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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 | 2024-2-18 |
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Date of birth | 1988-11-11 yyyy-mm-dd |
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Age | 35 Years |
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Education background | Middle school
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Occupation | Other
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Other (Description) | 职员 |
间断3天 小时 |
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无 |
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Number of pregnancy | 2 次 |
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Number of delivery | 2 次 |
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If has delivery history, select following items | |
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partus maturus | 2 次 |
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premature delivery | 0 次 |
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abortion | 0 次 |
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Last pregnancy | 7年前 yyyy-mm-dd |
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Average times of menstrual onset a year | 12 次/年 |
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Average menstrual cycle | 30 天(days) |
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Menarche time | 14 岁(years) |
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The time of last Menstruation | 2024-2-7 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) |
无 |
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-- 年/月/日（yyyy-mm-dd） |
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Namy of the drug to be allergied | 无 |
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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 | Abnormal
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Description in detail for abnormal | 增厚 |
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Right side | Normal
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Description in detail for abnormal | -- |
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Weight | 60 kg |
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Hight | 1580 mm |
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Systolic pressure (SP) | 108 mmHg |
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Diastolic pressure | 74 mmHg |
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Temperature | 37 degree Celsius |
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Pulse rate | 96 次/分 |
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Breath frequency | 21 次/分 |
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Doctor signature | 刘义彬 |
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Date | 2024-2-16 yyyy-mm-dd |
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WBC | 8.60 ×109 /L |
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NEUT% | 66.65 % |
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LY% | 24.24 % |
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MONO％ | 7.10 ％ |
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RBC | 4.37 ×10^12 /L |
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HGB | 136 g/L |
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PLT | 270 ×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 | Acidity
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pH value | 7.0 |
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Urine protein | Negative
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Urine red cell | Negative
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Urine WBC | Negative
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Urine glucos | Negative
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Urine Bilirubin | Negative
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Urine HCG | Negative
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KET | Negative
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SG | 1.023 |
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UBG | Negative
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NIT | Negative
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Date of test | 2024-2-19 yyyy-mm-dd |
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Date of test | 2024-2-19 yyyy-mm-dd |
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K | 4.86 mmol/L |
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Na | 140.9 mmol/L |
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Cl | 106.2 mmol/L |
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Ca | 2.26 mmol/L |
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P | 1.07 mmol/L |
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Date of examination | 2024-2-19 yyyy-mm-dd |
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Prothrombin time | 11.2 秒 |
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Thrombin time (TT) | 13.6 秒 |
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Activated partial thromboplastin time (APTT) | 29.1 秒 |
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Fibrinogen (FIB) | 2.95 g/L |
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ALT | 6.0 IU/L |
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AST | 13.3 IU/L |
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GGT | 21.0 U/L |
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Serum bilirubin | 19.6 μmol/L |
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Indirect bilirubin | 14.3 umol/L |
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Direct bilirubin | 5.3 umol/L |
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Serum albumin | 39.4 g/L |
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Serum globulin | 24.6 g/L |
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Serum total protein | 64.0 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 | 60.0 μmol/L |
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Blood urea | 2.80 mmol/L |
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Blood uric acid | 302.0 μmol/L |
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Date of test | 2024-2-19 yyyy-mm-dd |
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D-dimer value | 0.13 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 | 4.95 cm*cm |
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Uterine echo distribution | Even
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Endometrial thickness | 5.1 mm |
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Left ovary size | 3.78*2.59 cm ×cm |
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Shape of Left ovary | Ovarian cyst
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Size of the Ovarian cyst | 3.78*2.59cm低回声实质性回声区 |
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Right ovary size | 3.29*1.5 cm ×cm |
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Shape of right ovary | Normal
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Size of Ovarian cyst | -- |
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Description of other abnormal findings | -- |
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Diagnosis of the Ultrasound B | 左卵巢肿物蒂扭转 |
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Doctor signature | 刘义彬 |
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Date of examination | 2024-2-18 yyyy-mm-dd |
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Pain Visual Analogue Score | Occasionally very slight pain
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PH | 7.397 |
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PCO2 | 39.0 mmHg |
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P02 | 239.8 mmHg |
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SO2 | 99.4 ％ |
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HCO3 | 23.5 mmol/l |
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SBE | -1.2 mmol/l |
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LAC | 1.35 mmol/L |
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Date of examination | 2024-2-22 (yyyy-mm-dd) |
左附件 |
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2cm cm |
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无 ° |
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刘义彬 |
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2024-2-22 |
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D-dimer value | 0.16 ug/mL |
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Date of test | 2024-2-23 |
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Body temperature | 37.2 ℃ |
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Systolic pressure (SP) | 103 mmHg |
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Diastolic pressure (DP) | 63 mmHg |
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Heart Rate, HR | 80 次/分 |
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Pulse | 80 次/秒 |
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WBC | 9.5 ×109 /L |
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NEUT% | 68.71 % |
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LY% | 19.49 % |
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MONO％ | 10.48 ％ |
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RBC | 3.98 ×10^12 /L |
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HGB | 126 g/L |
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PLT | 251 ×10^9 /L |
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Date | 2024-2-23 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 | 2 ml |
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Time of collection | 2024-2-18 yyyy-mm-dd-hh-min. |
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Label Number of the sample | 2024-2-24 |
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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 |