Medical Laboratory Testing Instruments
Intelligent Medical Laboratory
Instruments and Equipment
The laboratory is the workplace of laboratory personnel; first it must be safe, second practical, and only then aesthetically pleasing. Laboratory furniture and laboratory fume hoods are important laboratory equipment: they should not only have excellent functionality and comply with industry standards, but also have an attractive appearance and harmonious colors, and be environmentally friendly and energy-saving, so as to improve the indoor environment, reflect the characteristics of the times, and align with international practice. Laboratory furniture differs from office furniture: in use it frequently comes into contact with water, electricity, gas, chemicals, and instruments and equipment, so higher requirements are placed on the furniture's structure and materials. When building a laboratory, furniture must be designed and selected according to the laboratory's work content, environmental conditions, and specific requirements. The layout, function, and flexibility design of laboratory furniture is one of the important components of laboratory architectural design.
Section 1 Medical Laboratory Testing Instruments
The following equipment list can serve as a guide for a routine laboratory design and construction project; some large instruments and equipment are described in detail. Different space standards and service requirements may call for different equipment selections, and each project should be carried out in accordance with the requirements of medical industry regulations.
I. Fully Automatic Biochemistry Analyzer
The fully automatic biochemistry analyzer is an instrument used to detect and analyze biochemical substances in living organisms, providing an information basis for clinical diagnosis, treatment, prognosis, and health status assessment. The fully automatic biochemistry analyzer measures specific chemical components in body fluids based on the photoelectric colorimetric principle. Because of its fast measurement speed, high accuracy, and low reagent consumption, its use can greatly improve the efficiency and benefit of routine biochemical testing.
An automated analyzer automates all or part of the steps of the original manual process—sampling, mixing, incubation (37°C), measurement, result calculation, judgment, display and printing of results, and washing. Today, biochemical testing has essentially been fully automated, and there are fully automatic biochemistry analysis systems designed for large or extra-large clinical laboratories and commercial laboratories, which can be configured freely according to the laboratory's testing volume. See Fig. 7-1.
[Figure: Photograph of a fully automatic biochemistry analyzer — an off-white floor-standing instrument with a purple-blue reagent carousel module on the right side of the front]
Fig. 7-1 Fully Automatic Biochemistry Analyzer
Bar-code recognition of reagents and samples and computer registration: early biochemistry instruments lacked bar-code recognition and were more prone to errors. In recent years, both imported and domestic biochemistry instruments have adopted bar-code detection; the use of this technology in biochemistry instruments provides technical support for the development of high-speed ACA and makes the instruments well supported. Software development is simple and easy; therefore, bar-code detection is the foundation of instrument intelligence. Open reagents: as an important factor for hospitals when selecting a model, whether the instrument supports open reagents is very important.
Whether it is today's fastest modular fully automatic biochemistry analyzer (9,600 tests/h) or the original manually operated photoelectric colorimeter, the principle is the absorption spectrometry technique in spectroscopy—the most fundamental core technology of the biochemistry analyzer.
Features:
- Technologically advanced optical reaction system
- Efficient, worry-free automatic washing system
- Intelligent, sensitive liquid level detection system
- Simple and fast software operating system
- Timely and considerate nationwide service network
II. Fully Automatic Hematology Analyzer
Fully automatic hematology analyzers and medical equipment have been popularized in hospitals at all levels, and their fast, accurate results provide great convenience for clinical diagnosis.
The fully automatic hematology analyzer uses the principles of the capacitance method and photoelectric colorimetry; initially it could only measure red blood cells and white blood cells and was easily disturbed by many factors. In 1948, the impedance principle was adopted to measure the formed elements in blood, greatly improving the precision and accuracy of measurement results. However, the impedance method can only measure cell size. In the 1980s, the laser method began to be used in hematology analyzers,
and by combining the impedance method with the laser method, not only cell size but also the morphology of the cell nucleus could be measured. See Fig. 7-2.
