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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

2018-11-05 yyyy-mm-dd

2.Baseline
2.1.Medical History

间断一周 小时

Average times of menstrual onset a year

11 次/年

Menarche time

13 岁(years)

Average menstrual cycle

4.5 天(days)

The time of last Menstruation

2018-10-05 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

2018-11-02 yyyy-mm-dd

2.2.General information

Date of signing the informed consent

2018-11-3

Date of birth

20000-8-23 yyyy-mm-dd

Age

18 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

Not examined

Description in detail for abnormal

Right side

Not examined

Description in detail for abnormal

Weight

50 kg

Hight

未记载 mm

Systolic pressure (SP)

110 mmHg

Diastolic pressure

70 mmHg

Temperature

36.9 degree Celsius

Pulse rate

64 次/分

Breath frequency

21 次/分

Doctor signature

刘义彬

Date

2018-11-09 yyyy-mm-dd

2.4.Blood Routine Tests

WBC

13.0 ×109 /L

NEUT%

80.80 %

LY%

8.5 %

MONO%

10.4

RBC

3.56 ×10^12 /L

HGB

116 g/L

PLT

230 ×10^9 /L

Researcher signature

刘义彬

Date

2024-2-19 yyyy-mm-dd

2.5.Urine Routine Test

Acidity and allkalinity

Acidity

pH value

6.0

Urine protein

Negative

Urine red cell

Negative

Urine WBC

Negative

Urine glucos

Negative

Urine Bilirubin

Negative

Urine HCG

KET

Positive++

SG

1.010

UBG

Negative

NIT

Negative

Date of test

2018-11-3 yyyy-mm-dd

2.6.Blood Biochemical items Tests

ALT

4.0 U/L

AST

10.3 U/L

GGT/γ-GT

10.0 U/L

ALP

72.0 U/L

TBIL

12.60 μmol/L

DBIL

6.20 μmol/L

IBIL

6.40 μmol/L

ALB

44.2 g/L

UA

234.0 umol/L

UREA

2.60 mmol/L

TC

1.40 mmol/L

Cr

53.0 umol/L

TG

0.44 mmol/L

HDL

1.40 mmol/L

LDL

0.87 mmol/L

CK

40.0 U/L

CK-MB

18.0 U/L

LDH

167.0 U/L

K

3.34 mmol/L

Na

136.6 mmol/L

Cl

99.1 mmol/L

Ca

2.27 mmol/L

Glu

3.72 mmol/L

Date

2018-11-3 yyyy-mm-dd

2.7.Coagulation Function Tests

Prothrombin time

15.4

Thrombin time (TT)

13.3

Activated partial thromboplastin time (APTT)

32.3

Fibrinogen (FIB)

3.74 g/L

Date of examination

2018-11-03 yyyy-mm-dd

2.8.HBV/HCV/HIV/Syphilis Markers Test

HBV

Negative

HCV

Negative

Negtive

Negative

Date of test

2018-11-3 yyyy-mm-dd

2.9.Blood Gas Analysis

Date of examination

2018-11-3 (yyyy-mm-dd)

LAC

0.71 mmol/L

SBE

-2.2 mmol/l

HCO3

21.5 mmol/l

SO2

97.7

PCO2

33.7 mmHg

P02

106.4 mmHg

PH

7.432

2.10.D-dimer Test

未查

2.11.HCG Test

-- mIU/mL

Urine HCG

Not detected

2.12.Visual Analogue Scale

Pain Visual Analogue Score

Mild pain

2.13.Image Examinations

26

5.15*5.84*4.37 cm*cm*cm

未报告

5.35*5.09*3.93 cm

左侧3.93*3.31 右侧3.2*1.45 cm

Date of examination

22018-11-03 yyyy-mm-dd

Abdomen CT examination

Abnormal with clinical significance

Description in detail for abnormal

左下腹盆腔内囊实性肿物伴出血。

Date of examination

2018-11-2 yyyy-mm-dd

--

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

左侧输卵管系膜

5cm cm

逆时针2160 °

excision

刘义彬

2018-11-5

4.Follow-up
4.1.Physical examination

BG Puncture site

No

Temperature

36.8

Systolic pressure (SP)

未查 mmHg

Diastolic pressure (DP)

未查 mmHg

Heart Rate, HR

未查 次/分

Blood pressure

未查 mmHg

4.2.Blood Routine Test

WBC

7.20 ×109 /L

NEUT%

71.50 %

LY%

19.70 %

MONO%

7.10

RBC

3.73 ×10^12 /L

HGB

117 g/L

PLT

258 ×10^9 /L

Date

2018-11-7 yyyy-mm-dd

4.3.D-dimer test

D-dimer

D-dimer

未查

Date of test

-- yyyy-mm-dd

4.4.Visual Analogue Scale

Pain Visual Analogue Score

Occasionally very slight pain
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Occasionally very slight pain

5.Management system of participants

sample collection

Collected

Volume

1 ml

Time of collection

2018-11-4 yyyy-mm-dd-hh-min.

Label Number of the sample

2093389

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)