1.Intraoperative renal collecting system damage increases risks of ipsilateral upper urinary tract stones after partial nephrectomy:a 1∶2 propensity-matched case-control study
Yanzhong LIU ; Run ZHU ; Yuzhu LI ; Xin MA ; Haixing MAI
Journal of Southern Medical University 2025;45(9):1880-1888
Objective To investigate the incidence of ipsilateral upper urinary tract stones after partial nephrectomy and its risk factors.Methods We retrospectively analyzed baseline patient characteristics(age,gender,and body mass index),smoking,alcohol consumption,comorbidities(hypertension,diabetes,hypertriglyceridemia,hyperuricemia,and cardiovascular diseases),preoperative tumor conditions(tumor diameter,multiple foci,location,hemorrhage,necrosis,cystic changes,and endophytic growth),preoperative glomerular filtration rate and intraoperative factors(renal collecting system damage,ischemia time,operation time,surgical approach,and estimated intraoperative blood loss)to identify the risk factors for ipsilateral upper urinary tract stones following partial nephrectomy in our center.Results The overall incidence of upper urinary tract stones following partial nephrectomy was 7.80%(112/1435).The incidence of ipsilateral upper urinary tract stones was significantly higher than those of contralateral stones(4.95%vs 1.46%,P<0.001)and bilateral stones(4.95%vs 1.39%,P<0.001).Intraoperative damage to the renal collecting system was identified as a significant risk factor for ipsilateral upper urinary tract stones(OR=4.550,95%CI:2.237-9.252,P<0.001).Diabetes was a probable risk factor for secondary ipsilateral upper urinary tract stones after partial nephrectomy(OR=2.419,95%CI:0.973-6.012,P=0.057).Conclusions The incidence of ipsilateral upper urinary tract stones after partial nephrectomy is higher than that of contralateral and bilateral stones.Intraoperative renal collecting system damage is a risk factor for secondary ipsilateral upper urinary tract stones after partial nephrectomy.
2.Pathogens and expressions of MEG3/miR-223/NLRP3 axis in peripheral blood for thoracoscopic lobectomy patients with postoperative pulmonary infections
Yaxiong GUO ; Chunhui SHEN ; Ming YANG ; Yanzhong LIU ; Zhenhui WANG ; Guoxiong ZENG ; Beiru WANG ; Jiyong WANG
Chinese Journal of Nosocomiology 2025;35(14):2110-2114
OBJECTIVE To explore the distribution of pathogens isolated from the thoracoscopic lobectomy patients with postoperative pulmonary infections and observe the expressions of maternal expression gene 3(MEG3)/microribonucleic acid-223(miR-223)/nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)axis in peripheral blood.METHODS Totally 48 lung cancer patients who underwent thoracoscopic lobec-tomy and had postoperative pulmonary infections in the First Affiliated Hospital of Guangzhou University of Chi-nese Medicine from Jun.2021 to Jun.2024 were assigned as the infection group,meanwhile,31 lung cancer pa-tients who underwent thoracoscopic lobectomy but did not have postoperative infections were chosen as the no in-fection group.The sputum specimens were collected from the infection group,the distribution of isolated patho-gens was analyzed.The clinical data and the expression MEG3,miR-223 and NLRP3 were observed and compared between the two groups.The values of MEG3,miR-223 and NLRP3 in prediction of the postoperative infections were analyzed by receiver operating characteristic(ROC)curves.RESULTS Totally 63 strains of pathogens were i-solated from the 48 thoracoscopic lobectomy patients with postoperative pulmonary infections,33(52.38%)of which were gram-negative bacteria,25(39.68%)were gram-positive bacteria,and 5(7.94%)were fungi.There were significant differences in age,diabetes mellitus,chronic obstructive pulmonary disease(COPD),operation duration,and expression levels of MEG3,miR-223 and NLRP3 between the infection group and the no infection group(P<0.05).ROC curve analysis showed that the areas under the curves of MEG3,miR-223 and NLRP3 and the joint detection of the three indexes were 0.861,0.760,0.912 and 0.968,respectively,in prediction of the post-operative pulmonary infections,and the predictive efficiency of the joint detection was highest(P<0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the thoracoscopic lo-bectomy patients with postoperative pulmonary infections,the occurrence and progression of the infections may be closely associated with the activation of MEG3/miR-223/NLRP3 axis.The joint detection of the three indexes can effectively predict the postoperative pulmonary infections in the thoracoscopic lobectomy patients.
