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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 | 2024-2-22 |
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Date of birth | 1945-04-25 yyyy-mm-dd |
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Age | 78 Years |
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Education background | Illiteracy
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Occupation | Famer
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Other (Description) | -- |
间断2天 小时 |
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改变体位后 |
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Number of pregnancy | 4 次 |
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Number of delivery | 4 次 |
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If has delivery history, select following items | |
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partus maturus | 4 次 |
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premature delivery | 0 次 |
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abortion | 0 次 |
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Last pregnancy | 49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 | 16 岁(years) |
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The time of last Menstruation | 30+年前 年、月、日(yyyy-mm-dd) |
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The time of menstrual onset before the last one | -- 年、月、日(yyyy-mm-dd) |
右附件切除术，高血压5年，脑梗2年。 |
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17年前手术。 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 | Abnormal
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Description in detail for abnormal | 有囊肿，14.69*11.76*9.59液性包块 |
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Right side | Abnormal
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Description in detail for abnormal | 确如 |
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Weight | 60 kg |
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Hight | 1650 mm |
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Systolic pressure (SP) | 165 mmHg |
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Diastolic pressure | 98 mmHg |
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Temperature | 36.5 degree Celsius |
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Pulse rate | 84 次/分 |
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Breath frequency | 24 次/分 |
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Doctor signature | 刘义彬 |
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Date | 2024-2-22 yyyy-mm-dd |
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WBC | 7.6 ×109 /L |
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NEUT% | 57.28 % |
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LY% | 33.99 % |
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MONO％ | 7.48 ％ |
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RBC | 3.94 ×10^12 /L |
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HGB | 128 g/L |
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PLT | 187 ×10^9 /L |
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Researcher signature | 刘义彬 |
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Date | 刘义彬 yyyy-mm-dd |
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Acidity and allkalinity | Acidity
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pH value | 6.0 |
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Urine protein | Negative
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Urine red cell | Negative
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Urine WBC | Positive++
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Urine glucos | Negative
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Urine Bilirubin | Negative
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Urine HCG | |
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KET | Negative
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SG | 1.011 |
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UBG | Negative
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NIT | Negative
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Date of test | 2024-2-22 yyyy-mm-dd |
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Date of test | 2022-2-22 yyyy-mm-dd |
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K | 4.47 mmol/L |
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Na | 141.4 mmol/L |
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Cl | 105.3 mmol/L |
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Ca | 2.13 mmol/L |
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P | 1.07 mmol/L |
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Date of examination | 2024-2-22 yyyy-mm-dd |
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Prothrombin time | 12.3 秒 |
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Thrombin time (TT) | 15.5 秒 |
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Activated partial thromboplastin time (APTT) | 24.6 秒 |
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Fibrinogen (FIB) | 3.06 g/L |
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ALT | 11.2 IU/L |
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AST | 16.2 IU/L |
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GGT | 32.0 U/L |
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Serum bilirubin | 21.0 μmol/L |
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Indirect bilirubin | 13.50 umol/L |
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Direct bilirubin | 7.50 umol/L |
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Serum albumin | 38.2 g/L |
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Serum globulin | 22.2 g/L |
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Serum total protein | 60.4 g/L |
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Date of test | 2024-2-22 yyyy-mm-dd |
Negative
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Date of test | 2024-2-22 yyyy-mm-dd |
Negative
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Date of test | 2024-2-22 yyyy-mm-dd |
Negative
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Date of test | 2024-2-22 yyyy-mm-dd |
Negative
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Date of test | 2024-2-22 yyyy-mm-dd |
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SCr | 68.0 μmol/L |
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Blood urea | 4.40 mmol/L |
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Blood uric acid | 215.0 μmol/L |
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Date of test | 2024-2-22 yyyy-mm-dd |
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D-dimer value | 0.06 ug/mL |
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Date of test | 2024-2-22 |
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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 | 2.83*3.54*3.09 cm*cm |
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Uterine echo distribution | Even
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Endometrial thickness | 0.14 mm |
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Left ovary size | 未报告 cm ×cm |
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Shape of Left ovary | Ovarian cyst
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Size of the Ovarian cyst | 14.69*11.76*9.59 |
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Right ovary size | 缺如 cm ×cm |
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Shape of right ovary | |
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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 | 左卵巢肿物扭转 |
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Doctor signature | 刘义彬 |
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Date of examination | 2024-2-21 yyyy-mm-dd |
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Pain Visual Analogue Score | Quit pain barely tolerable
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PH | 7.446 |
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PCO2 | 36.4 mmHg |
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P02 | 66.0 mmHg |
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SO2 | 94.0 ％ |
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HCO3 | 24.5 mmol/l |
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SBE | 0.8 mmol/l |
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LAC | 1.04 mmol/L |
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Date of examination | 2024-2-23 (yyyy-mm-dd) |
左附件 |
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15 cm |
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顺时针扭转360 ° |
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刘义彬 |
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2024-2-23 |
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D-dimer value | 0.48 ug/mL |
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Date of test | 2024-2-24 |
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Body temperature | 36.4 ℃ |
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Systolic pressure (SP) | 134 mmHg |
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Diastolic pressure (DP) | 85 mmHg |
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Heart Rate, HR | 80 次/分 |
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Pulse | 80 次/秒 |
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WBC | 10.50 ×109 /L |
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NEUT% | 65.93 % |
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LY% | 26.39 % |
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MONO％ | 6.99 ％ |
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RBC | 4.17 ×10^12 /L |
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HGB | 134 g/L |
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PLT | 200 ×10^9 /L |
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Date | 2024-2-24 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 | 2024-2-23 2024-2-24 yyyy-mm-dd-hh-min. |
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Label Number of the sample | 2566998 |
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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 |