ObjectiveTo compare the development status of health facilities in different regions （non-agricultural and agricultural districts）and different types across four dimensions： organizational management， health environment， health activities， and health outcomes， to explore factors that may affect the current development status and summarize effective experiences， and to provide a foundation for the subsequent comprehensive， standardized， and effective promotion of health facility development and tiered and classified management. MethodsInvestigators conducted a health status survey based on the four dimensions for 50 health facilities in 16 districts of Shanghai， representing three types （including government agencies， enterprises， and communities）. Evaluation forms were filled out through on-site observation and document reviews， which were developed in accordance with the Shanghai Health Settings Evaluation Standards （for trial implementation in 2019）. ResultsThe average total score of health facilities in Shanghai was （88.42±11.93） points， with an overall excellence rate of 86.0%. The excellence rate of each dimension， from highest to lowest， were healthy environment （84.0%）， organizational management （82.0%）， health activities （78.0%）， and health outcomes （44.0%）. Health facilities in agricultural districts scored higher in both total score and average score on the organizational management dimension compared to non-agricultural districts. The excellence rate for the organizational management dimension was also higher in agricultural districts than in non-agricultural districts. There was no statistical significance in the total score， the score of each dimension， the overall excellence rate， and the excellence rate of each dimension among different types of health facilities （P>0.05）. ConclusionThe development of health facilities among government agencies， enterprises， and communities in Shanghai has begun to yield positive results. Health facilities in non-agricultural districts should actively draw on the experience of those in agricultural districts， particularly in organizational management， adjust development ideas and planning based on their own realities， so as to continuously improve the levels of development.

The construction of healthy schools is one of the key measures to implement the Outline of the Healthy China 2030 Plan. The establishment and implementation of the Guidelines for Healthy Primary and Secondary School Evaluation （Guidelines） is helpful for the large-scale promotion and standardization of healthy school construction by government departments in Shanghai and other major cities in China， thereby more students benefited from the Healthy China Initiative. The Guidelines integrate the efforts of multiple departments related to school health， based on internationally recognized content and strategies for health-promoting schools. They aim to foster students’ health development by combining the basic requirements for school health with priority projects for health promotion. Healthy school evaluation indicators and standardized requirements suitable for the current socio-economic development level of Shanghai have been developed， aligning with international concepts of health-promoting schools. They also reflect a high starting point and high level of investment and development in school health in Shanghai over the past decade. The Guidelines provide recommendations on the basic requirements， organization guarantees and management， social and culture environment， health promotion education， health services， and connection between school and communities， and families， of healthy school evaluation for primary and secondary schools. This paper aims to interpret the compilation process and main content of the Guidelines.

Various types of industrial parks in Shanghai play an important role in promoting industrial upgrading and technological progress， yet they are also fraught with occupational health hazards. To effectively promote workplace health and enable various industrial parks to play a positive role， the Shanghai Municipal Government has proposed accelerating the construction of healthy industrial parks. To meet the requirements for the scientific and standardized construction of healthy parks， the Shanghai Municipal Center for Disease Control and Prevention has compiled the Guidelines for Healthy Industrial Park Construction（Guidelines）. Adhering to the overall principles of scientific， feasibility， advancement， and standardization， the Guidelines address three construction levels： industrial parks， employers， and employees. They set clear requirements for organizational management， healthy environments， health services， health activities， and occupational health in the workplaces， respectively. The Shanghai healthy industrial park evaluation form was provided as an informative appendix for the Guidelines. The Guidelines offer a scientific basis for standardizing and guiding the construction of healthy industrial parks， providing new solutions and technical support for urban occupational health management.

The development of health-promoting hospitals is an important part of the Healthy China Initiative， facilitating the transformation of medical institutions from a primary focus on medical and surgical treatments to a patient-centered approach prioritizing public health. To promote the scientific， standardized， and sustainable development of health-promoting hospitals， the Shanghai Municipal Center for Health Promotion， together with Shanghai General Hospital and other institutions， has jointly developed the Standards for the Development of Health⁃promoting Hospitals （Standards） in accordance with the principles of scientific rigor， feasibility， and advancing with the times. The Standards outlines the requirements for the development of health-promoting hospitals across four aspects： organizational and institutional guarantees， creation of a healthy environment， implementation of health education and promotion， and evaluation. It is applicable to all levels and types of public medical institutions in Shanghai， and can also be referred to and implemented by other medical institutions. The introduction of the Standards is of great significance for promoting the formation of a long-term mechanism in health-promoting hospitals. This paper introduces the basis， principles， main content， precautions， and implementation suggestions of the Standards. Taking into account relevant policies and standards， it interprets the technical aspects in the process of developing health-promoting hospitals， which is helpful for medical institutions and their management to better understand and apply the standards in their work.

