ObjectiveTo summarize the research progress of relationship between distal landing zone geometric and outcomes of endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm. MethodsThe domestic and foreign literature on the accumulation of the impact of proximal and distal landing zone geometric morphology on clinical outcomes, the evaluation methods for related complications of proximal and distal landing zones, preventive measures for adverse outcomes related to the geometric morphology of the distal landing zone, and the pathophysiological mechanisms of complications related to the distal landing zone were retrieved to make an review. ResultsThe irregular geometric morphology of the proximal landing zone was closely associated with adverse events following EVAR. The morphology of the distal landing zone was actually more complex than that of the proximal zone, and the measurement methods for its parameters were also more complicated. Common methods used in the literature for studying landing zones included the centerline distance method, the minimum distance method, and the landing area method. Primary preventive measures for adverse outcomes related to the geometry of the distal landing zone included increasing radial support force and contact area, using endostaples, and extending the landing zone. In addition to anatomical factors, the distal landing zone was also influenced by various pathophysiological factors. ConclusionsThe morphology and related pathological changes of the distal landing zone significantly impact the clinical outcomes following EVAR for abdominal aortic aneurysm. However, current research on the distal landing zone is limited. Future studies should focus on developing new technologies and methods to improve the evaluation and management of the distal landing zone, thereby reducing the complications after EVAR, enhancing the success rate of the surgery, and improving patient survival quality.
Objective To investigate the role of preoperative serum thyroid stimulating hormone (TSH) in evaluating differentiated thyroid cancer (DTC). Methods A total of 551 patients with thyroid nodules met the study criteria, who got treatment in the First Affiliated Hospital of Jiamusi University between Aug. 2017 and Dec. 2017. And the patients were divided into DTC group (n=110) and benign group (n=441) according to the postoperative pathological results. The difference of serum TSH level between the 2 groups was compared and then explored the diagnostic significance of serum TSH level, thyroid imaging report and data system (TI-RADS), and serum TSH combined withTI-RADS. Results The serum TSH level was higher in the DTC group than that of the benign group (Z=5.198, P<0.05). The sensitivity of preoperative serum TSH level in the diagnosis of DTC was 80.9% (89/110), the specificity was 74.4% (328/441), and the area under receiver operating characteristic (ROC) curve was 0.660 ［95%CI was (0.602, 0.719), P<0.05］. The sensitivity of TI-RADS in the diagnosis of DTC was 82.7% (91/110), the specificity was 73.5% (324/441), and the area under the ROC curve was 0.772 ［95%CI was (0.711, 0.823), P<0.05］. The sensitivity of preoperative serum TSH combined with TI-RADS in the diagnosis of DTC was 91.8% (101/110), the specificity was 87.5% (386/441), and the area under the ROC curve was 0.831 ［95%CI was (0.786, 0.876), P<0.05］. Conclusions Preoperative serum TSH level may be a potential risk factor for the occurrence of DTC. Preoperative serum TSH level combined with TI-RADS classification can improve the accuracy of preoperative diagnosis of DTC, not only to reduce the misdiagnosis of thyroid cancer, but also can avoid excessive treatment.