Neurosurgical publications in China: an analysis of the web of science database
© Liu et al. 2015
Received: 19 May 2015
Accepted: 12 October 2015
Published: 18 December 2015
Neurosurgery in China has made great progress. The aim of this study was to analyze neurosurgical publications by Chinese authors using the Web of Science database as a way to illustrate the current state of neurosurgery in China.
We searched the Web of Science core database for articles containing “neurosurg*” with or without an author address in “China” to obtain the set of neurosurgical publications in China and worldwide. We then extracted data from the search results to obtain information such as document type, countries/territories, organizations, publication year, title and research area. Then, we analyzed the search results of articles (document type) to generate a citation report. We identified publications by Chinese neurosurgeons that were cited more than 100 times.
A total of 165,365 neurosurgical publications were identified. Among them, 10,770 were published by Chinese neurosurgeons. Chinese neurosurgical publications have increased year by year, accounting for 2 % of neurosurgical publications before 2010 and rising to 13 % from 2010 to the present. The most frequent journals for Chinese neurosurgeons differ from the most frequent journals worldwide. We identified 34 Chinese organizations that published more than 100 publications. We also identified 19 studies written by Chinese neurosurgeons that were cited more than 100 times. Basic research represents a large proportion of Chinese publications in this area, while clinical research remains a weak area. Cooperative studies were overrepresented among Chinese studies.
While China’s publication output in the area of neurosurgery has made great progress, significant room for improvement remains. The next step is to strengthen Chinese neurosurgical clinical studies and improve the publishing environment for Chinese neurosurgeons.
For historical reasons, the field of neurosurgery has developed in China along its own unique path [1, 2]. Today’s China is more open than ever, including in academic research. Chinese neurosurgeons need to learn from their foreign counterparts, while doctors outside China also need to know what Chinese doctors have done. Publications represent the best bridge between these groups. In recent years, China doctors have begun to realize the importance of publication, and have begun to capture their discoveries and experience in publications to communicate their findings to others. As the main international academic language is English, Chinese neurosurgeons have to publish their work in English to reach worldwide recognition. As a result, language limitations obstruct academic exchanges between Chinese doctors and those from other countries.
Chinese neurosurgeons have published a significant body of work. Thus far, Chinese neurosurgery has made significant achievements in both clinical practice and scientific research, obtaining worldwide recognition and respect. As China has the largest population in the world, it should represent the largest disease resource database, and the voices of Chinese physicians should be well represented in the academic discussion. The first task is to understand the work that has already been done by Chinese neurosurgeons and China’s current position in the field.
The most commonly used medical biological databases—PubMed, Web of Science, and Google Scholar—each have their own strengths and weaknesses . Among them, Web of Science (WoS) is a strong research database that was officially inaugurated in 2004 by the Thomson Scientific and Health Care Corporation. The WoS database not only contains the affiliations of all authors but also provides the numbers of citations of published articles. WoS provides access to Thomson Reuter’s multidisciplinary databases of bibliographic information. WoS is a powerful web interface providing access to the citation database . WoS offers a significant advantage for literature reviews in some particular fields [5, 6], especially for efforts to understand overall trends [7, 8]. Previous studies have evaluated Chinese neurosurgical publications, but they only focused on local Chinese journals  or carried out only superficial research on Chinese neurosurgical publications . The aim of this study was to comprehensively analyze neurosurgical publications in China using the WoS database.
The Web of Science (WoS) database was accessed on May 4, 2015. Publications in the Web of science core collection database were searched for publications of all types with authors’ addresses containing “neurosurg*” or “surgical neurology”. The number of publications and other information was obtained. In the first stage, an international comparison of neurosurgeons’ research outputs by country was carried out. Then, the search was divided into two periods, before 2010 (1928–2009) and after 2010 (2010 to present) to extract more detailed information.
Chinese neurosurgical publications were identified using the following search strategy: ((address: neurosurg*) OR (address: surgical neurology)) AND (address: China). Data were extracted from the search results to obtain information such as document type, countries/territories, funding agencies, organizations, publication year, title and research area. Then, the search results were analyzed using the “analyze results” tool on the WoS webpage.
We only included articles in the citation report, excluding reviews, meeting abstracts, letters, editorial material and other document types. We searched for papers with Chinese corresponding authors cited more than 100 times to identify Chinese neurosurgeons playing important roles in research. We also spoke with senior experts in the neurosurgical field and manually retrieved some original documents to ensure a complete survey.
