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China already has the highest numbe of,and largest cities in its history. According to recent statistics, Chinese cities were home to 52.6% of China's total population at the end of 2012. If the current trend holds, it is predicted that by 2025 the Chinese urban population will be over 1 billion including eight megacities, each with a population of over 10 million. Urbanisation is part of a central strategy of the Chinese Government to aid development and gradually raise welfare standards. Meanwhile, environmental problems in China are getting more severe which now threatens the balance of sustainable development. To address the environmental challenges caused by and in cities and to balance its economic growth with social and environmental aspects, China has made itself a vast living laboratory for sustainable urban development approaches. Many city concepts such as green city, garden city, and eco-city and low-carbon city have been promoted and put into practicein the past two decades at different levels and scales. The reasons why so many concepts have been used in China are: the vague definition of sustainable development; different governmental departments have been engaged in promoting different concepts each with a different focus; the concept itself evolved over time. One common feature of these concepts is that none of them is well defined. However, there is a clear trend that the concepts are becoming more comprehensive regarding their coverage of more aspects of sustainability. Case analysis of the more popular concepts eco-city, low-carbon city, low-carbon eco-city, eco-civilization, and other experiences show, that the lack of definition of the concepts proves important barriers in practice. It's not possible to clearly define these concepts because they are more or less value based, but it is desirable to develop more scientifically based frameworks within which urban planning can be carried out. Another barrier is that urban planning in China is implemented with a confused backdrop of a state ...

Zhongping Duan,1,* Shaojie Xin,2,* Jing Zhang,1 Shaoli You,2 Yu Chen,1 Hongling Liu,2 Sujun Zheng,1 Zheng Li,3 Robert Ashley,3 Michael Millis4 1Artificial Liver Center, Beijing You'an Hospital of Capital Medical University, Beijing, China; 2Department of Infectious Disease, Division III, 302 Military Hospital of China, Beijing, China; 3Research and Development, Vital Therapies, Inc, San Diego, CA, USA; 4Department of Surgery, University of Chicago, Chicago, IL, USA *These authors contributed equally to this work Background: Preliminary evidence of safety and efficacy of an extracorporeal cellular therapy (ELAD®) has been demonstrated in subjects with acute forms of liver failure. This study compared ELAD with standard of care in Chinese subjects with acute-on-chronic liver failure (ACLF), predominantly secondary to chronic viral hepatitis.Subjects and methods: Subjects meeting eligibility criteria were randomized to either the ELAD group or the control group. All subjects received plasma exchange and venovenous hemofiltration and either ELAD treatment for 3–5 days, unless terminated early, along with standard of care or standard of care alone (control) and were then followed up for 12 weeks.Results: Forty-nine subjects (ELAD subjects, 32; controls, 17) were randomized under this protocol. Kaplan–Meier analysis of transplant-free survival (TFS) revealed a significant difference in favor of ELAD vs control (P=0.049, Wilcoxon signed-rank test). There was a significant difference in TFS on day 28 in ELAD vs control (P=0.022). In a multiple regression model, the relationship between group assignment and outcome was significant (P=0.031) when changes in food intake and Model for End-Stage Liver Disease (MELD) scores at screening were included as additional independent variables. The duration of ELAD treatment alone was a significant predictor of TFS (P=0.043). Median time to a 5-point increase in MELD, transplant, or death was longer than 72 days with ELAD vs 26 days for control (P=0.036). Total bilirubin level decreased by 25% during ELAD treatment vs 37% increase in the control group (P<0.001) over an equivalent period. Adverse events attributed to the ELAD system were expected and could be managed conservatively. Intergroup differences in certain vital signs and laboratory parameters were noted during treatment and generally resolved posttreatment.Conclusion: ELAD treatment was well tolerated by Chinese subjects with ACLF, predominately secondary to chronic viral hepatitis. Results demonstrate a significant improvement in TFS in ELAD vs control groups in association with significant improvements in serum bilirubin levels presumably related to improvement in hepatic function. Keywords: acute-on-chronic liver failure, ELAD, bioartificial liver support, ACLF, C3A cells, cellular therapy