3.Effect and mechanism of retinoic acid-related orphan receptor alpha on cognitive impairment of mice induced by chronic alcohol use
Lina LIU ; Shuai LIU ; Dan WANG ; Zijun WANG ; Yanzhong BAI ; Zhong ZHANG ; Chuansheng WANG ; Ruiling ZHANG ; Yanjie ZHANG
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(8):680-685
Objective:To explore the role of retinoic acid-related orphan receptor α (RORα) in cognitive impairment induced by chronic alcohol consumption in mice.Methods:(1)The SPF grade RORαflox/flox transgenic mice aged 8 weeks were generated, and 22 transgenic mice were evenly divided into two groups by the method of matching body mass, which were the control group (Con group) and the alcohol group (EtOH group), with 11 mice in each group.(2)Emx1-Cre transgenic mice were used to selectively knock out the RORα gene in the forebrain of RORαflox/flox transgenic mice, producing conditional knockout mice (cKO mice) with the genotype RORαflox/flox-Emx1-Cre+ /+. Fourteen cKO mice were further split into two groups by the method of matching body mass, which were the conditional knockout group (cKO group) and the conditional knockout + alcohol group (cKO + EtOH group), with 7 mice in each group. A chronic alcohol use cognitive impairment model was developed in the EtOH group and cKO + EtOH group through the two-bottle free-choice method, while the Con group and cKO group were given two bottles of water for the same period. Cognitive abilities of mice in all groups were evaluated using behavioral novel object recognition test and Y-maze test.RORα mRNA and protein expression levels in the hippocampus of the Con group and EtOH group were assessed by RT-qPCR and Western blot, respectively.The GraphPad Prism 9.0 software was used for data analysis.One-way ANOVA was used for the comparison of multiple groups and Tukey test was used for further pairwise comparisons.Results:(1) Comparison between Con group and EtOH group: the relative levels of ROR α protein (0.63±0.04) and mRNA (0.78±0.03) in the hippocampus of mice in the EtOH group were significantly lower than those in the Con group((1.00±0.06), (1.00±0.05), both P<0.05). The duration of the EtOH group in the Y maze was significantly lower than that of the Con group ((212.30±32.05) s, (129.30±21.50) s, P<0.05), and the new object recognition index of the EtOH group was lower than that of the Con group ((14.73±25.49)% vs (-15.55±27.88)%, P=0.08). (2)Comparison between Con group and cKO group: the frequency and duration of entering the Y maze of mice in the cKO group ((7.43±2.30) times, (124.10±13.95) s) were lower than those in the Con group ((14.90±3.65) times, (212.30±32.05) s, both P<0.05). There was no statistically significant difference in the new object recognition index between the cKO group and the Con group ( P>0.05). (3) Comparison between the cKO+ EtOH group and the cKO group: the frequency ((2.71±1.11)times) and duration ((161.70±17.95) s) of entering the new heteroarm of Y maze in the KO+ EtOH group were lower than those in the cKO group ((7.43±2.30) times, (124.10±13.95) s, both P<0.05), and there was no statistically significant difference in the new object recognition index ( P>0.05). (4) Comparison between the cKO+ EtOH group and the EtOH group: the frequency of entering new heteroarm of the Y maze in the cKO+ EtOH group ((2.71±1.11)times) was significantly lower than that in the EtOH group (12.18±4.49) ( P<0.05), while there was no statistically significant difference in other behavioral results between the two groups ( P>0.05). Conclusion:Chronic alcohol consumption leads to cognitive impairment through the downregulation of RORα in the hippocampus of mice. Specific knockout of RORα in the forebrain exacerbates cognitive impairment induced by chronic alcohol use. RORα may represent a potential therapeutic target for cognitive impairment resulting from chronic alcohol consumption.