Publications from the departments/institutes of neurosurgery in China and data sources from the Web of science core collection database were searched. The types of publications included articles, letters, reviews, proceedings papers, editorial materials, and more. Analyses included yearly research output, research output over the whole time period, WoS subject category, authors, organizations/institutes that submitted published articles, and the names of journals publishing articles.
Data from WoS were exported to a Microsoft Office® Excel spreadsheet and then transferred to a Microsoft Word document. We considered the top ranked publications in each item. ANOVA, Student’s t-, and c2 tests were used to assess the statistical significance of differences in the mean citation numbers among different study periods (SPSS version 17.0; SPSS Inc., Chicago, IL, USA). A p value <0.05 was considered statistically significant (2-tailed test).
Proportional growth in Chinese publications
Details of Chinese neurosurgical publications
The top 10 journals publishing Chinese’s and world neurosurgeon’s publications
Chinese neurosurgeon publications
World neurosurgeon publications
% of all
% of all
Chinese medical journal
Journal of neurosurgery
Journal of clinical neuroscience
Neural regeneration research
Childs nervous system
Journal of neuro oncology
Neurologia medico chirurgica
Journal of clinical neuroscience
Clinical neurology and neurosurgery
Journal of neuro oncology
Organizations who published more 100 publications in China
% of all
Capital Medical University
Beijing Neurosurgical Institute
Shanghai Jiao tong University
Fourth Military Medical University
China Medical University
Second Military Medical University
Chinese University Of Hong Kong
Harbin Medical University
Third Military Medical University
China Medical University Taiwan
Tianjin Medical University
Nanjing Medical University
Southern Medical University China
Sun Yat Sen University
Prince Of Wales Hospital
Chinese Academy of Sciences
China Medical University Hospital Taiwan
Chinese Academy Of Medical Sciences Peking Union Medical College
Huazhong University of Science Technology
Central South University
Xi An Jiaotong University
University of Hong Kong
Chongqing Medical University
Fujian Medical University
Chinese neurosurgical publications cited more than 100
Glioma-Derived Mutations in IDH1 Dominantly Inhibit IDH1 Catalytic Activity and Induce HIF-1 alpha. 
Zhao, Shimin; Lin, Yan; Xu, Wei; Jiang, Wenqing; Zha, Zhengyu; Wang, Pu; Yu, Wei; Li, Zhiqiang; Gong, Lingling; Peng, Yingjie; Ding, Jianping; Lei, Qunying; Guan, Kun-Liang; Xiong, Yue
Stroke in China: epidemiology, prevention, and management strategies 
Liu, Ming; Wu, Bo; Wang, Wen-Zhi; Lee, Li-Ming; Zhang, Shi-Hong; Kong, Ling-Zhi
The Lancet Neurology 2007, 6:456–64.
hsa-mir-181a and hsa-mir-181b function as tumor suppressors in human glioma cells 
Shi, Lei; Cheng, Zihao; Zhang, Junxia; Li, Rui; Zhao, Peng; Fu, Zhen; You, Yonyping
Brain research 2008, 1236:185–93.
Conversion of human umbilical cord mesenchymal stem cells in Wharton’s jelly to dopaminergic neurons in vitro: Potential therapeutic application for parkinsonism 
Fu, YS; Cheng, YC; Lin, MYA; Cheng, H; Chu, PM; Chou, SC; Shih, YH; Ko, MH; Sung, MS
Stem cells (Dayton, Ohio) 2006, 24:115–24.
Improved outcomes from the administration of progesterone for patients with acute severe traumatic brain injury: a randomized controlled trial 
Xiao, Guomin; Wei, Jing; Yan, Weiqi; Wang, Weimin; Lu, Zhenhui
Critical care (London, England) 2008, 12:R61
Astrocyte elevated gene-1 is a novel prognostic marker for breast cancer progression and overall patient survival 
Li, Jun; Zhang, Nu; Song, Li-Bing; Liao, Wen-Ting; Jiang, Li-Li; Gong, Li-Yun; Wu, Jueheng; Yuan, Jie; Zhang, Hui-Zhong; Zeng, Mu-Sheng; Li, Mengfeng
Clinical cancer research : 2008, 14:3319–26.
Monodisperse water-soluble magnetite nanoparticles prepared by polyol process for high-performance magnetic resonance imaging 
Wan, Jiaqi; Cai, Wei; Meng, Xiangxi; Liu, Enzhong
Chemical communications (Cambridge, England) 2007:5004–6.
