Metabolic associated fatty liver disease has become the most important chronic liver disease in China.Its mechanism is not completely clear.Professor Sheng Guoguang examines the symptoms and seek the cause,treats the disease by stages from the perspective of"earth-obstructing and wood-stagnation,phlegm and blood stasis",summarizes the core pathogenesis of each stage,and prescribes drugs for the pathogenesis.In the early stage,the disease is mainly caused by earth-obstructing and wood-stagnation and phlegm and blood stasis and the corresponding treatment method should be activating spleen to eliminate depression,relieving phlegm and promoting blood circulation,with common use of modified Sizhu Decoction combined with Erchen Decoction.In the middle stage,phlegm and blood stasis transform into heat are the main pathogenesis,and the appropriate treatment is clearing liver and purging fire,and relieving phlegm and promoting blood circulation,with common use of modified Xiaochaihu Decoction combined with Erchen Decoction.In the late stage,weakness of the internal organs is the main pathogenesis,and it is appropriate to nourish liver and fortify the spleen,tonifying the kidney and consolidate the root,supplementing with reducing phlegm and activating blood circulation,with common use of modified Yiguan Decoction combined with Liujunzi Decoction in modification,which has achieved confirmed clinical efficacy.

ObjectiveTo systematically review the ancient and modern literature about Maimendongtang, so as to provide a scientific basis for the modern clinical application and preparation research and development of Maimendongtang. MethodThe Chinese Medical Code (version 5) was searched with "Maimendongtang" as the keyword. The modern clinical studies of Maimendongtang were retrieved from CNKI with “Maimendongtang” as the keyword and the time interval from January 1, 1975 to December 31, 2022. The articles involving the main symptoms, herb composition, dosage, and decocting and medication methods of Maimendongtang were selected and screened according to the inclusion and exclusion criteria. Finally, the information including the book name, indications, herbs, dosage, and decocting and medication methods were included to summarize the ancient and modern application of Maimendongtang. ResultA total of 357 publications of Maimendongtang were included, involving 115 ancient books. Maimendongtang was first published in the Synopsis of the Golden Chamber by ZHANG Zhongjing in the Han dynasty. It is composed of Ophiopogonis Radix, Pinelliae Rhizoma, Ginseng Radix et Rhizoma, Semen Oryzae Sativae, Jujubae Fructus, and Glycyrrhizae Radix et Rhizoma. Despite the slight changes during the inheritance by later generations, the indications, herb composition, dosage, and decocting and medication methods of this formula were generally consistent with those in the Synopsis of the Golden Chamber. A total of 182 modern articles were included to analyze the clinical application of Maimendongtang. This formula was mainly used to treat respiratory system diseases, digestive system diseases, tumor-related diseases, etc. ConclusionAccording to the textual research on the ancient and modern literature, the composition, dosage, indications, and decocting and medication methods of Maimendongtang are basically consistent with those recorded in the Synopsis of the Golden Chamber. The modern clinical application not only follows the main indications but also expands the clinical application scope of this formula, which is mainly used to treat patients with the syndrome of yin deficiency of lung and stomach. The modern clinical application of Maimendongtang has promoted the inheritance and innovation of classic famous prescriptions and provided a scientific basis for the drug research and development.

Objective : To investigate the effects and mechanism of small ubiquitin-like modifier ( SUMO) specific proteinase-1 (SENP-1) on chronic intermittent hypoxia ( CIH) induced myocardial injury in rats． Methods : 32 male SD rats were randomly divided into : control group，CIH group，negative control adeno-associated virus interven- tion group (AAV-shNC) and SENP-1 shRNA adeno-associated virus intervention group (AAV-shSENP-1) ，with 8 rats in each group．After 6 weeks of CIH induction，echocardiography was performed．The levels of cardiac troponin I (cTNI) ，creatine kinase MB isoenzyme ( CKMB) ，myoglobin (Mb) ，lactate dehydrogenase (LDH) in serum and malondialdehyde (MDA) ，uperoxide dismutases ( SOD) ，glutathione ( GSH) ，interleukin( IL) -1 β , IL-6 and tumor necrosis factor-α(TNF-α) in myocardial tissue were detected by ELISA．The pathological changes of myocardial tis- sue was observed by HE staining．The reactive oxygen species ( ROS) level in myocardial tissue was detected by DCFH-DA fluorescence probe labeling．The small ubiquitin-like modifier (SUMO) level of hypoxia inducible factor- 1 α (HIF-1 α) protein in myocardial tissue was detected by kit．The mRNA and protein levels of SENP-1 and HIF- 1 α in myocardial tissue were detected by qRT-PCR and Western blot. Results : Compared with the control group， the pathological damage of myocardial tissue in CIH group was serious，the levels of left ventricular end diastolic diameter (LVEDD) ，left ventricular end systolic dimension (LVESD) and serum cTNI，CKMB，Mb and LDH signif- icantly increased (P＜0. 05) ，and the levels of ROS，MDA，IL-1 β , IL-6，TNF-α and the mRNA and protein levels of SENP-1 and HIF-1α in myocardial tissue also significantly increased (P ＜0. 05 ) ，while the levels of LVEF， LVFS，serum GSH and SOD significantly decreased (P ＜0. 05) ，and the SUMOylates level of HIF-1α protein in myocardial tissue also significantly decreased (P ＜0. 05 ) ．Compared with CIH group，AAV-shSENP-1 group had less myocardial pathological damage，the levels of LVEDD，LVESD and serum cTNI，CKMB，Mb and LDH signifi- cantly decreased (P＜0. 05) ，and the levels of ROS，MDA，IL-1 β, IL-6，TNF-α and the mRNA and protein levels of SENP-1 and HIF-1α in myocardial tissue also significantly decreased (P＜0. 05) ，the levels of LVEF，LVFS，serum GSH and SOD significantly increased (P＜0. 05) ，and the SUMOylates level of HIF-1α protein in myocardial tissue also significantly decreased (P＜0. 05) ． Conclusion Inhibition of SENP-1 expression can alleviate CIH induced myocarditis and oxidative stress in rats，improve myocardial injury and cardiac dysfunction，and its mechanism may be related to the improvement of HIF-1α SUMOylates level，thus inhibiting HIF-1α expression.