4.Effect and mechanism of retinoic acid-related orphan receptor alpha on cognitive impairment of mice induced by chronic alcohol use
Lina LIU ; Shuai LIU ; Dan WANG ; Zijun WANG ; Yanzhong BAI ; Zhong ZHANG ; Chuansheng WANG ; Ruiling ZHANG ; Yanjie ZHANG
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(8):680-685
Objective:To explore the role of retinoic acid-related orphan receptor α (RORα) in cognitive impairment induced by chronic alcohol consumption in mice.Methods:(1)The SPF grade RORαflox/flox transgenic mice aged 8 weeks were generated, and 22 transgenic mice were evenly divided into two groups by the method of matching body mass, which were the control group (Con group) and the alcohol group (EtOH group), with 11 mice in each group.(2)Emx1-Cre transgenic mice were used to selectively knock out the RORα gene in the forebrain of RORαflox/flox transgenic mice, producing conditional knockout mice (cKO mice) with the genotype RORαflox/flox-Emx1-Cre+ /+. Fourteen cKO mice were further split into two groups by the method of matching body mass, which were the conditional knockout group (cKO group) and the conditional knockout + alcohol group (cKO + EtOH group), with 7 mice in each group. A chronic alcohol use cognitive impairment model was developed in the EtOH group and cKO + EtOH group through the two-bottle free-choice method, while the Con group and cKO group were given two bottles of water for the same period. Cognitive abilities of mice in all groups were evaluated using behavioral novel object recognition test and Y-maze test.RORα mRNA and protein expression levels in the hippocampus of the Con group and EtOH group were assessed by RT-qPCR and Western blot, respectively.The GraphPad Prism 9.0 software was used for data analysis.One-way ANOVA was used for the comparison of multiple groups and Tukey test was used for further pairwise comparisons.Results:(1) Comparison between Con group and EtOH group: the relative levels of ROR α protein (0.63±0.04) and mRNA (0.78±0.03) in the hippocampus of mice in the EtOH group were significantly lower than those in the Con group((1.00±0.06), (1.00±0.05), both P<0.05). The duration of the EtOH group in the Y maze was significantly lower than that of the Con group ((212.30±32.05) s, (129.30±21.50) s, P<0.05), and the new object recognition index of the EtOH group was lower than that of the Con group ((14.73±25.49)% vs (-15.55±27.88)%, P=0.08). (2)Comparison between Con group and cKO group: the frequency and duration of entering the Y maze of mice in the cKO group ((7.43±2.30) times, (124.10±13.95) s) were lower than those in the Con group ((14.90±3.65) times, (212.30±32.05) s, both P<0.05). There was no statistically significant difference in the new object recognition index between the cKO group and the Con group ( P>0.05). (3) Comparison between the cKO+ EtOH group and the cKO group: the frequency ((2.71±1.11)times) and duration ((161.70±17.95) s) of entering the new heteroarm of Y maze in the KO+ EtOH group were lower than those in the cKO group ((7.43±2.30) times, (124.10±13.95) s, both P<0.05), and there was no statistically significant difference in the new object recognition index ( P>0.05). (4) Comparison between the cKO+ EtOH group and the EtOH group: the frequency of entering new heteroarm of the Y maze in the cKO+ EtOH group ((2.71±1.11)times) was significantly lower than that in the EtOH group (12.18±4.49) ( P<0.05), while there was no statistically significant difference in other behavioral results between the two groups ( P>0.05). Conclusion:Chronic alcohol consumption leads to cognitive impairment through the downregulation of RORα in the hippocampus of mice. Specific knockout of RORα in the forebrain exacerbates cognitive impairment induced by chronic alcohol use. RORα may represent a potential therapeutic target for cognitive impairment resulting from chronic alcohol consumption.
5.Intraoperative renal collecting system damage increases risks of ipsilateral upper urinary tract stones after partial nephrectomy: a 1∶2 propensity-matched case-control study.
Yanzhong LIU ; Run ZHU ; Yuzhu LI ; Xin MA ; Haixing MAI
Journal of Southern Medical University 2025;45(9):1880-1888
OBJECTIVES:
To investigate the incidence of ipsilateral upper urinary tract stones after partial nephrectomy and its risk factors.
METHODS:
We retrospectively analyzed baseline patient characteristics (age, gender, and body mass index), smoking, alcohol consumption, comorbidities (hypertension, diabetes, hypertriglyceridemia, hyperuricemia, and cardiovascular diseases), preoperative tumor conditions (tumor diameter, multiple foci, location, hemorrhage, necrosis, cystic changes, and endophytic growth), preoperative glomerular filtration rate and intraoperative factors (renal collecting system damage, ischemia time, operation time, surgical approach, and estimated intraoperative blood loss) to identify the risk factors for ipsilateral upper urinary tract stones following partial nephrectomy in our center.