Early indicators of prognosis in 846 cases of severe traumatic brain injury 
Jiang, JY; Gao, GY; Li, WP; Yu, MK; Zhu, C
Journal of neurotrauma 2002, 19:869–74.
Downregulation of miR-21 inhibits EGFR pathway and suppresses the growth of human glioblastoma cells independent of PTEN status 
Zhou, Xuan; Ren, Yu; Moore, Lynette; Mei, Mei; You, Yongping; Xu, Peng; Wang, Baoli; Wang, Guangxiu; Jia, Zhifan; Pu, Peiyu; Zhang, Wei; Kang, Chunsheng
Laboratory investigation; 2010, 90:144–55.
MicroRNA-128 inhibits glioma cells proliferation by targeting transcription factor E2F3a 
Zhang, Yu; Chao, Tengfei; Li, Ran; Liu, Wei; Chen, Yang; Yan, Xingqi; Gong, Yanhua; Yin, Bin; Liu, Wei; Qiang, Boqing; Zhao, Jizhong; Yuan, Jiangang; Peng, Xiaozhong
Journal of molecular medicine (Berlin, Germany) 2009, 87:43–51.
Detection of multiple gene amplifications in glioblastoma multiforme using array-based comparative genomic hybridization 
Hui, ABY; Lo, KW; Yin, XL; Poon, WS; Ng, HK
Laboratory investigation; 2001, 81:717–23.
Effect of long-term mild hypothermia therapy in patients with severe traumatic brain injury: 1-year follow-up review of 87 cases 
Jiang, JY; Yu, MK; Zhu, C
Journal of neurosurgery 2000, 93:546–9.
Incidence and trends of stroke and its subtypes in China - Results from three large cities 
Jiang, B; Wang, WZ; Chen, HL; Hong, Z; Yang, QD; Wu, SP; Du, XL; Bao, QJ
Stroke; 2006, 37:63–8.
Influence of patients’ age on functional recovery after transplantation of olfactory ensheathing cells into injured spinal cord injury 
Huang, HY; Chen, L; Wang, HM; Xiu, B; Li, BC; Wang, R; Zhang, J; Zhang, F; Gu, Z; Li, Y; Song, YL; Hao, W; Pang, SY; Sun, JZ
Chinese medical journal 2003, 116:1488–91.
Surgical management of brain-stem cavernous malformations: Report of 137 cases 
Wang, CC; Liu, A; Zhang, JT; Sun, B; Zhao, YL
Surgical neurology 2003, 59:444–54; discussion 454
Clinical evaluation and follow-up outcome of diffusion tensor imaging-based functional neuronavigation: a prospective, controlled study in patients with gliomas involving pyramidal tracts. 
Wu, Jin-Song; Zhou, Liang-Fu; Tang, Wei-Jun; Mao, Ying; Hu, Jin; Song, Yan-Yan; Hong, Xun-Ning; Du, Gu-Hong
Neurosurgery 2007, 61: 935–48; discussion 948-9
Poly-L-lactic acid/hydroxyapatite hybrid membrane for bone tissue regeneration 
Sui, Gang; Yang, Xiaoping; Mei, Fang; Hu, Xiaoyang; Chen, Guoqiang; Deng, Xuliang; Ryu, Seungkon
Journal of biomedical materials research Part A 2007, 82:445–54.
Overexpression of astrocyte elevated gene-1 (AEG-1) is associated with esophageal squamous cell carcinoma (ESCC) progression and pathogenesis 
Yu, Chunping; Chen, Kun; Zheng, Haiqing; Guo, Xianzhi; Jia, Weihua; Li, ManZhi; Zeng, Musheng; Li, Jun; Song, Libing
Carcinogenesis 2009, 30:894–901.
An in vivo evaluation of a biodegradable genipin-cross-linked gelatin peripheral nerve guide conduit material 
Chen, YS; Chang, JY; Cheng, CY; Tsai, FJ; Yao, CH; Liu, BS
Biomaterials 2005, 26:3911–8.
Research area trends
Comparing publications before and after 2010, the distribution of worldwide publications among different research areas has changed somewhat. The following research areas have increased in proportion between the two periods: oncology, research experimental medicine, orthopedics, general internal medicine, cardiovascular system, cardiology, cell biology, pharmacology, and pharmacy.
