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Objective: To estimate the effects of therapy of short veno-venous hemofiltration (SVVH, 4hr) on severe acute pancreatitis (SAP)., Methods: Twenty patients were divided randomly into hemofiltration group (HF, 10 pts) and non-hemofiltration group (NHF, 10 pts). The local, systemic manifestations were compared between two groups; and the concentration of serum pro-inflammatory cytokines (TNFalpha, IL-1beta, IL-6, IL-8, sIL-2R) and anti-inflammatory cytokines (IL-2, IL-10) were determined at different observation points., Results: In the HF and NHF group, the duration for disappearance of abdominal pain and tenderness, and amelioration for abdominal distension was (8.5 +/- 6.3) d vs. (90.0 +/- 49.0) d and (16.9 +/- 5.2) d vs. (63.4 +/- 36.0) d. CT scores at the 14th day and APACHE II scores at the 10th day was (5.6 +/- 1.3) vs. (7.7 +/- 0.8) and (4.5 +/- 1.5) vs. (7.4 +/- 2.1). The average hospital stay and cost of therapy were (33.0 +/- 20.7) d vs. (56.4 +/- 16.0) d and (53,200 +/- 16,000) vs. (89,100 +/- 25,000) RMB (P < 0.05). The concentration of 5 serum pro-inflammatory cytokines at each observation points after hemofiltration was decreased significantly (P < 0.05) in the HF group. But the concentration of the two serum anti-inflammatory cytokines was increased significantly (P < 0.05) as compared with that of the NHF group., Conclusions: Through SVVH, the imbalance of pro-inflammatory and anti-inflammatory cytokines has been corrected at early stage; thus, the severity of the disease is ameliorated significantly and the efficacy of therapy is increased.

Objective: To explore the effects of tumor necrosis factor-alpha (TNF-alpha) monoclonal antibody (MAb) on tissue TNF-alpha and lipopolysaccharide-binding protein (LBP) mRNA expression, and multiple organ dysfunction in rats after thermal injury., Method: 24 male Wistar rats were subjected to a 35% total body surface area full-thickness thermal injury., Result: The tissue TNF-alpha and LBP mRNA expressions of liver, lung, intestine, and kidney were markedly increased (P < 0.05 approximately equal 0.01) after thermal injury. Treatment with TNF-alpha MAb could significantly lower TNF-alpha mRNA expression of lung, intestine and kidney, but had no effect on liver TNF-alpha mRNA expression (P > 0.05). Similarly, the tissue LBP mRNA expression also decreased significantly (36.0% - 72.9%), and returned to normal in lung, intestine and kidney. In addition, biochemical parameters including GPT, TBiL, BUN, CK-MB, and LDH were markedly elevated after thermal injury, and decreased significantly after treatment with TNF-alpha MAb., Conclusion: The increase of tissue TNF-alpha gene expression caused by thermal injury might be associated with a marked elevation of tissue LBP mRNA expression, which could contribute to the development of multiple organ dysfunction. The early use of TNF-alpha MAb seems to be effective in inhibiting significant LBP mRNA expression in various tissues and ameliorating multiple organ damage after major thermal injury.