Eligible participant has to fullfill all of the following items | / / / / |
Anyone with one of following items or more should be excluded: | / / / / / / / / |
- General information
- Medical history
- Physical examination
- Blood Routine Tests
- Urine Routine Test
- Blood Electrolytes Tests
- Coagulation Function Tests
- Serum Liver Function Tests
- HBV/HCV/HIV/Syphilis Markers Test
- Renel Function Test
- D-dimer
- hCG Test
- Image Examinations
- Visual Analogue Scale
- Blood Gas Analysis
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 |
9 小时 |
|
排便后 |
|
Number of pregnancy | 6 次 |
Number of delivery | 2 次 |
If has delivery history, select following items | |
partus maturus | 2 次 |
premature delivery | 0 次 |
abortion | 4 次 |
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 | - |
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 |
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 |
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 |
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 |
Date of examination | 2023-10-04 yyyy-mm-dd |
Prothrombin time | 12.3 秒 |
Thrombin time (TT) | 12.6 秒 |
Activated partial thromboplastin time (APTT) | 26.8 秒 |
Fibrinogen (FIB) | 2.81 g/L |
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 |
Negative
|
|
Date of test | 2023-10-04 yyyy-mm-dd |
Negative
|
|
Date of test | 2023-10-04 yyyy-mm-dd |
Negative
|
|
Date of test | 2023-10-04 yyyy-mm-dd |
Negative
|
|
Date of test | 2023-10-04 yyyy-mm-dd |
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 |
D-dimer value | 2.41 ug/mL |
Date of test | 2023-10-04 |
Urine pregnancy test | Not tested
|
Blood HCG concentration | -- mIU/mL |
Date of test | -- yyyy-mm-dd |
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 | 无 |
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 |
Pain Visual Analogue Score | Very pain
|
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) |
左卵巢 |
|
12*9*9 cm |
|
顺时针扭转720度 ° |
|
张丽娟 |
|
2023-10-04 |
D-dimer value | 0.39 ug/mL |
Date of test | 2023-10-05 |
Body temperature | 36.2 ℃ |
Systolic pressure (SP) | 96 mmHg |
Diastolic pressure (DP) | 60 mmHg |
Heart Rate, HR | 80 次/分 |
Pulse | 80 次/秒 |
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 |
/ | |
Pain Visual Analogue Score | very slight pain
|
sample collection | Collected
|
Volume | 1 ml |
Time of collection | 2023-10-04 yyyy-mm-dd-hh-min. |
Label Number of the sample | 2529461 |
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 |