***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract Systemic inflammatory response syndrome ( SIRS ) prevention is key to severe acute pancreatitis ( SAP ) treatment and the assessment of high-volume hemofiltration ( HVHF ) for treating SAP accompanying multiple organ dysfunction syndromes . In this prospect i ve controlled study , 40 SAP patients were divided into 2 groups : control ( n = 22 , treated with fasting , decompression , and intravenous somatostatin ) and HVHF ( n = 18 , HVHF administration in addition to the treatment in the control group ) groups ; and were assessed for serum and urine amylase , WBC , C-reactive protein ( CRP ) , and hepatic and renal functions . Vital signs and abdominal symptoms were recorded , and complications and mortality were analyzed . APACHE II scores in the HVHF group were significantly lower than in the control group at 3 and 7 days ( 6.3 ± 1.7 vs 9.2 ± 2.1 and 3.3 ± 0.8 vs 6.2 ± 1.7 , respectively ) . Compared with controls , serum , and urine amylase , WBC , CRP , and organ functions significantly improved after HVHF treatment . Meanwhile , mortality ( 16.7 % vs 31.8 % ) and complication ( 11.1 % vs 40.9 % ) rates were significantly reduced . The other clinical parameters were significantly ameliorated by HVHF . HVHF rapidly reduces abdominal symptoms and improves prognosis , reducing mortality in SAP patients ; and is likely through systemic inflammatory response syndrome attenuation in the early disease stage BACKGROUND AND OBJECTIVES The evidence for high-volume hemofiltration plus hemoperfusion ( HVHF&HP ) for hyperlipidemic severe acute pancreatitis ( HL-SAP ) is anecdotal . The purpose of our study was to evaluate the efficacy of HVHF&HP for HL-SAP in a prospect i ve controlled study . DESIGN AND SETTING Prospect i ve controlled pilot study between May 2010 and May 2013 in a hospital intensive care unit . PATIENTS AND METHODS HL-SAP patients chose conventional treatment alone (  the control group ) or conventional treatment combined with the experimental protocol  ( the HVHF&HP group ) and were prospect ively followed in our hospital . APACHE II score , SOFA score , ICU and hospital stay duration , and serum biomarkers were considered endpoints . RESULTS Ten HL-SAP patients accepted conventional treatment alone  ( the control group ) and 10 patients underwent HVHF&HP combined with conventional treatment ( the HVHF&HP group ) . The APACHE II score , SOFA score , systolic blood pressure , diastolic blood pressure , heart rate , serum amylase , and serum creatinine were significantly reduced after the HVHF&HP treatment . The changes in these variables were significantly different between the HVHF&HP and control group at 48 hours after the initiation of treatment . Patients in the HVHF&HP group had a significantly shorter ICU stay ( P=.015 ) . The reduction in serum triglyceride and cholesterol in the HVHF&HP group after 2 , 6 , 12 , 24 , and 48 hours was greater than the control group . All of the tested serum cytokines were significantly decreased after HVHF&HP treatment ( P<.05 ) . However , in patients who underwent conventional treatment alone , there was no significant change in the serum cytokines . CONCLUSION This study suggests that the addition of HVHF&HP to conventional treatment for HL-SAP patients may be superior to conventional treatment alone for the improvement of serum biomarkers and clinical outcomes OBJECTIVE To evaluate the efficacy of early continuous high-volume-hemofiltration in the treatment of patients with severe acute pancreatitis ( SAP ) . METHODS Based on the method of prospect i ve , r and omized and controlled clinical trial , 60 patients with SAP between January 2005 and July 2011 from the First Affiliated Hospital of Nanchang University were divided into control group and hemofiltration group . The hemofiltration group was treated with early continuous high-volume-hemofiltration and not in the control group . The changes of vital signs , clinical symptoms and