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Eligible participant has to fullfill all of the following items | / / / / / / / |
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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
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Date of signing the informed consent | 2024-02-19 |
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Date of birth | 1999-07-02 yyyy-mm-dd |
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Age | 24 Years |
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Education background | University
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Occupation | Other
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Other (Description) | 职员 |
7+ 小时 |
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上厕所后 |
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Number of pregnancy | 0 次 |
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Number of delivery | - 次 |
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If has delivery history, select following items | |
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partus maturus | - 次 |
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premature delivery | - 次 |
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abortion | - 次 |
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Last pregnancy | - yyyy-mm-dd |
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Average times of menstrual onset a year | 5.5 次/年 |
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Average menstrual cycle | 45 天(days) |
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Menarche time | 13 岁(years) |
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The time of last Menstruation | 2023-12 年、月、日(yyyy-mm-dd) |
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The time of menstrual onset before the last one | 不详 年、月、日(yyyy-mm-dd) |
-- |
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-- 年/月/日（yyyy-mm-dd） |
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Namy of the drug to be allergied | -- |
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Vulva | Normal
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Description in detail for abnormal |
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Vagina | Normal
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Description in detail for abnormal |
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Uterine neck | Normal
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Description in detail for abnormal |
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Corpus uteri | Normal
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Description in detail for abnormal |
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Adnexa uteri | |
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Left side | Normal
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Description in detail for abnormal |
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Right side | Abnormal
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Description in detail for abnormal | 右附件可触及直径8cm质硬肿物，边界清，压痛 |
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Weight | 75 kg |
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Hight | 164 mm |
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Systolic pressure (SP) | 113 mmHg |
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Diastolic pressure | 80 mmHg |
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Temperature | 36.4 degree Celsius |
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Pulse rate | 84 次/分 |
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Breath frequency | 22 次/分 |
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Doctor signature | 刘义彬 |
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Date | 2024-2-19 yyyy-mm-dd |
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WBC | 9.0 ×109 /L |
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NEUT% | 66.22 % |
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LY% | 25.06 % |
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RBC | 4.37 ×10^12 /L |
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MONO％ | 6.21 ％ |
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HGB | 137 g/L |
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PLT | 398 ×10^9 /L |
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Researcher signature | 刘义彬 |
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Date | 2024-2-19 yyyy-mm-dd |
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Acidity and allkalinity | |
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pH value | 未查 |
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Urine protein | |
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Urine red cell | |
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Urine WBC | |
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Urine glucos | |
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Urine Bilirubin | |
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Urine HCG | |
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KET | |
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SG | 未查 |
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UBG | |
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NIT | |
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Date of test | -- yyyy-mm-dd |
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Date of test | 2024-2-19 yyyy-mm-dd |
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K | 4.21 mmol/L |
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Na | 139.7 mmol/L |
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Cl | 101.6 mmol/L |
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Ca | 2.45 mmol/L |
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P | 1.03 mmol/L |
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Date of examination | 2024-2-19 yyyy-mm-dd |
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Prothrombin time | 12.0 秒 |
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Thrombin time (TT) | 13.8 秒 |
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Activated partial thromboplastin time (APTT) | 34.0 秒 |
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Fibrinogen (FIB) | 3.02 g/L |
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ALT | 25.9 IU/L |
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AST | 22.9 IU/L |
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GGT | 21.0 U/L |
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Serum bilirubin | 16.70 μmol/L |
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Indirect bilirubin | 11.80 umol/L |
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Direct bilirubin | 4.90 umol/L |
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Serum albumin | 46.8 g/L |
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Serum globulin | 28.7 g/L |
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Serum total protein | 75.5 g/L |
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Date of test | 2024-2-19 yyyy-mm-dd |
Negative
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Date of test | 2024-2-19 yyyy-mm-dd |
Negative
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Date of test | 2024-2-19 yyyy-mm-dd |
Negative
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Date of test | 2024-2-19 yyyy-mm-dd |
Negative
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Date of test | 2024-2-19 yyyy-mm-dd |
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SCr | 58.0 μmol/L |
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Blood urea | 4.10 mmol/L |
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Blood uric acid | 237.0 μmol/L |
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Date of test | 2024-2-19 yyyy-mm-dd |
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D-dimer value | 0.05 ug/mL |
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Date of test | 2024-2-19 |
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Urine pregnancy test | Not tested
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Blood HCG concentration | -- mIU/mL |
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Date of test | -- yyyy-mm-dd |
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Size of the ulcer | 4.41*5.02*3.11 cm*cm |
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Uterine echo distribution | Not even
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Endometrial thickness | 1.06 mm |
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Left ovary size | 3.54*1.95*2.52 cm ×cm |
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Shape of Left ovary | Normal
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Size of the Ovarian cyst |
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Right ovary size | 3.98*8.04 cm ×cm |
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Shape of right ovary | Ovarian cyst
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Size of Ovarian cyst | 9.55 |
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Description of other abnormal findings | -- |
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Diagnosis of the Ultrasound B | 右附件扭转？ |
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Doctor signature | 刘义彬 |
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Date of examination | 2024-2-19 yyyy-mm-dd |
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Pain Visual Analogue Score | Quit pain barely tolerable
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SBE | 未查 mmol/l |
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HCO3 | 未查 mmol/l |
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Date of examination | 未查 (yyyy-mm-dd) |
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LAC | 未查 mmol/L |
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P02 | 未查 mmHg |
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SO2 | 未查 ％ |
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PCO2 | 未查 mmHg |
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PH | 未查 |
右侧卵巢 |
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9*6*6 cm |
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无扭转 ° |
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刘义彬 |
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2024-2-19 |
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D-dimer value | 0.24 ug/mL |
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Date of test | 2024-2-21 |
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Body temperature | 36.6 ℃ |
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Systolic pressure (SP) | 未查 mmHg |
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Diastolic pressure (DP) | 未查 mmHg |
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Heart Rate, HR | 84 次/分 |
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Pulse | 84 次/秒 |
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WBC | 8.7 ×109 /L |
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NEUT% | 62.76 % |
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LY% | 25.43 % |
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MONO％ | 8.49 ％ |
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RBC | 3.61 ×10^12 /L |
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HGB | 113 g/L |
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PLT | 294 ×10^9 /L |
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Date | 2024-2-21 yyyy-mm-dd |
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Pain Visual Analogue Score | Occasionally very slight pain
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sample collection | Collected
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Volume | 1 ml |
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Time of collection | 2024-2-19 2024-2-21 yyyy-mm-dd-hh-min. |
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Label Number of the sample | 2566287 |
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Date received at DCC | -- yyyymmdd |
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Report type | |
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Name of this event | -- |
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SAE start date | yyyymmdd |
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SAE stop date | -- yyyymmdd |
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Was this an unanticipated adverse event | |
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Attribution to Study Drug | |
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Outcome Type(check all that apply) | |
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Recovery Description: (check only one) | |
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Please provide a brief narrative of the SAE occurrence below | -- |
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Name of the recorder | -- |
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Data | -- yyyymmdd |
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Site Investigator’s signature | -- |
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Data | -- yyyymmdd |