In the late 1980s, with the development of high-energy electromagnetic wave technology, the Coulter company in the United States used impedance, laser, and high-energy electromagnetic wave technologies to detect a single cell simultaneously, then classified cells through comprehensive data analysis.
[Figure: Photograph of a fully automatic hematology analyzer — an off-white bench-top analytical instrument with a display screen and operating keypad on top, a sample rack filled with purple-capped blood collection tubes in the front sample area, and a computer monitor visible on the left]
Fig. 7-2 Fully Automatic Hematology Analyzer
High-energy electromagnetic wave technology can detect the size and density of intracellular granules. Bayer in Germany adopted a principle combining cytochemical reactions with laser technology to classify white blood cells.
Because the cytoplasm of neutrophils contains abundant peroxidase, monocytes less, blast cells very little, and lymphocytes and basophils lack this enzyme, the instrument can use the action of peroxidase to classify neutrophils versus lymphocytes and basophils. Flow cytometry is also used to count and classify reticulocytes. Immature cells are classified using the principle that immature and mature cells differ in the lipid content of their membranes and in the amount of sulfated amino acids bound to the membrane, and therefore differ in membrane protection after the addition of a lysing agent.
Features of fully automatic hematology analyzers:
- Independent hemoglobin measurement system; unique volumetric metering tube direct quantification technology eliminates sources of interference and improves accuracy.
- Brand-new high-precision micro-blood processing technology; impedance method, cyanmethemoglobin method, and the cyanide-free SFT method.
- Particle guidance technology: cell particles move in a straight line, producing true pulses, ensuring accurate WBC, RBC, and PLT counts.
- Advanced floating threshold algorithm, combined with a complete expert recognition system for abnormal blood samples, providing screening prompts for abnormal samples.
- Fully digital processing of cell signals and mature fluidic design ensure the reliability of measurement results during operation.
- Two-way stereoscopic back-sheath flow technology: avoids fluid interference with PLT counts; three-part WBC differential; dual channels;
60 tests/hour.
III. Fully Automatic Chemiluminescence Analyzer
Immunoassay has gone through stages such as radioimmunoassay, fluoroimmunoassay, and enzyme immunoassay; fully automatic chemiluminescence immunoassay is a new stage in the development of immunoassay, and its environmental friendliness, speed, and accuracy have been widely recognized. Fully automatic chemiluminescence immunoassay is therefore the inevitable path toward the ideal state of immunoassay testing.
The chemiluminescence immunoassay analyzer is a medical testing instrument that performs immune analysis of the human body by testing patient serum. A measured quantity of patient serum and horseradish peroxidase (HRP) conjugate are added to a white opaque microplate whose solid phase is coated with antibodies; the analyte molecules in the serum (bound to horseradish peroxidase) specifically bind to the antibodies on the solid-phase carrier. Unreacted free components are separated by washing. Then the luminol (Luminol) substrate solution is added; the free energy released by the chemical reaction excites the intermediate from the ground state, and on returning to the excited state the energy is released in the form of photons. The microplate is then placed in the analyzer, and the photon counts of each well are read in turn by the photon counter through the instrument's internal three-dimensional transmission system. The concentration of the analyte in the sample is quantitatively analyzed according to a mathematical model established with standards. Finally, a data report is printed to assist clinical diagnosis. See Fig. 7-3.
[Figure: Fully automatic chemiluminescence analyzer — a bench-top instrument with a transparent blue top cover over the sample/microplate area, a light gray-green base, and a front control panel with indicator lights and buttons]
Fig. 7-3 Fully Automatic Chemiluminescence Analyzer
IV. Fully Automatic Coagulation Analyzer
[The lower half of this page timed out during recognition; to be supplemented: the main text of the fully automatic coagulation analyzer and the beginning of the features list]
- Detection using photoelectric principles; capable of measuring PT, APTT, TT, FBG, and the activity of various coagulation factors.
- Equipped with an automatic reagent addition sensing system—an ordinary pipette can be used; the instrument uses a vibratory mixing device, requiring no stirring rod, making operation simpler and more convenient.
