Objective    To explore the mechanism of how shikonin to reverse the multi-drug resistance of human choriocarcinoma cells.     Methods    JAR/MTX cells were divided into 4 groups. The cell growth condition of each group at 24

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and 72 h was observed and cell adhesion rate was calculated. β-HCG values at 24 and 48 h after adding drugs were assayed. Cytomorphologic changes were observed by H-E staining. The gene expression of survivin and Bcl-2 was detected by S-P immunocytochemistry and RT-PCR.     Results    There was no significant difference in cell adhesion rate and secretion of β-HCG between methotrexate treatment group and control group (P0.05)

but there was difference between shikonin group and control one (P0.05).The strong effect was noted after combining use of methotrexate and shikonin as compared with control group (P0.01). There were significant differences in mRNA and protein expression of survivin and Bcl-2 between shikonin group and control one (P0.01).     Conclusion    Shikonin can reverse drug-resistance of JAR/MTX to methotrexate by down-regulating the expression of survivin and Bcl-2 and accelerating apoptosis. Shikonin is promising as a synergist of chemotherapy used for choriocarcinoma.