ObjectiveTo analyze the epidemiological characteristics of pathogens in foodborne disease cases in Haining City， Zhejiang Province， and to provide a basis for the prevention and investigation of foodborne diseases and outbreak events. MethodsInformation on foodborne disease patients from 2014 to 2023 was collected， and stool or anal swab samples were tested for relevant pathogens. The χ² test was used to compare the differences in pathogen detection rates among different groups， and multivariate logistic regression analysis was used to analyze the risk factors for pathogen detection. ResultsA total of 5 814 samples were tested， with a positive detection rate of 15.36%. The detection rates were 4.95% for norovirus， 4.49% for Escherichia coli， 3.59% for Salmonella， 2.22% for Vibrio parahaemolyticus， and 0.11% for Shigella. The positive detection rates showed seasonal characteristics， with a minor peak in March-April dominated by norovirus and a major peak in July-September dominated by bacteria. The three groups with the highest detection rates were workers， white-collar workers and other groups. Multivariate logistic regression analysis showed that age， season， and antibiotic use before consultation were significant influencing factors for pathogen detection （P<0.05）. Total pathogen detection risk was lower in the group that took antibiotics before visiting the clinic compared to those who did not （OR=0.29， 95%CI： 0.15‒0.49）. The detection risk for norovirus was lower in the preschool age group （OR=0.19， 95%CI： 0.04‒1.00）， in summer and autumn （OR range 0.23‒0.41）， and in the group taking antibiotics （OR=0.42， 95%CI： 0.15‒0.92）， but higher in the adolescent group （OR=1.40， 95%CI： 1.05‒1.88）. The detection risk for enteropathogenic Escherichia coli was higher in summer （OR=1.82， 95%CI： 1.30‒2.60）. The detection risk for Salmonella increased in the elderly group and in summer （OR range 1.44‒2.21）， but decreased in the adolescent group， in winter， and in the group taking antibiotics （OR range 0.22‒0.65）. The detection risk for Vibrio parahaemolyticus increased in summer and autumn （OR range 1.80‒1.90）， but decreased in the primary and secondary school student group and in winter （OR range 0.10‒0.32）. ConclusionThe prevalence of foodborne disease pathogens in Haining City is relatively high. Age， season， and antibiotic use before consultation are independent influencing factors for pathogen detection. These findings suggest that specific hypotheses regarding pathogenic factors can be proposed based on the time of occurrence and the age distribution of cases during field investigations of foodborne outbreaks.

ObjectiveTo investigate the contamination status of Staphylococcus aureus in food and the presence of enterotoxin genes in Jiading District， Shanghai， and to provide a basis for the prevention and treatment of foodborne Staphylococcus aureus disease. MethodsFrom 2021 to 2023， 15 types of food were sampled for S. aureus testing， and the presence of five enterotoxin genes， including sea⁃see， was tested in the strains. ResultsOut of 705 food samples， 88 （12.48%） were positive for S. aureus. S. aureus was detected in 12 of the 15 food types， with the three food types with the highest positive rates being cold noodles （45.00%）， raw poultry （26.25%）， and vegetable salads （20.00%）. The enterotoxin gene carriage rate was 32.95% in food strains. The carriage rates for sea， seb， and sec were 7.95%， 12.50%， and 14.77%， respectively. Neither sed nor see was detected. The detection rate of strains carrying two types of enterotoxin genes was 2.27%. The enterotoxin carriage rates in strains from vegetables， beverages， and raw meat were 57.14%， 40.00%， and 30.00%， respectively. ConclusionThe S. aureus detection rate in food in Jiading District is much higher than the national average. The enterotoxin gene carriage rates are high， with food strains carrying sea， seb， and sec， with sec being the most prevalent. There is a need to enhance monitoring of S. aureus and enterotoxins， especially in high-risk foods such as noodles， vegetables， and non-packaged beverages.

