Resistance to cisplatin (DDP)-based chemotherapy is a major cause of treatment failure in human gastric cancer (GC).It is necessary to identify the drugs to re-sensitize GC cells to DDP.In our previous research,Zuo Jin Wan Formula (ZJW) has been proved could increase the mitochondrial apoptosis via cofilin-1 in a immortalized cell line,SGC-7901/DDP.Due to the immortalized cells may still difficult highly recapitulate the important molecular events in vivo,primary GC cells model derived from clinical patient was constructed in the present study to further evaluate the effect of ZJW and the underlying molecular mechanism.Immunofluores-cent staining was used to indentify primary cultured human GC cells.Western blotting was carried out to detect the protein expression.Cell Counting Kit-8 (CCK-8) was used to evaluate cell proliferation.Flow cytometry analysis was performed to assess cell apoptosis.ZJW inhibited proliferation and induced apoptosis in primary DDP-resistant GC cells.Notably,the apoptosis in GC cells was mediated by inducing cofilin-1 mitochondrial translocation,down-regulating Bcl-2 and up-regulating Bax expression.Surprisingly,the level of p-AKT protein was higher in DDP-resistant GC cells than that of the DDP-sensitive GC cells,and the activation of AKT could attenuate ZJW-induced sensitivity to DDP.These data revealed that ZJW can increase the chemosensitivity in DDP-resistant primary GC cells by inducing mitochondrial apoptosis and AKT inactivation.The combining chemotherapy with ZJW may be an effective therapeutic strategy for GC chemoresistance patients.