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1.Screening
1.1.Inclusion Criteria

Inclusion criteria

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1.2.Exclusion Criteria

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刘义彬

Date

2024-1-25 yyyy-mm-dd

2.Baseline
2.1.Medical History

间断2个月 小时

剧烈活动

Average times of menstrual onset a year

12 次/年

Average menstrual cycle

28 天(days)

Menarche time

12 岁(years)

The time of last Menstruation

2024-1-12 年、月、日(yyyy-mm-dd)

The time of menstrual onset before the last one

不详 年、月、日(yyyy-mm-dd)

Disease or surgery name

--

Date of the confirmation or the surgery

-- 年/月/日(yyyy-mm-dd)

Date

2024-1-25 yyyy-mm-dd

2.2.General information

Date of signing the informed consent

2024-1-25

Date of birth

2008-9-24 yyyy-mm-dd

Age

15 Years

Education background

Middle school

Occupation

Other

Other (Description)

学生

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

Normal

Description in detail for abnormal

--

Right side

Not examined

Description in detail for abnormal

直径4cm包块

Weight

53 kg

Hight

1620 mm

Systolic pressure (SP)

118 mmHg

Diastolic pressure

78 mmHg

Temperature

36.4 degree Celsius

Pulse rate

100 次/分

Breath frequency

22 次/分

Doctor signature

刘义彬

Date

2024-1--25 yyyy-mm-dd

2.4.Blood Routine Tests

WBC

7.20 ×109 /L

NEUT%

58.22 %

LY%

34.54 %

RBC

4.37 ×10^12 /L

MONO%

5.72

HGB

133 g/L

PLT

259 ×10^9 /L

Researcher signature

刘义彬

Date

2024-1-25 yyyy-mm-dd

2.5.Urine Routine Test

Acidity and allkalinity

pH value

--

Urine protein

Urine red cell

Urine WBC

Urine glucos

Urine Bilirubin

Urine HCG

KET

SG

--

UBG

NIT

Date of test

未查 yyyy-mm-dd

2.6.Blood Biochemical items Tests

ALT

19.0 U/L

AST

20.2 U/L

GGT/γ-GT

23.0 U/L

ALP

78.6 U/L

TBIL

14.10 μmol/L

DBIL

5.40 μmol/L

IBIL

8.70 μmol/L

ALB

46.8 g/L

UA

289.0 umol/L

UREA

5.40 mmol/L

TC

未查 mmol/L

Cr

64.0 umol/L

TG

未查 mmol/L

HDL

未查 mmol/L

LDL

未查 mmol/L

CK

未查 U/L

CK-MB

未查 U/L

LDH

未查 U/L

K

4.90 mmol/L

Na

141.4 mmol/L

Cl

102.8 mmol/L

Ca

2.49 mmol/L

Glu

-- mmol/L

Date

2024-1-25 yyyy-mm-dd

2.7.Coagulation Function Tests

Prothrombin time

12.0

Thrombin time (TT)

13.7

Activated partial thromboplastin time (APTT)

30.2

Fibrinogen (FIB)

2.33 g/L

Date of examination

2024-1-25 yyyy-mm-dd

2.8.HBV/HCV/HIV/Syphilis Markers Test

HBV

Negative

HCV

Negative

Negtive

Negative

Date of test

2024-1-25 yyyy-mm-dd

2.9.Blood Gas Analysis

Date of examination

(yyyy-mm-dd)

LAC

0.82 mmol/L

SBE

1.2 mmol/l

HCO3

25.2 mmol/l

SO2

98.7

PCO2

37.8 mmHg

P02

316.7 mmHg

PH

7.441

2.10.D-dimer Test

0.05

2.11.HCG Test

-- mIU/mL

Urine HCG

Not detected

2.12.Visual Analogue Scale

Pain Visual Analogue Score

very slight pain

2.13.Image Examinations

13

3.48*3.3*2.53 cm*cm*cm

未报告

右侧6.37cm cm

左侧2.74*1.91cm右侧6.74*4.04cm cm

Date of examination

2024-1-25 yyyy-mm-dd

Abdomen CT examination

Abnormal with clinical significance

Description in detail for abnormal

两侧附件区混杂密度占位

Date of examination

2023-10-? yyyy-mm-dd

--

2.14.Other Tests
3.In the process of the treatment
3.1.Treatment Record

右卵巢

7*6*6 cm

°

decollement

刘义彬

2024-1-26

4.Follow-up
4.1.Physical examination

BG Puncture site

No

Temperature

37.2

Systolic pressure (SP)

99 mmHg

Diastolic pressure (DP)

70 mmHg

Heart Rate, HR

92 次/分

Blood pressure

99/70 mmHg

4.2.Blood Routine Test

WBC

11.40 ×109 /L

NEUT%

74.20 %

LY%

19.53 %

MONO%

5.69

RBC

4.34 ×10^12 /L

HGB

131 g/L

PLT

260 ×10^9 /L

Date

2024-1-25 yyyy-mm-dd

4.3.D-dimer test

D-dimer

D-dimer

0.22

Date of test

2024-1-27 yyyy-mm-dd

4.4.Visual Analogue Scale

Pain Visual Analogue Score

Occasionally very slight pain
/
Occasionally very slight pain

5.Management system of participants

sample collection

Collected

Volume

1 ml

Time of collection

2024-1-26 yyyy-mm-dd-hh-min.

Label Number of the sample

0500-34200

6.ADR/ADE management system

Is there any adverse event?

No

No

No

Severity

Within 30 minites or not?

Begin time at

-- 年/月/日(yyyy-mm-dd)

Time of stop

-- 年/月/日(yyyy-mm-dd)