Effects of shikonin and paclitaxel on the expression of apoptosis-associated proteins in ESCC cells. Cells were exposed to 100 nM paclitaxel for 24 h in either the presence or absence of 1 µM shikonin. (A and B) Cellular proteins were analyzed by western blotting. Combined treatment with shikonin and paclitaxel markedly enhanced paclitaxel-induced increased levels of cleaved PARP and cleaved caspase 3, and p53 expression, while it suppressed Bcl-2 expression. Effects of shikonin and pactlitaxel on (C) Bcl-2 and (D) p53 mRNA were analyzed by reverse transcription-quantitative polymerase chain reaction. Significantly altered levels were observed in the combined treatment group compared with all other groups. Data were analyzed by one-way ANOVA with Dunnett's multiple comparisons test, and presented as the mean ± standard error or the mean from three independent experiments. **P<0.001. Ctr, control; PAX, paclitaxel; SHK, shikonin; PARP, poly (ADP-ribose) polymerase; c, cleaved; t, total.