- All test items can be pre-calibrated; input parameters and calibration results can be stored long-term and recalled, saving reagents.
- The advanced optical system design and intelligent software system overcome interference from lipemia, jaundice (icterus), hemolysis, and chyle in plasma samples.
[Figure: Fully automatic coagulation analyzer — photograph of a white bench-top coagulation analyzer with a color LCD screen in the upper right, a black detection area in the middle, and sample racks and reagent positions visible at the front]
Fig. 7-4 Fully Automatic Coagulation Analyzer
V. ESR Analyzer
The ESR (erythrocyte sedimentation rate) test has certain reference value for the diagnosis and treatment of many diseases, such as whether inflammation or active lesions are present in the body.
The erythrocyte sedimentation rate (ESR) is a commonly used clinical test indicator. A blood sample is collected into an ESR tube containing anticoagulant; after mixing, the tube is placed vertically on the instrument's sample rack. Under gravity, red blood cells gradually sink, leaving a section of transparent plasma at the top of the tube. The instrument uses a pair of infrared transmitting and receiving tubes (TX-RX) moving up and down to determine the interface between the red blood cells and the transparent plasma, measuring the dynamic sedimentation changes of red blood cells over a certain period. See Fig. 7-5.
[Figure: ESR analyzer — photograph of a small white bench-top ESR analyzer with an LCD screen and keypad on the upper right and a large flip-up door at the lower front]
Fig. 7-5 ESR Analyzer
VI. Hemorheology Analyzer
Hemorheology is the science that studies the flow and deformation properties of blood and its components using a hemorheology analyzer; it is related to many clinical diseases. The various indicators measured by hemorheology instruments have important clinical significance for the etiology, diagnosis, prevention, treatment, and monitoring of cardiovascular and cerebrovascular diseases such as hypertension, arteriosclerosis, coronary heart disease, myocardial infarction, pulmonary heart disease, cerebral embolism, and cerebral infarction, as well as peripheral vascular disease, diabetes, tumors, and neuropsychiatric diseases; they have been widely applied in internal medicine (Chinese and Western medicine), emergency departments, surgery, obstetrics and gynecology, oncology, geriatrics, rehabilitation, drug research, and population screening. Hemorheological testing is an indispensable and important means for clinical medicine and scientific research.
The measurement of blood viscosity by a hemorheology analyzer is closely related to the testing instrument, the anticoagulant, blood sample collection, collection time, collection method, post-collection handling of the sample, and measurement temperature and timing. If
not strictly controlled, these factors can greatly affect the test results. To make the test results reliable and provide a credible scientific basis for clinical medicine and scientific research, the standardization of measurement methods and hemorheology instruments is of extremely great significance. See Fig. 7-6.
[Figure: Hemorheology analyzer — a bench-top instrument with a vertical measurement/sample column at the left front, multiple rows of tube positions on the front, a display screen at the upper right, and a keypad below the screen]
Fig. 7-6 Hemorheology Analyzer
VII. Urine Analyzer
The urine analyzer is an automated instrument for measuring certain chemical components in urine, and it is an important tool for automated urine examination in medical laboratories; this type of instrument has the advantages of simple operation and speed. However, improper use of the urine analyzer and many intermediate steps and influencing factors directly affect the accuracy of automated analysis results, not only causing errors in test results but even delaying diagnosis. Therefore, operators are required to have a full understanding of the automated instrument's principle, performance, precautions, and influencing factors, and to use the automated instrument correctly, so that the results produced by the urine analyzer are more reliable and accurate. See Fig. 7-7.
[Figure: Urine analyzer — a bench-top instrument with a dark display screen at the rear left, a print/paper outlet beside it, and a rounded light-colored top cover in the foreground]
Fig. 7-7 Urine Analyzer
VIII. Trace Element Analyzer
[The lower half of this page (the main text of Section VIII, Trace Element Analyzer, and Fig. 7-8) timed out during recognition; to be supplemented]
IX. Tissue Embedding Station
The embedding station, also called a biological tissue embedding station or paraffin embedding station. A tissue embedding station is a device for embedding tissue blocks of human or animal/plant specimens in paraffin after dehydration and wax infiltration, so that they can be sectioned for histological diagnosis or research; it is suitable for medical schools, hospital pathology departments, medical research institutions, animal and plant research institutions, and food testing departments.