RESULTS:
The overall incidence of upper urinary tract stones following partial nephrectomy was 7.80% (112/1435). The incidence of ipsilateral upper urinary tract stones was significantly higher than those of contralateral stones (4.95% vs 1.46%, P<0.001) and bilateral stones (4.95% vs 1.39%, P<0.001). Intraoperative damage to the renal collecting system was identified as a significant risk factor for ipsilateral upper urinary tract stones (OR=4.550, 95% CI: 2.237-9.252, P<0.001). Diabetes was a probable risk factor for secondary ipsilateral upper urinary tract stones after partial nephrectomy (OR=2.419, 95% CI: 0.973-6.012, P=0.057).
CONCLUSIONS
The incidence of ipsilateral upper urinary tract stones after partial nephrectomy is higher than that of contralateral and bilateral stones. Intraoperative renal collecting system damage is a risk factor for secondary ipsilateral upper urinary tract stones after partial nephrectomy.
Humans
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Nephrectomy/methods*
;
Retrospective Studies
;
Risk Factors
;
Male
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Female
;
Case-Control Studies
;
Middle Aged
;
Aged
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Kidney Neoplasms/surgery*
;
Adult
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Intraoperative Complications
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Kidney Tubules, Collecting/injuries*
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Propensity Score
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Incidence
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Kidney Calculi/etiology*
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Urinary Calculi/epidemiology*
6.Pathogens and expressions of MEG3/miR-223/NLRP3 axis in peripheral blood for thoracoscopic lobectomy patients with postoperative pulmonary infections
Yaxiong GUO ; Chunhui SHEN ; Ming YANG ; Yanzhong LIU ; Zhenhui WANG ; Guoxiong ZENG ; Beiru WANG ; Jiyong WANG
Chinese Journal of Nosocomiology 2025;35(14):2110-2114
OBJECTIVE To explore the distribution of pathogens isolated from the thoracoscopic lobectomy patients with postoperative pulmonary infections and observe the expressions of maternal expression gene 3(MEG3)/microribonucleic acid-223(miR-223)/nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)axis in peripheral blood.METHODS Totally 48 lung cancer patients who underwent thoracoscopic lobec-tomy and had postoperative pulmonary infections in the First Affiliated Hospital of Guangzhou University of Chi-nese Medicine from Jun.2021 to Jun.2024 were assigned as the infection group,meanwhile,31 lung cancer pa-tients who underwent thoracoscopic lobectomy but did not have postoperative infections were chosen as the no in-fection group.The sputum specimens were collected from the infection group,the distribution of isolated patho-gens was analyzed.The clinical data and the expression MEG3,miR-223 and NLRP3 were observed and compared between the two groups.The values of MEG3,miR-223 and NLRP3 in prediction of the postoperative infections were analyzed by receiver operating characteristic(ROC)curves.RESULTS Totally 63 strains of pathogens were i-solated from the 48 thoracoscopic lobectomy patients with postoperative pulmonary infections,33(52.38%)of which were gram-negative bacteria,25(39.68%)were gram-positive bacteria,and 5(7.94%)were fungi.There were significant differences in age,diabetes mellitus,chronic obstructive pulmonary disease(COPD),operation duration,and expression levels of MEG3,miR-223 and NLRP3 between the infection group and the no infection group(P<0.05).ROC curve analysis showed that the areas under the curves of MEG3,miR-223 and NLRP3 and the joint detection of the three indexes were 0.861,0.760,0.912 and 0.968,respectively,in prediction of the post-operative pulmonary infections,and the predictive efficiency of the joint detection was highest(P<0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the thoracoscopic lo-bectomy patients with postoperative pulmonary infections,the occurrence and progression of the infections may be closely associated with the activation of MEG3/miR-223/NLRP3 axis.The joint detection of the three indexes can effectively predict the postoperative pulmonary infections in the thoracoscopic lobectomy patients.
