations of surveillance systems found inadequacies with systems based solely on physician reporting. To improve these systems, most state health departments have required reports of laboratory tests used to diagnose notifiable diseases. This article has a brief summary of the benefits and limitations of laboratory reporting.     

To QC or not to QC: the key to a consistent laboratory?

A limiting factor in every embryology laboratory is its capacity to grow 'normal' embryos. In human in vitro fertilisation (IVF), there is considerable awareness that the environment of the laboratory itself can alter the quality of the embryos produced and the industry as a whole has moved towards the implementation of auditable quality management systems. Furthermore, in some countries, such as Australia, an established quality management system is mandatory for clinical IVF practice, but such systems are less frequently found in other embryology laboratories. Although the same challenges of supporting consistent and repeatable embryo development are paramount to success in all embryology laboratories, it could be argued that they are more important in a research setting where often the measured outcomes are at an intracellular or molecular level. In the present review, we have outlined the role and importance of quality control and quality assurance systems in any embryo laboratory and have highlighted examples of how simple monitoring can provide consistency and avoid the induction of artefacts, irrespective of the laboratory's purpose, function or species involved.     

Laboratory capacity building for the International Health Regulations (IHR[2005]) in resource-poor countries: the experience of the African Field Epidemiology Network (AFENET)

Laboratory is one of the core capacities that countries must develop for the implementation of the International Health Regulations (IHR[2005]) since laboratory services play a major role in all the key processes of detection, assessment, response, notification, and monitoring of events. While developed countries easily adapt their well-organized routine laboratory services, resource-limited countries need considerable capacity building as many gaps still exist. In this paper, we discuss some of the efforts made by the African Field Epidemiology Network (AFENET) in supporting laboratory capacity development in the Africa region. The efforts range from promoting graduate level training programs to building advanced technical, managerial and leadership skills to in-service short course training for peripheral laboratory staff. A number of specific projects focus on external quality assurance, basic laboratory information systems, strengthening laboratory management towards accreditation, equipment calibration, harmonization of training materials, networking and provision of pre-packaged laboratory kits to support outbreak investigation. Available evidence indicates a positive effect of these efforts on laboratory capacity in the region. However, many opportunities exist, especially to support the roll-out of these projects as well as attending to some additional critical areas such as biosafety and biosecuity. We conclude that AFENET's approach of strengthening national and sub-national systems provide a model that could be adopted in resource-limited settings such as sub-Saharan Africa.