Embedding means infiltrating certain special supporting substances into the interior of a tissue block; using the physical properties of the supporting substance—such as transitioning from liquid to solid—the entire tissue is given a uniform, consistent solid structure and sufficient hardness to allow a microtome to cut extremely thin sections. Using paraffin as the embedding medium, placing the wax-infiltrated tissue block in paraffin to form a wax block, is the most commonly used embedding method in histological sectioning. See Fig. 7-9.
[Figure: Tissue embedding station — a light-colored bench-top embedding station with a raised control/display panel at the rear, a heated working area with a paraffin dispensing nozzle in the middle, and embedding molds and cassettes placed on the left working surface]
Fig. 7-9 Tissue Embedding Station
X. Fully Automatic Stainer
Mainly used in histology, pathology, biology, and other fields to automatically stain paraffin sections, frozen sections, cells, and other specimens mounted on slides. See Fig. 7-10.
[Figure: Fully automatic stainer — a large floor-standing stainer with a dark front; slide racks and reagent processing stations are visible inside the transparent/sliding cover; a control panel with a screen is on the left]
Fig. 7-10 Fully Automatic Stainer
The following are tables of common instrument configurations for the functional laboratories of hospitals at various levels:
Table 7-1 Basic Instrument and Equipment Configuration for a Primary (Level 1) Hospital Laboratory
| Department | Instrument |
|---|---|
| Laboratory | Fully automatic biochemistry analyzer |
| Hematology analyzer | |
| Urine analyzer | |
| Microscope | |
| Water purification system | |
| Refrigerator | |
| Computer |
Continued table
| Department | Instrument |
|---|---|
| HIV screening laboratory | Microplate reader (ELISA reader) |
| Microplate washer | |
| Pipettes | |
| Biosafety cabinet | |
| Refrigerator | |
| Computer |
Table 7-2 Basic Instrument and Equipment Configuration for a Secondary (Level 2) Hospital Laboratory
| Department | Instrument |
|---|---|
| Biochemistry, clinical testing | Fully automatic biochemistry analyzer |
| Urine analyzer | |
| Urine sediment analyzer | |
| Fully automatic hematology analyzer | |
| Hemorheology analyzer | |
| Fully automatic coagulation analyzer | |
| Water purification system | |
| Electronic balance | |
| Microscope | |
| Refrigerator | |
| Computer | |
| HIV laboratory | Water bath |
| Horizontal (swinging-bucket) centrifuge | |
| Internal-circulation autoclave | |
| Biosafety cabinet | |
| Microplate reader | |
| Microplate washer | |
| Pipettes | |
| UV lamp | |
| Electronic balance | |
| Microscope | |
| Refrigerator | |
| Computer |
Continued table
| Department | Instrument |
|---|---|
| Microbiology laboratory | Fully automatic bacterial identification analyzer |
| Blood culture system | |
| Ambient-temperature incubator | |
| CO₂ incubator | |
| Water purification system | |
| Refrigerator | |
| Computer | |
| Pathology department | Grossing station |
| Fume hood | |
| Specimen storage cabinet | |
| Paraffin microtome | |
| Cryostat (freezing microtome) | |
| Fully automatic tissue processor | |
| Fully automatic stainer | |
| Coverslipper | |
| Cassette printer | |
| Slide printer | |
| Tissue embedding station | |
| Constant-temperature incubator | |
| Oven | |
| Autoclave | |
| Fax machine | |
| Centrifuge | |
| Specimen storage cabinet | |
| Microscope | |
| Image and text software | |
| Computer | |
| Refrigerator |
