China has Asia's most extensive stem cell research effort, with a particular emphasis on driving innovative adult stem cell therapies toward clinical trials. Although it is hard to find statistics that pull together China's fast-growing patchwork of stem cell initiatives, the country must have at least 300 researchers in the field, working in 30 separate institutions.

A delegation sent late last year by the UK Department of Trade and Industry to look at stem cell research in Asia visited a dozen Chinese labs and concluded: "The facilities were, in every case we saw, equipped, funded and staffed to levels at least as good--in most cases better--than equivalent centres in the UK".Chinese stem cell labs have plenty of well-motivated junior staff, many of whom have returned from postgraduate training in Europe and North America. The senior researchers, who have also worked abroad, are providing strong leadership, but there seems to be a temporary gap in the middle, among the cadre of postdoctoral scientists who form the background of the scientific effort in the West. China has a few rudimentary stem cell companies, but commercialisation is still at an early stage.

Like their counterparts elsewhere in Asia, Chinese stem cell researchers benefit from an ethical and regulatory environment that is generally more favourable to stem cell research than in even the most permissive Western countries. "The status accorded to the embryo is similar to that in the UK, but regulations are operated in China with a fairly light touch", says Genevra Richardson, professor of public law at Queen Mary, University of London. "Most ES research teams in China use fresh embryos".

China is well represented in embryonic stem cell work, with at least 10 ES cell lines established in the country--and is working on therapeutic cloning. "China has better access to human oocytes than we have in the West--and fantastic nuclear transfer skills", says Peter Mountford, chief executive of Stem Cell Sciences, based in Edinburgh. "There are many extremely dextrous hands available to manipulate those tiny dots [human eggs]".

But the Chinese scene is still dominated by adult stem cell work. "There is a very significant focus on clinical translation, which is much more palatable in China than in the US or Europe", says Stephen Minger of King's College London. "Treatments will be pushed ahead more quickly than in the West".

A colourful example is Jianhong Zhu of Huashan Hospital, part of Shanghai's Fudan University. He is working with adult neural stem cells, extracted from brain tissues exposed in patients who suffer open head wounds. (A classic local example is the "chopstick injury", in which a barbed bamboo chopstick is pushed--usually through an eye socket--into the head during an argument over a meal; when the stick is removed, enough brain tissue sticks to it to be a source of neural stem cells.) Zhu has obtained encouraging results from a clinical trial in which eight such patients had their own neural stem cells cultured and transplanted back into the site of their injury; they fared significantly better than eight matched controls who had open brain surgery but no cell grafting.