Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2018; 6(3): 35-43
Published online Mar 16, 2018. doi: 10.12998/wjcc.v6.i3.35
Chinese research into severe ulcerative colitis has increased in quantity and complexity
Cheng-Xin Luo, Zhong-Hui Wen, Yu Zhen, Zhu-Jun Wang, Jing-Xi Mu, Min Zhu, Qin Ouyang, Hu Zhang
Cheng-Xin Luo, Zhong-Hui Wen, Yu Zhen, Zhu-Jun Wang, Jing-Xi Mu, Min Zhu, Qin Ouyang, Hu Zhang, Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Luo CX and Wen ZH contributed equally to this article; Luo CX designed the research, performed the databases search, and drafted the article; Wen ZH designed the research, repeated the databases search, and made critical revisions to the manuscript; Zhen Y, Wang ZJ, Mu JX and Zhu M performed literature review, recorded and checked relevant information, and did statistical analyses; Ouyang Q and Zhang H supervised the study and edited the Manuscript; All of the authors approved the version of the article to be published.
Supported by Doctoral Fund of Ministry of Education of China, No. 20130181120041.
Conflict-of-interest statement: There is no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Hu Zhang, MD, PhD, Associate Professor, Department of Gastroenterology, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu 610041, Sichuan Province, China.
Telephone: +86-28-85423387 Fax: +86-28-85423387
Received: November 23, 2017
Peer-review started: November 24, 2017
First decision: December 28, 2017
Revised: February 6, 2018
Accepted: February 28, 2018
Article in press: February 28, 2018
Published online: March 16, 2018
Research background

Severe ulcerative colitis (SUC) is a potentially life-threatening condition and its effective management remains a great challenge. China is experiencing an increasing incidence and prevalence of UC. However, data about the state of SUC related research outputs are unavailable and thus, a comprehensive study on the SUC-related Chinese publications is desperately needed. A bibliometric analysis and literature review of the SUC-related publications in Chinese periodical databases would provide more epidemiological information and provide a perspective of research hotspots.

Research motivation

The SUC research performance in China can be evaluated by the number of publications and the complexity of research designs presented with these manuscripts. Bibliometric analysis will provide information about the temporal trends of the number of publications and the change in complexity of the research described. Further, a literature review will provide information about the number of patients reported each year, the clinical characteristics, and the state of the management of SUC patients. Such a study can provide information useful for the design of new treatment programs for SUC patients worldwide.

Research objectives

The aim of this study is to perform a bibliometric analysis to determine the temporal trends in the number of Chinese publications on UC and SUC (2001-2015), to assess the overall SUC research performance; to provide a review of the data on treatment type and efficacy in SUC patients that has been reported in Chinese medical journals. Such a study can provide an understanding of the current state of research output from Chinese studies into SUC, a perspective of research hotspots, and provide information for SUC patient treatment worldwide.

Research methods

We retrieved the Chinese publications related to SUC published between 2001 to 2015 in the Chinese periodical databases (WANFANG, VIP, and China National Knowledge Infrastructure). The number of publications for each year was recorded after the duplicates were removed. The topic of each paper was recorded and only those that were clinical in nature were included in the assessment of the complexity of SUC research. The complexity of SUC research was evaluated according to the methods described by Scott et al. The proportion of the total within each group was compared in every 5-year period (2001-2015). The statistical significance of the differences between proportions was compared using a Chi-squared test where a P-value of < 0.05 was considered as statistically significant. The number of SUC patients reported in each year, the clinical characteristics of these patients, the treatment and efficacy reported were recorded and analyzed.

Research results

There were 201 publications regarding SUC published in Chinese medical journals between 2001 and 2015. The number of publications increased rapidly. Significant increase was found in analytical studies and clinical trials over the study period, with research into the management of SUC, included pharmacotherapy, nutrition support as well as surgery, predominating. About 46.2% of the observational analytical studies and clinical trials focused on Traditional Chinese Medicine, with little research on the efficacy of cyclosporin and infliximab in the disease management. About 6222 SUC patients were reported in 201 relevant papers (ratio of male/female patients: 1.38). The number of patients reported in each 5-year period significantly increased. The colectomy rate and short-term mortality rate were 7.7% and 0.8% respectively. Total proctocolectomy with ileal pouch-anal anastomosis was the most commonly employed operation.

Research conclusions

This study documents that significant progress has occurred in Chinese SUC research, as reflected by the increased output and complexity of publications available in research databases. The complexity of publications was evaluated with the new methods described by Scott et al. The number of patients reported significantly increased. The information on the clinical characteristics of SUC in Chinese patients obtained from our literature review should be verified and extended by further well-designed and detailed population-based studies. Although Traditional Chinese Medicine has been widely used as a complementary therapy for SUC, rigorous experiments and careful analysis of the resulting experimental data are required to validate the benefit and safety of this type of treatment. More research into the efficacy of treatment with cyclosporin or infliximab in Chinese SUC patients is required.

Research perspectives

Chinese research into severe ulcerative colitis has increased in quantity and complexity according to our bibliometric analysis. The methods previously described by Scott et al could be used to evaluate the complexity of publications for SUC and other diseases. We also reported an increase in the number of SUC patients, a male predominance in SUC incidence, and a lower risk of colectomy for Chinese patients compared with SUC outcomes worldwide. Further well-designed population-based studies are required to validate these results. In addition, more research into the efficacy of treatment with cyclosporin or infliximab in Chinese SUC patients is required.