Table 7-3 Basic Instrument and Equipment Configuration for a Tertiary (Level 3) Hospital Laboratory
| Department | Instrument |
|---|---|
| Emergency laboratory | Fully automatic biochemistry analyzer |
| Blood gas analyzer | |
| Fully automatic hematology analyzer | |
| Urine analyzer | |
| Fully automatic chemiluminescence analyzer | |
| Microscope | |
| ESR analyzer | |
| CRP analyzer | |
| Centrifuge | |
| Water bath | |
| PCT analyzer | |
| Water purification system | |
| Refrigerator | |
| Computer | |
| Clinical testing laboratory | Urine analyzer |
| Urine sediment analyzer | |
| CRP analyzer | |
| Fully automatic hematology analyzer | |
| ESR analyzer | |
| Hemorheology analyzer | |
| Fully automatic coagulation analyzer | |
| Water bath | |
| Horizontal (swinging-bucket) centrifuge | |
| Refrigerator | |
| Fume hood | |
| Computer | |
| Microscope |
Continued table
| Department | Instrument |
|---|---|
| Biochemistry room | Fully automatic biochemistry analyzer |
| Blood gas analyzer | |
| Electrolyte analyzer | |
| Specific protein analyzer | |
| Glycated hemoglobin analyzer | |
| Trace element analyzer | |
| Microscope | |
| Water purification equipment | |
| Refrigerator | |
| Constant-temperature water bath | |
| Large-capacity horizontal centrifuge | |
| Electronic balance | |
| Immunology room | Fully automatic chemiluminescence analyzer |
| Biosafety cabinet | |
| Microplate reader | |
| Microplate washer | |
| Large-capacity horizontal centrifuge | |
| Constant-temperature water bath | |
| Fully automatic enzyme immunoassay system | |
| Pipettes | |
| Fluorescence microscope | |
| Internal-circulation autoclave | |
| Refrigerator | |
| Computer | |
| Morphology room | Microscope |
| Computer | |
| Flow cytometry room | Flow cytometer |
| Biosafety cabinet | |
| Constant-temperature water bath | |
| Centrifuge |
Continued table
| Department | Instrument |
|---|---|
| Flow cytometry room | Refrigerator |
| Pipettes | |
| Computer | |
| Refrigerator | |
| Electronic balance | |
| Trace element laboratory | Trace element analyzer |
| Atomic absorption spectrometer | |
| Fume hood | |
| Refrigerator | |
| Computer | |
| Electronic balance | |
| HIV laboratory | Microplate reader |
| Microplate washer | |
| Centrifuge | |
| Pipettes | |
| Constant-temperature water bath | |
| Internal-circulation autoclave | |
| Biosafety cabinet | |
| Refrigerator | |
| Computer | |
| PCR laboratory | Thermal cycler (gene amplification instrument) |
| Biosafety cabinet | |
| Pipettes | |
| Shaker (oscillator) | |
| High-speed centrifuge | |
| Constant-temperature water bath | |
| Constant-temperature dry bath (metal bath) | |
| UV lamp | |
| Electronic balance | |
| Mixer |
Continued table
| Department | Instrument |
|---|---|
| PCR laboratory | Clean bench |
| Refrigerator | |
| Microplate reader | |
| Microplate washer | |
| Computer | |
| Electronic balance | |
| Real-time fluorescence quantitative PCR instrument | |
| Gene sequencer | |
| Microbiology laboratory | Fully automatic bacterial identification analyzer |
| Biosafety cabinet | |
| Electronic balance | |
| Blood culture system | |
| Ambient-temperature incubator | |
| CO₂ incubator | |
| Centrifuge | |
| Internal-circulation autoclave | |
| Spectrophotometer | |
| Constant-temperature water bath | |
| Clean bench | |
| Refrigerator | |
| Computer | |
| Pathology department | Grossing station |
| Fume hood | |
| Specimen storage cabinet | |
| Paraffin microtome | |
| Cryostat (freezing microtome) | |
| Fully automatic tissue processor | |
| Fully automatic stainer | |
| Coverslipper | |
| Cassette printer |