laboratory indicators were compared between the two groups before and after the treatment . RESULTS After hemofiltration , the clinical symptoms such as abdominal pain , fever , tachycardia and respiratory distress in hemofiltration group were significantly remitted compared to those in the control group ( P < 0.05 ) . The APACHEIIscore ( 13.3 ± 1.0 vs 14.1 ± 1.2 ) and the level of TBil [ ( 20.4 ± 11.3 ) µmol/L vs ( 28.1 ± 10.9 ) µmol/L ] , creatinine [ ( 178.7 ± 71.8 ) µmol/L vs ( 215.6 ± 51.3 ) µmol/L ] , blood urea nitrogen [ ( 10.1 ± 5.6 ) mmol/L vs ( 13.2 ± 3.8 ) mmol/L ] and ALT [ ( 51.3 ± 13.2 ) U/L vs ( 62.5 ± 14.3 ) U/L ] were decreased compared to those in the control group ( all P values < 0.05 ) . The level of PaO2/FiO2 ( 197.3 ± 32.4 vs 178.3 ± 31.7 ) was increased ( P < 0.05 ) . After hemofiltration , heart rate was decreased gradually ( P < 0.05 ) in the hemofiltration group than in the control group . Mean artery pressure ( mAP ) increased gradually ( P < 0.05 ) in the hemofiltration group than in the control group . CONCLUSION Early continuous high-volume-hemofiltration has significant effects on the treatment of SAP including the improvement of clinic symptoms , the blockade of development from systemic inflammatory response syndrome ( SIRS ) to multiple organ dysfunction syndrome ( MODS ) , improvement of organ function and prevention from the complications . It may become one of the important therapies for SAP Objectives : To evaluate the efficacy of adjunctive continuous high-volume hemofiltration ( HVHF ) in patients with severe acute pancreatitis . Methods : Seventy-five patients admitted to the intensive care unit for severe acute pancreatitis from July 2006 to May 2009 were given informed consent and were followed prospect ively . Patients were divided into 4 groups according to whether they accepted continuous HVHF ( 42 vs 33 ) and if they showed signs of acute kidney injury . Results : Patients of the 4 groups were comparable at baseline . The 28-day survival rate was higher in patients who accepted HVHF ( 81 % vs 57.6 % , P = 0.026 ) , especially in those without acute kidney injury ( 95 % vs 66.7 , P = 0.026 ) . Furthermore , after 72 hours of therapy , the patients who accepted HVHF had significantly better Acute Physiology and Chronic Health Evaluation II scores ( 16.8 ± 4.37 vs 13.39 ± 3.17 ; P < 0.05 ) , body temperature ( 38.2 ° C ± 1.01 ° C vs 37.73 ° C ± 0.95 ° C ; P < 0.05 ) , urine volume ( 1186 ± 841 mL vs 2381 ± 2462 mL ; P < 0.05 ) , and base excess ( −6.3 ± 4.5 vs 0.64 ± 3.4 ; P < 0.05 ) . However , the improvement in patients who did not accept HVHF was not so obviously . Conclusion : High-volume hemofiltration was associated with improved clinical outcome in acute pancreatitis patients , and should be initiated before kidney injury appearance Objectives This study aim ed to conduct a single-center prospect i ve trial of short-term continuous high-volume hemofiltration ( HVHF ) in patients with predicted severe acute pancreatitis ( SAP ) . Methods Patients with acute pancreatitis with Acute Physiology and Chronic Health Evaluation II scores of greater than 15 on admission between January 2008 and December 2010 were allocated to receive either optimal st and ard therapy or 72 hours of continuous HVHF on an alternate basis , beginning as soon as possible after admission . Biomarkers and clinical outcomes were compared between the 2 groups . Results A total of 61 patients received either conventional therapy ( n = 29 ) or HVHF ( n = 32 ) . High-volume hemofiltration treatment was associated with a significant reduction in the incidence of renal failure ( P = 0.013 ) , infected pancreatic necrosis ( P = 0.048 ) , length of hospitalization ( P = 0.005 ) , mortality ( P = 0.033 ) , as well as duration of renal ( P < 0.001 ) , respiratory ( P = 0.002 ) , and hepatic failure ( P = 0.001 ) . Acute Physiology and Chronic Health Evaluation II score and C-reactive protein and interleukin 6 levels were significantly reduced