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1.Screening
1.1.Inclusion Criteria

Eligible participant has to fullfill all of the following items

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1.2.Exclusion Criteria

Anyone with one of following items or more should be excluded:

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2.Baseline
2.1.General information

Date of signing the informed consent

2023-10-04

Date of birth

1985-08-03 yyyy-mm-dd

Age

38 Years

Education background

University

Occupation

Other

Other (Description)

职员

2.2.Medical history

9 小时

排便后

Number of pregnancy

6

Number of delivery

2

If has delivery history, select following items

partus maturus

2

premature delivery

0

abortion

4

Last pregnancy

10年前 yyyy-mm-dd

Average times of menstrual onset a year

11 次/年

Average menstrual cycle

33.5 天(days)

Menarche time

15 岁(years)

The time of last Menstruation

2023-09-10 年、月、日(yyyy-mm-dd)

The time of menstrual onset before the last one

不详 年、月、日(yyyy-mm-dd)

体健

- 年/月/日(yyyy-mm-dd)

Namy of the drug to be allergied

-

2.3.Physical examination

Vulva

Normal

Description in detail for abnormal

-

Vagina

Not examined

Description in detail for abnormal

-

Uterine neck

Not examined

Description in detail for abnormal

-

Corpus uteri

Not examined

Description in detail for abnormal

-

Adnexa uteri

Left side

Not examined

Description in detail for abnormal

-

Right side

Not examined

Description in detail for abnormal

-

Weight

55 kg

Hight

1600 mm

Systolic pressure (SP)

110 mmHg

Diastolic pressure

71 mmHg

Temperature

36.6 degree Celsius

Pulse rate

72 次/分

Breath frequency

18 次/分

Doctor signature

刘义彬

Date

2023-10-04 yyyy-mm-dd

2.4.Blood Routine Tests

WBC

15.2 ×109 /L

NEUT%

89.60 %

LY%

7.70 %

MONO%

2.30

RBC

4.07 ×10^12 /L

HGB

127 g/L

PLT

242 ×10^9 /L

Researcher signature

刘义彬

Date

2023-10-04 yyyy-mm-dd

2.5.Urine Routine Test

Acidity and allkalinity

pH value

未查

Urine protein

Urine red cell

Urine WBC

Urine glucos

Urine Bilirubin

Urine HCG

KET

SG

未查

UBG

NIT

Date of test

-- yyyy-mm-dd

2.6.Blood Electrolytes Tests

Date of test

2023-10-04 yyyy-mm-dd

K

3.93 mmol/L

Na

140.2 mmol/L

Cl

103.1 mmol/L

Ca

2.34 mmol/L

P

0.92 mmol/L

2.7.Coagulation Function Tests

Date of examination

2023-10-04 yyyy-mm-dd

Prothrombin time

12.3

Thrombin time (TT)

12.6

Activated partial thromboplastin time (APTT)

26.8

Fibrinogen (FIB)

2.81 g/L

2.8.Serum Liver Function Tests

ALT

20.5 IU/L

AST

21.2 IU/L

GGT

19.0 U/L

Serum bilirubin

22.80 μmol/L

Indirect bilirubin

15.10 umol/L

Direct bilirubin

7.7 umol/L

Serum albumin

42.0 g/L

Serum globulin

30.1 g/L

Serum total protein

72.1 g/L

Date of test

2023-10-04 yyyy-mm-dd

2.9.HBV/HCV/HIV/Syphilis Markers Test
2.2.9.2.9.1、HBV Markers Test

Negative

Date of test

2023-10-04 yyyy-mm-dd

2.2.9.2.9.2、HCV Marker Test

Negative

Date of test

2023-10-04 yyyy-mm-dd

2.2.9.2.9.3、HIV Marker Test

Negative

Date of test

2023-10-04 yyyy-mm-dd

2.2.9.2.9.4、Syphilis Marker Test

Negative

Date of test

2023-10-04 yyyy-mm-dd

2.10.Renel Function Test

SCr

69.0 μmol/L

Blood urea

3.40 mmol/L

Blood uric acid

248.0 μmol/L

Date of test

2023-10-04 yyyy-mm-dd

2.11.D-dimer

D-dimer value

2.41 ug/mL

Date of test

2023-10-04

2.12.hCG Test

Urine pregnancy test

Not tested

Blood HCG concentration

-- mIU/mL

Date of test

-- yyyy-mm-dd

2.13.Image Examinations
2.2.13.2.13.1、Ultrasound

Size of the ulcer

5.65*5.06 cm*cm

Uterine echo distribution

Even

Endometrial thickness

0.49 mm

Left ovary size

未描述 cm ×cm

Shape of Left ovary

Ovarian cyst

Size of the Ovarian cyst

6.35*6.23*5.49 12.33*9.42*5。48

Right ovary size

3.09*1.94 cm ×cm

Shape of right ovary

Ovarian cyst

Size of Ovarian cyst

4.94*4.81*4.42

Description of other abnormal findings

Diagnosis of the Ultrasound B

腹痛待查 卵巢扭转

Doctor signature

刘义彬

Date of examination

2023-10-04 yyyy-mm-dd

2.2.13.2.13.2、Other examination
2.14.Visual Analogue Scale

Pain Visual Analogue Score

Very pain

2.15.Blood Gas Analysis

PH

7.395

PCO2

35.5 mmHg

P02

2322.2 mmHg

SO2

98.5

HCO3

21.3 mmol/l

SBE

-3 mmol/l

LAC

2.31 mmol/L

Date of examination

2023-10-04 (yyyy-mm-dd)

3.In the process of the treatment
3.1.Treatment Record

左卵巢

12*9*9 cm

顺时针扭转720度 °

张丽娟

2023-10-04

4.Follow-up
4.1.D-dimer

D-dimer value

0.39 ug/mL

Date of test

2023-10-05

4.2.Physical examination

Body temperature

36.2

Systolic pressure (SP)

96 mmHg

Diastolic pressure (DP)

60 mmHg

Heart Rate, HR

80 次/分

Pulse

80 次/秒

4.3.Blood Routine Tests

WBC

10.2 ×109 /L

NEUT%

70.10 %

LY%

20.80 %

MONO%

7.40

RBC

3.55 ×10^12 /L

HGB

113 g/L

PLT

222 ×10^9 /L

Date

2023-10-05 yyyy-mm-dd

4.4.Visual Analogue Scale

/

Pain Visual Analogue Score

very slight pain

5.Speciman management system

sample collection

Collected

Volume

1 ml

Time of collection

2023-10-04 yyyy-mm-dd-hh-min.

Label Number of the sample

2529461

6.ADR/ADE management system

Date received at DCC

-- yyyymmdd

Report type

Name of this event

-

SAE start date

- yyyymmdd

SAE stop date

- yyyymmdd

Was this an unanticipated adverse event

Attribution to Study Drug

Outcome Type(check all that apply)

Recovery Description: (check only one)

Please provide a brief narrative of the SAE occurrence below

-

Name of the recorder

刘义彬

Data

yyyymmdd

Site Investigator’s signature

刘义彬

Data

2023-10-05 yyyymmdd