BackgroundSivelestat is widely used in treating acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), although the clinical efficacy of sivelestat remains controversial. This study aimed to evaluate the impact of sivelestat in patients with ALI/ARDS.MethodsElectronic databases, PubMed, Embase, and the Cochrane Library, were searched to identify trials through April 2017. Randomized controlled trials (RCTs) were included irrespective of blinding or language that compared patients with and without sivelestat therapy in ALI/ARDS. A random-effects model was used to process the data, and the relative risk (RR) and standard mean difference (SMD) with corresponding 95% confidence intervals (CIs) were used to evaluate the effect of sivelestat.ResultsSix RCTs reporting data on 804 patients with ALI/ARDS were included. Overall, no significant difference was found between sivelestat and control for the risk of 28–30 days mortality (RR: 0.94; 95% CI: 0.71–1.23; P = 0.718). Sivelestat therapy had no significant effect on ventilation days (SMD: 0.05; 95% CI: −0.27 to 0.38; P = 0.748), arterial oxygen partial pressure (PaO2)/fractional inspired oxygen (FiO2) level (SMD: 0.48; 95% CI: −0.45 to 1.41; P = 0.315), and intensive care unit (ICU) stays (SMD: −9.87; 95% CI: −24.30 to 4.56; P = 0.180). The results of sensitivity analysis indicated that sivelestat therapy might affect the PaO2/FiO2 level in patients with ALI/ARDS (SMD: 0.87; 95% CI: 0.39 to 1.35; P < 0.001).ConclusionsSivelestat therapy might increase the PaO2/FiO2 level, while it had little or no effect on 28–30 days mortality, ventilation days, and ICU stays. These findings need to be verified in large-scale trials.Electronic supplementary materialThe online version of this article (10.1186/s12890-017-0498-z) contains supplementary material, which is available to authorized users.

These results demonstrated that BTLA may be a therapeutic target for the treatment of severe CAP and that BTLA expression may reflect the body's immune status and guide decisions regarding steroid therapy for treating severe CAP.

Purpose Transcription co‐activator p300/CBP, a histone acetyltransferase, has a central role in tumours, inflammation and neurodegenerative diseases. We investigated the effect of p300/CBP and its association with various IL‐17‐related indicators and prognosis in patients with acute respiratory distress syndrome (ARDS). Materials and Methods We enrolled 45 adult ARDS patients who were followed for 28 days and 22 healthy controls. The mRNA expression of p300, CBP, RORγt and Foxp3 and the plasma levels of several cytokines were measured. Result The mRNA levels of p300, CBP and RORγt, and plasma concentration of IL‐17, IL‐6, were higher in acute ARDS patients (P < 0.05) compared with controls, and the mean levels of p300, CBP and IL‐6 in non‐survivors were higher than in survivors (P < 0.05). The expression of p300 was associated with the level of RORγt, IL‐17 and disease prognosis. Conclusion The levels of p300, RORγt mRNA and plasma concentration of IL‐6 and IL‐17 in acute ARDS patients were increased compared with controls. Increased p300/CBP expression may be an independent risk factor for 28‐day mortality in ARDS.