To curb the increase in health care costs and improve government efficiency , a series of structural and governance reforms for U.S.Military Health System(MHS) were implemented, which is the biggest structural organizational change in the MHS′s history.The reform focusing on the establishment of Defense Health Agency ( DHA) and enhancement of multi-service markets will achieve its goal by the end of 2015.This paper analyzes the major reasons for the reform and changes of the U.S.MHS before and after the reform and offer some tips for the reform of the Chinese Military Health System .

The U.S.Armed Forces Forward Surgical Team ( FST) was first used in the Gulf War , while Operation Iraqi Freedom and Operation Enduring Freedom represented the largest military operations to date in which the FST has been utilized.The FST was an integral and major component of the Medical Brigade and provided support for echelon Ⅱmedical care.This paper describes the development of FST , investigates the roles, organization and training of FST and finally brings forward some enlightenment for health service development of Chinese PLA .

An integrated district health care model is an important field development .Since 2007, The US Armed Forces have been constructing district health care systems , integrating the medical resources in National Capital Region and San Antonio.The two new established district health care systems have been making military health care more effective while reducing costs and improving the quality of care to beneficiaries .

Objective By analyzing domestic and foreign papers on plague research with bibliometrics and visualized methods, we explored the current situation research trends and cutting-edge dynamics in order to provide information sup-port for plague research as well as strategies for countering bioterrorism.Methods Based on data sources from SCI and CNKI databases, bibliometrics and visualized methods were adopted,including Pajek,VOSviewer, Bibexcel and Citespace, so as to show the major cutting-edge areas of plague research.Results Comprehensive research analysis showed that the USA is leading in plague research, with some strong related institutions.There is still a gap between China and international community for research.Academy of Military Medical Sciences and other institutions are our main plague research efforts. Conclusion We should strengthen plague research, improve our overall level of plague research to provide the necessary support for effective response to natural epidemics and potential bioterrorism incidents.

Objective To find the course of theme evolution for study of medical protection against nerve agents.Meth-ods A method of information visualization based on co-cited analysis was used.The research domain of medical protection against nerve agents was mapped using software VOSviewer.Results There were five research clusters including clinical research, oxime reactivators, detoxification and detection,and bioscavengers.Conclusion Theme evolution is described and research trends are predicted.

Human enhancement technology is an emerging field that aims to enhance human physical and mental power of humans with the latest developments of the life science , information science , electronic science , cognitive neuroscience and other fields .This paper provides an overview of status quo of human enhancement technology and its military applica -tions, and analyzes the factors that may adversely affect its applications .

Based on a study of the relationship between research hospitals and furthering of the healthcare reform,the authors hold that a key to the ongoing reform lies in building the hierarchical medical system,an objective in building and development of research hospitals as well.Furthering of the reform will highlight advantages of such hospitals,as they can play an important role in leading practice with theoretical innovation,translating frontier technology to clinical use,promoting the system to serve primary care,and upgrading quality effectiveness at general level.

Objective To develop an early diagnosis strategy for radiation-associated breast angiosarcoma after breast cancer radiotherapy (RABASBCR) and to avoid the misdiagnosis of this disease.Methods A systematic search of PubMed for published reports of RABASBCR cases was performed.The clinical manifestations and radiological features in the early stage of disease,as well as biopsies,were analyzed to screen out valuable markers for early diagnosis and develop the early diagnosis strategy for RABASBCR.Results Fifty-five original articles involving 80 RABASBCR patients were selected for this analysis.Twenty-four (30％) of the 80 patients were misdiagnosed;the median time of misdiagnosis was 3 months (1-24 months).The earliest symptom was skin changes in 76 (95％) of the 80 patients.The misdiagnosis rates of ultrasound,mammography,computed tomography,and magnetic resonance imaging for RABASBCR were 9/9,31/32,2/2,and 1/5,respectively.The misdiagnosis rates of fine needle biopsy,core needle biopsy,and incisional biopsy were 7/14,12/25,and 10/26,respectively.Conclusions By analyzing published case reports,we have set up the early diagnosis strategy for RABASBCR with reference to the Cahan criteria.

Objective To identify research fronts of synthetic biology by mapping knowledge domains .Methods The research articles were clustered by co-cited analysis and bibliographic coupling while research domains of synthetic biology were mapped using software VOSviewer .Results There were seven research clusters by co-cited analysis and 32 clusters by bibliographic coupling .The articles published in the last two years have changed the structure of research domains .Con-clusion Bibliographic coupling is better at recognizing research fronts .Synthetic bioengineering , RNA expression , biology bone, biology library,and biology parts are research fronts of synthetic biology .

Objective To analyze domestic and foreign papers on H5N1 virus research using literature metrology and visualized knowledge mapping.Methods Pajek, Bibexcel,and VoSviewer software were used based on Web of Knowledge platform.Results Study on H5N1 virus has been a research focus wide since 2005 and a series of institutions and investi-gators have appeared, with US being the leader in this area and followed by China.The most popular topics of studies on H5N1 included its virology, epidemiology, basic research, anti-virus drugs and vaccines.Conclusion Studies on H5N1 have received more attention, which suggests that more efforts have to be made in China in terms of communication and co-operation with key institutions and famous researchers so as to achieve more success in key areas.