A foodborne poisoning incident occurred in a street， Ouhai District， Wenzhou City， Zhejiang Province on May 9， 2023， which was caused by the accidental consumption of medicinal liquor containing aconitum alkaloids. Three individuals drank homemade aconite-containing medicinal liquor and were subsequently poisoned， of which two cases were severe， and one case was mild. All three patients exhibited symptoms such as numbness in the mouth， tongue and limbs， dizziness， fatigue， nausea， vomiting， and blurred vision. Two of them successively entered a state of shock and coma， with an incubation period of approximately 30 minutes. Among seven samples of suspected homemade medicinal liquor， one sample tested positive simultaneously for aconitine， neaconitine， hypaconitine， and benzoylaconitine， with concentrations of 62.3 mg·L^-1， 2.6 mg·L^-1， 17.7 mg·L^-1， and 31.6 mg·L^-1， respectively. Four kinds of aconite alkaloids were detected in all the urine， blood， and vomit samples from the patients， and the most toxic aconitine was detected at levels of 1.5 μg·L^-1， 5.9 μg·L^-1， and 26.2 μg·L^-1， respectively. Based on the field epidemiological investigation， combined with clinical manifestations and laboratory test results， it was determined that this incident was a case of food poisoning caused by the accidental consumption of medicinal liquor containing aconite. Due to timely rescue and proper treatment measures， all poisoned patients have recovered， with no fatalities. It is suggested that relevant authorities should strengthen the regulation of the processing and sale of aconite herbs and promote the awareness of food safety.

ObjectiveTo establish a method using ultra-high performance liquid chromatography-tandem mass spectrometry （UHPLC-MS/MS） for the detection of six common trichothecene toxins in oats. MethodsOats were selected as the research subject in this study. Response surface design was used to optimize the QuEChERS extraction method. Additionally， a rapid and efficient strategy for sample extraction and purification was developed. Combined with UHPLC-MS/MS， six commonly co-occurring trichothecene toxins in oats were quantitatively analyzed simultaneously. ResultsThis method demonstrated good analytical performance for each analyte across the corresponding concentration ranges （r>0.99）， with accuracy ranging from 87.26% to 99.64%. The inter-day and intra-day relative standard deviations were less than 6.8% and 5.5%， respectively， indicating its potential for practical application. This method was used to detect mycotoxins in 12 oat samples from China， and it was found that one sample exceeded the standard limits for deoxynivalenol （DON）， and the co-contamination of trichothecene toxin was prevalent. ConclusionThe risk posed by these toxins has been underestimated. Ongoing， extensive monitoring is necessary to provide contamination data to assess the consumer risk.

ObjectiveTo identify and clarify the key issues faced by tertiary hospitals in responding to public health emergencies. MethodsA literature review index system was constructed， and key issues were identified using hierarchical analysis. ResultsAfter a systematic literature review， 20 types of problems faced by tertiary hospitals in responding to public health emergencies were identified. Three key issues were ultimately identified by prioritizing the issues that needed to be addressed. ConclusionThe key issues of tertiary hospitals in responding to public health emergencies are concentrated in the areas of emergency response capabilities and competencies of medical staff， the number of emergency response personnel， and the standardization and specificity of training and drills. Tertiary hospitals should focus on these issues in developing public health emergency response systems to improve the effectiveness of their emergency response.

ObjectiveTo identify the key issues in emergency response to public health emergencies in the Yangtze River Delta region， and to provide a basis for the formulation of relevant policies. MethodLiterature on emergency response to public health emergencies in the Yangtze River Delta region was systematically reviewed and collected， and 18 main problems were identified after collecting and organizing the problems. A questionnaire survey and cluster analysis were used to identify the key issues. ResultsThe study of 18 major problems revealed that "insufficient reserve of emergency medical supplies"， "insufficient financial investment to meet the needs of emergency response"， "lack of a sound mechanism for the deployment of supplies， resulting in the untimely deployment of materials"， were the key issues of emergency response to public health emergencies in the Yangtze River Delta region. ConclusionFuture development of the emergency response system in the Yangtze River Delta region should focus on accelerating the integration process of the Yangtze River Delta， establishing and improving information systems， optimizing the material storage and deployment network， prioritizing the fund investment and utilization mechanism， and improving the effectiveness of public health emergency response.