7.Apatinib and gamabufotalin co-loaded lipid/Prussian blue nanoparticles for synergistic therapy to gastric cancer with metastasis
Chen BINLONG ; Zhao YANZHONG ; Lin ZICHANG ; Liang JIAHAO ; Fan JIALONG ; Huang YANYAN ; He LEYE ; Liu BIN
Journal of Pharmaceutical Analysis 2024;14(5):707-721
Due to the non-targeted release and low solubility of anti-gastric cancer agent,apatinib(Apa),a first-line drug with long-term usage in a high dosage often induces multi-drug resistance and causes serious side effects.In order to avoid these drawbacks,lipid-film-coated Prussian blue nanoparticles(PB NPs)with hyaluronan(HA)modification was used for Apa loading to improve its solubility and targeting ability.Furthermore,anti-tumor compound of gamabufotalin(CS-6)was selected as a partner of Apa with reducing dosage for combinational gastric therapy.Thus,HA-Apa-Lip@PB-CS-6 NPs were constructed to synchro-nously transport the two drugs into tumor tissue.In vitro assay indicated that HA-Apa-Lip@PB-CS-6 NPs can synergistically inhibit proliferation and invasion/metastasis of BGC-823 cells via downregulating vascular endothelial growth factor receptor(VEGFR)and matrix metalloproteinase-9(MMP-9).In vivo assay demonstrated strongest anti-tumor growth and liver metastasis of HA-Apa-Lip@PB-CS-6 NPs adminis-tration in BGC-823 cells-bearing mice compared with other groups due to the excellent penetration in tumor tissues and outstanding synergistic effects.In summary,we have successfully developed a new nanocomplexes for synchronous Apa/CS-6 delivery and synergistic gastric cancer(GC)therapy.
8.Expression of nicotinamide -N- methyltransferase in various tumor tissues and its prognostic value in papillary thyroid carcinoma
Jia LIU ; Yanzhong WANG ; Fei YU ; Bingjie WANG ; Jun ZHANG
Cancer Research and Clinic 2023;35(12):887-893
Objective:To investigate the expression of nicotinamide-N-methyltransferase (NNMT) in various tumor tissues and its prognostic value in papillary thyroid carcinoma.Methods:The paraffin samples of surgically resected tissues from 168 cases of colorectal cancer, 75 cases of gastric cancer, 178 cases of lung cancer, 15 cases of liver cancer, 60 cases of thyroid cancer, 7 cases of prostate cancer, 74 cases of breast cancer, and 14 cases of renal cancer were collected from Sir Run Run Show Hospital, Zhejiang University School of Medicine and the Third Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine between January 2016 and December 2021; tissue samples of 58 cases of papillary thyroid cancer and another 19 cases of thyroiditis were collected between January 2016 and December 2016. Immunohistochemistry kits were prepared and performance tests were performed. Normal specimens (>5 cm from the margin of paracancerous tissues) and the samples of gastric cancer, colorectal cancer, lung cancer, thyroid cancer, prostate cancer, breast cancer, and kidney cancer tissues as well as their paracancerous tissues (3 cm from the tumor edge) were selected. Immunohistochemistry kits were used to detect the expression of NNMT protein in normal tissue samples, different tumor tissues and their paracancerous tissues. X-tile software combined with the receiver operating characteristics curve of NNMT in the diagnosis of tumor tissues and paracancerous tissues in papillary throid carcinoma were used to determine the optimal cut-off value (41.5); < 41.5 was treated as the NNMT protein low expression group and ≥ 41.5 was treated as the NNMT protein high expression group. The expression of NNMT protein in patients with papillary thyroid carcinoma with different clinicopathological characteristics was compared; Kaplan-Meier method was used to analyze the overall survival of the patients with papillary thyroid carcinoma; Cox proportional risk model was used to conduct multivariate analysis on the influencing factors of overall survival.Results:The prepared immunohistochemistry kits were valid for at least 12 months, with good intra-batch and batch-to-batch repeatability, good stability and specificity. NNMT protein was not or occasionally lowly expressed in colorectal, lung, thyroid, prostate, breast, kidney, and gastric tissues. NNMT protein was highly expressed in colorectal cancer, gastric cancer, breast cancer, kidney cancer, thyroid cancer, lung cancer, prostate cancer tissues, while lowly expressed in colorectal cancer, gastric cancer, breast cancer, kidney cancer, thyroid cancer, lung cancer, prostate cancer adjacent tissues. The high expression rates of NNMT protein in thyroiditis tissue, papillary thyroid cancer tumor tissue and paracancerous tissues were 15.79% (3/19), 68.97% (40/58) and 31.03% (18/58), respectively, and the high expression rate of NNMT protein in papillary thyroid carcinoma tissue was higher than that in thyroiditis tissue and paracancerous tissue. All patients with papillary thyroid cancer were divided into the NNMT protein high expression group (40 cases) and the low expression group (18 cases). There were no statistically significant differences in NNMT protein expression among patients with different age, gender, degree of differentiation, lump diameter, TNM stage, lymph node metastasis, and serum anti-thyroglobulin antibody (TgAb) level (all P > 0.05). The median overall survival time of 58 patients was 18.5 months, and the 5-year overall survival rate was 90.0%. The overall survival of patients with a lump diameter of ≥2 cm was worse than that of those with a lump diameter of < 2 cm ( P < 0.001), and the overall survival of patients with lymph node metastasis was worse than that of those without lymph node metastasis ( P = 0.041). The overall survival of patients in the NNMT protein high expression group was worse than that of those in the NNMT protein low expression group, and the overall survival of patients with high serum TgAb level was worse than that of those with low serum TgAb level, while the differences were not statistically significant (all P >0.05). Lump diameter ( HR = 35.56, 95% CI 2.64-478.25, P = 0.007), NNMT protein expression ( HR = 308.12, 95% CI 2.21-42 958.20, P = 0.023), serum TgAb level ( HR = 142.85, 95% CI 1.88-10 854.25, P = 0.025) were independent influencing factors for the OS of patients with papillary thyroid carcinoma. Conclusions:NNMT is highly expressed in various tumor tissues. NNMT expression is related to the prognosis of patients with papillary thyroid carcinoma;the patients with high expression of NNMT have worse prognosis compared with those with low expression of NNMT.
