The development of the internet has prompted a drastic change in the ecology of academic publication worldwide and Chinese journals are no exception. Some observers may note that the purpose of publishing provincial journals may be to present epidemiological findings mainly of local use and serve as a local publication outlet. However, as all of these journals are now available online, the original raison d'être of provincial journals to foster the exchange of research output on a provincial level may diminish. A doctor from Sichuan can now easily download a paper published in the Shanghai Journal of Preventive Medicine, while a scientist from Guangzhou (Canton) can easily publish his/her paper in the Zhejiang Journal of Preventive Medicine. One can imagine fierce competition for good research papers among these journals in the near future and through the invisible hand of the market, some journals may prosper and attain international status while others may wither and die.