after the start of HVHF on days 1 , 3 , and 7 ( all , P < 0.05 ) . Conclusions This study suggests that short-term HVHF may reduce local and systemic complications and mortality in patients with SAP with Acute Physiology and Chronic Health Evaluation score of greater than 15 OBJECTIVES The aim of this study was to investigate the effect of continuous blood purification ( CBP ) on early gut mucosal dysfunction in patients with severe acute pancreatitis ( SAP ) . METHODS Patients with SAP were r and omized to receive 24 hours of continuous veno-venous hemofiltration ( CVVH ; n = 33 ) or no CVVH ( n = 30 ) . Blood sample s were taken from the patients at 0 , 6 , 12 , and 24 hours during CVVH therapy . Serum diamine oxidase ( DAO ) and endotoxin , epithelial permeability , transepithelial electrical resistance ( TER ) and F-actin rearrangement of the epithelial monolayer were used as the markers for the assessment of gut barrier function and the effect of CBP therapy in patients with SAP . RESULTS Patients with SAP had increased levels of serum DAO , endotoxin , and epithelial permeability when compared with normal controls , and the increase was more pronounced in patients with organ dysfunction ( p<0.01 ) . F-actin rearrangement , loose cell-cell junction , and iNOS mRNA upregulation were found in all patients . After CBP treatment , Acute Physiology and Chronic Health Evaluation II score and SOFA score improved significantly ; levels of serum DAO , endotoxin , and epithelial permeability decreased(p<0.05 ) . CBP also significantly attenuated reorganization of actin and downregulated iNOS mRNA expression and NO production ( p<0.05 ) . CONCLUSIONS CBP can not only improve the general conditions but also effectively improve gut barrier dysfunction . The beneficial effect of CBP on gut barrier dysfunction is associated with the improvement of cytoskeletal instability , by downregulating iNOS through the removal of excess proinflammatory factors OBJECTIVE To explore the protective effect of continuous veno-venous hemofiltration ( CVVH ) on tissue and organ damage induced by severe acute pancreatitis ( SAP ) . METHODS Thirty-seven SAP patients were r and omly divided into  CVVH group ( n=22 ) and control group ( n=15 ) . Patients in control group were treated with conventional therapy , while patients in CVVH group were treated with conventional therapy combined with CVVH .  Serum amylase ( AMS ) and lipase ( Lip ) , the plasma levels of endotoxin , tumor necrosis factor-alpha ( TNF-alpha ) , interleukin-1beta ( IL-1beta ) , and C-reactive protein ( CRP ) , and faecal occult blood test and blood serum leukocyte were determined . Functions of brain , kidney , liver , heart and lung were observed . RESULTS The treatment effect was better in CVVH group than that in normal group . The mortality rate was lower and the number of hospitalization day was decreased in CVVH group than those in normal group , they were 18.2 percent vs. 33.3 percent and ( 18.3+/-5.7 ) days vs. ( 27.5+/-8.6 ) days . CONCLUSION CVVH has a significant protective effect against tissue and organ damage induced by SAP Objectives : Early aggressive intravenous hydration is recommended for acute pancreatitis treatment although r and omized trials have not documented benefit . We performed a r and omized trial of aggressive vs. st and ard hydration in the initial management of mild acute pancreatitis . Methods : Sixty patients with acute pancreatitis without systemic inflammatory response syndrome ( SIRS ) or organ failure were r and omized within 4 h of diagnosis to aggressive ( 20 ml/kg bolus followed by 3 ml/kg/h ) vs. st and ard ( 10 ml/kg bolus followed by 1.5 mg/kg 
    Output:
    
Conclusion : Compared with conventional treatment , CBP remedy evidently improved clinical outcomes , including reduced incidence organ failure , decreased serum amylase , APACHE II score , length of stay in the ICU and lower mortality rate , leading us to conclude that it is a safer treatment option for SAP .