Objective: To test whether nonalcoholic hepatic steatosis sensitizes carbon tetrachloride (CC14)-induced liver injury,and to assess the therapeutic effect of Chinese medicine extracts of Dangfei Liganning capsules (当 飞利肝宁胶囊)and their potential underlying mechanisms.Methods: Male Wistar rats were fed a high-fat diet to induce nonalcoholic fatty liver disease (NAFLD) or a normal diet (N).Eight weeks later,a nonlethal dose of CC14 was applied intraperitoneally.From the start,HF-CC14 rats were administered daily Dangyao extracts (D),Dangfei Liganning capsules (DF),or Diammonium Glycyrrhizinate (G) intragastrically.Rats were sacrificed 48 h after CC14 administration.In addition to serum biochemistry,liver histopathology was observed using hematoxylin-eosin (HE) and oil red O staining,and hepatic levels of triglyceride (TG),malondialdehyde (MDA),glutathione (GSH),superoxide dismutase (SOD),caspase-3 activation and cytochrome P450 (CYP2E1) expression were assessed.Results: There was almost no response to the nonlethal dose of CC14 in the N control group.However,the HF group demonstrated massive steatosis,and elevated levels of serum ALT and AST,liver MDA,CYP2E1,and caspase-3 activation,whereas the levels of GSH and SOD were significantly decreased.All indexes assessed were dramatically worse in the HF-CC14 group compared to the HF group,in addition to the more severe steatosis,hepatocyte ballooning,and inflammatory infiltration apparent in the centrilobular area.The medicines we tested affected the pathological changes in HF-CC(l)4 rats to differing degrees: DF and G led to improvements in all of the above examined indexes,including an obvious improvement in histopathology,and DF improved serum ALT and MDA levels more markedly than G,whereas D extracts produced only mild liver injury attenuation.Conclusion: Liver with NAFLD is more sensitive to hepatotoxicity; furthermore,the disrupted balance of oxidative stress and anti-oxidant defense contributes to the underlying mechanisms.Dangfei Liganning capsules potentially decrease this toxic susceptibility and alleviate liver injury in non-alcoholic fatty liver.