As for Chinese publications, basic research areas such as cell biology, pharmacology, pharmacy, biochemistry, and molecular biology represent a higher proportion of publications compared with other countries. Clinical research areas such as neurosciences, neurology, and surgery are underrepresented among Chinese publications compared with the rest of the world (Fig. 5).
International collaborative research
Citation report of all China neurosurgeon’s publications and cooperation publications
All Chinese publications
Sum of the Times Cited
Citing Articles without self-citations
Average Citations per Item
For historical reasons, Chinese neurosurgeons have only recently begun to publish their work in English language publications. Compared with foreign neurosurgeons, Chinese neurosurgeons have not historically published prolifically. With China’s development, the health care system in China has entered a new era. Chinese physicians need to update their knowledge to remain consistent with global trends, and they also want to share their findings with the world. Publications represent the ideal medium for these communications, and Chinese doctors have recognized this point.
The research output of Chinese neurosurgeons has increased every year, with a growth rate obviously higher than the worldwide average. The proportion of neurosurgical publications with Chinese authors has increased to 13 %, second only after the United States (35 %). Both the quality and quantity of Chinese research has improved, facilitating exchange with neurosurgeons all over the world.
This study highlights the great gap in neurosurgery between China and developed countries. While clinical practice research is an important area of research (neurosciences, neurology, and surgery) for neurosurgeons throughout the world, this research area represents a weak point for Chinese neurosurgeons. In real clinical work, Chinese neurosurgeons also follow guidelines from developed countries. Each country’s clinical practice has its own features, and issues with the implementation of clinical practice guidelines must be taken into account [11, 12]. Chinese neurosurgeons should develop guidelines in line with their evidence combined with their social and cultural environment . This calls for increased attention to clinical research in the future.
China presents several advantages for clinical research. China has the largest population base, the largest pool of disease cases, and the largest group of neurosurgeons. Chinese clinical research results should be credible and widespread because of the large number of Chinese neurosurgeons. Meanwhile, we should maintain our strength in basic research, as these research results can be translated into clinical practice.
Chinese authors have infrequently published in the classic neurosurgical journals such as “Journal of Neurosurgery” and “Neurosurgery”. To solve this problem, Chinese neurosurgeons need to target these journals with the aim of allowing more foreign counterparts to understand what Chinese doctors have done. Although there are a few neurosurgical journals in China, they are all published in Chinese and can only be read by Chinese readers. A direct way to expand the influence of Chinese neurosurgery is to build China’s own neurosurgical publication platform. “Chinese Neurosurgical Journal” is the first Neurosurgical journal published in English in China. There is no doubt that “Chinese Neurosurgical Journal” will play an important role in introducing Chinese studies to the world.
Capital Medical University and Fudan University are the leading Chinese organizations in this field, mainly because these two universities have very well-known neurosurgical centers, such as the neurosurgical departments in Tiantan Hospital  and Huashan Hospital . Beijing Neurosurgical Institute (number 3 in the list) is also set in Beijing Tiantan Hospital and has many links with Beijing Tiantan Hospital. The list of organizations shows that most of the organizations are in central cities of eastern China, reflecting China’s vast territory and unbalanced development.
China presents several advantages for clinical research. China has he largest population base, the largest pool of disease cases, and the largest group of neurosurgeons. Chinese clinical research results should be credible and widespread because of the large number of Chinese neurosurgeons.
Neurosurgeons play an unparalleled role in the development of brain research. Neurosurgery is a rapidly developing field of research, and now that Chinese neurosurgeons have begun to play a major role in this field, they should seize the opportunity and continue to publish important basic and clinical research in top journals in the field.
Limitations of this study
While the Web of Science is an excellent database, it has several limitations. Web of Science is an English-language database, containing very little literature in other languages. This may lead to a selection bias.
Another limitation comes from scientometrics and bibliometrics. The statement that “no one metric can fully capture the complex contributions scholars make to their disciplines” highlights the deficiencies of the journal impact factor (JIF) . There is a growing view that for greater accuracy, the JIF must be supplemented with an article-based assessment and peer-review . Therefore, this study valued article-based citations rather than the journal impact factor.
While Chinese neurosurgical publication has made great progress, there is still significant room for improvement. The next step is to strengthen Chinese neurosurgical clinical studies and to improve the publishing environment of Chinese neurosurgeons in an effort to introduce the results to the rest of the world.
No additional acknowledgements.
Dr. Weiming Liu received funding for this study from Capital Medical University Basics-Clinical Research Cooperation Fund (15JL49).
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