9.Comparison of the clinical efficacy of "one-cut" circumcision and traditional circumcision
Run ZHU ; Weizhe FAN ; Yuzhu LI ; Gang GUO ; Lu XIAO ; Yanzhong LIU
Journal of Modern Urology 2023;28(7):576-578
【Objective】 To introduce the key techniques of "one-cut" circumcision, and to compare its clinical efficacy with traditional circumcision. 【Methods】 A retrospective analysis was conducted on 120 cases of circumcision in our center during Jul.2020 and Jul.2022, including 60 cases in the "one-cut" group and 60 cases in the traditional circumcision group. The operation time, postoperative edema time, satisfaction with cosmetics and improvement of sexual life were compared between the two groups. 【Results】 Compared with the tradition group, the "one-cut" group had shorter operation time [(19.2±7.4) min vs. (23.1±1.7) min, P<0.001] , shorter postoperative edema time [(5.5±3.2) d vs. (9.6±5.5) d, P<0.001] , and higher satisfaction with cosmetics [(3.6±0.5) vs. (3.1±0.8), P<0.001)] , but there was no difference in improvement of sexual life between the two groups (P=0.08). 【Conclusion】 "One-cut" circumcision is easy to operate, with short operation time, fast postoperative recovery, neat incision and satisfactory appearance, which is worth popularizing.
10.Meta analysis of the efficacy of three kinds of uterine barriers in preventing re-adhesion after separation of moderate or severe intrauterine adhesion
Lifang WANG ; Xiaoyu LI ; Yuhuan LIU ; Yanzhong ZHAO
Chinese Journal of Postgraduates of Medicine 2023;46(1):57-63
Objective:To evaluate the efficacy of three kinds of uterine barriers: cook balloon, Foley balloon and intrauterine devices in preventing re-adhesion after separation of moderate or severe intrauterine adhesions.Methods:Seven databases including PubMed, Embase, Medline, Cochrane Library, China HowNet, Wanfang and CQVIP were used to retrieve, and the randomized controlled trials on the effect of using COOK balloon, Foley balloon and intrauterine devices to prevent re-adhesion after the separation of moderate and severe intrauterine adhesions were collected from the establishment of the database to December 2021. Revman 5.1 software was used for Meta analysis.Results:A total of 16 articles were selected according to the inclusion criteria. Meta analysis results showed that the rates of preventing postoperative re-adhesion, improving menstruation and pregnancy in COOK balloon were significantly better than those in intrauterine devices ( OR = 0.31, 2.75 and 1.58; 95% CI 0.19 to 0.49, 1.74 to 4.35 and 1.07 to 2.34; P<0.01); the rates of preventing postoperative re-adhesion, improving menstruation and pregnancy in Foley balloon were significantly better than those in intrauterine devices ( OR = 0.39, 1.90 and 1.73; 95% CI 0.27 to 0.57, 1.33 to 2.71 and 1.02 to 2.39; P<0.01 or <0.05). Conclusions:The use of COOK balloon and Foley balloon to prevent adhesion is better than the use of intrauterine devices in preventing re-adhesion in patients with moderate or severe intrauterine adhesions.

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