In this paper,the technology development process of morphological analysis was reviewed based on the blood cell analyzers in recent 40 years.The clinical values,advantages and limitations using blood cell analyzer to classify the white blood cell in different development stages were illuminated.It was evident that the manual microscopic examination is still a necessary way for clinical diagnosis,which is not necessarily replaced by the automated clinical analyzers,although some high-precision or high-intelligence machines are helpful for detecting the disease better on various levels.Therefore,it should be adopted in the rational ways for clinical examination based on the evidence-based medicine,and the appropriate diagnosis instruments should be chosen which not only satisfy the needs of clinical diagnosis,but also conform to the national benefit-for-people policies and requirements of healthcare reform.Herein,valuing the morphological examination in clinical diagnosis and strengthening the basic skills trainings should be advocated to improve the qualities and academic levels of clinic examination technicians.

In this paper,we reviewed the recent developments of blood cell analyzer,summarized the problems during the analyzer-operation,presented our viewpoints on how to optimize the methods and innovate the technologies in the field of cytological diagnosis.Based on the actual demands of cytological diagnosis in China,in order to solve the emerging problems better in the process of updating technologies and operation models of blood analyzer,we advocate to comply with the core principles,including abiding by the “best-convictive-evidence oriented” rule,valuing the “combination-test model” using multiple methods,raising the levels on clinic diagnosis and prognosis evaluation,improving the qualities and capabilities of diagnosis technicians,to finally achieve the aims of narrowing the gaps and advancing the overall diagnosis levels.Moreover,we also strongly suggest making the realistic policies to support the developments of morphological examination,reasonably increasing the charging standard in some specific morphologicalexamination-items characterized by high-technology,time-costing and working-costing to faithfully reflect their values.

As an on-site inspection team leader, I have joined the inspection on the clinical laboratories in six hospitals designed especially 2008 Olympic game organized by China National Laboratory Accreditation Committee (ISO15189 Accreditation). Two years' preparation promotes the standization, skill, management and academic level of these laboratories and boost the development 2-3 years forward. But there still were some deficiencies in the cell morphological examination including: ( 1 ) Low ratio of blood smear check when machine was used for hematological analysis; (2) Lack of criteria for blood smear check ; (3) Low capability of identification of cell; (4) Lack of personnel for microscopic examination. The reasons causing above deficiencies were concluded as follows: (1) The lab director did not pay sufficient attention to the morphological examination;(2)The technicians were unable to perform microscopic examination properly due to the heavy workload and lack of personnel; (3) The technicians were unable to use machine correctly as screening tool. So I put forward some measures for improvement of morphological examination. These measures included: (1) strengthening the propaganda on the importance of morphology examination and training the new stuffs; (2) Renovating the concept and improving the skill of lab technicians.

Based on the connotation of ISO15189 and philosophy of current laboratory medicine,this article discussed about the important significance and role of quality management in diagnosing and curing of patients during post-analytic phase.This article also expounded the attention to these questions of examination results verification,procedure of reviewing and reporting examination results,establishment of principle for reserving samples after examination,range of consulting service and methods of handling complaint,the relationship between the whole quality management and information exchange of laboratory and clinical department.

In order to implement the spirit of the document awarded by the three ministries,promote the medical reform process of public hospital,promote the heahhy development of the laboratory medicine,this paper expounds the significance of the study and implementation of the file,and puts forward several ideas.

Urine sediment analysis is of importance for the diagnosis, differential diagnosis and prognosis in urinary system diseases.To understand the standardization of sediment analysis and its development, This article analyzes the advantage and disadvantage of automated instrument used in urine sediment analysis, and then developes the criteria for microscopy review following automated urinalysis.

It is important for improvement of the diagnosis and treatment level and development of both the lab and the clinic to reinforce the communication between them and promote their combination.The communication mainly comprises pre-analysis quality management, demonstration of new experimental projects, selection and combination of test items, accurate interpretation of the test results, rational use of test reports, laboratory methodology and quality guarantee.The reinforcement of communication can be accomplished by (1)Publicizing the importance of the communication.(2)Enriching the clinical knowledge for the laboratory staff.(3)Establishing the position of the clinical laboratory physician in the lab.(4)Attending the ward around and consultation and providing the counseling service.

The fifth mid-youth laboratory medicine congress was held by the Chinese Society of Laboratory Medicine and the Chinese Journal of Laboratory Medicine at Guiyang. The purpose of the congress was establish the communication platform for the development of mid-youth professionals. Regarding research development trend and problems of laboratory medicine, we prove some proposals for better development of mid-youth professionals: (1)Pay more attention to practice and ability; (2)Change concept, optimize orientation; (3)The research work should target “clinical practice”.

The improvement of national economy and the society,the transformation of the health concept,the reform of the national medical system,and the development of clinical medicine and emergency medicine facilitated the growth of point of care testing(POCT)technology.This article outlined the concept of POCT,the foundation of implementation,and existing problems in the application,quality management and future prospect,aiming for proper use and extended application of POCT.

The progress on methodology evaluation and quality control of laboratory diagnosis of venous thrombosis and hemophilia and that of platelet function assessment were summarized.Methods to promote the development of routine test of hemorrhagic and thrombotic disorders and to improve the quality of laboratory testing were suggested.