Abstract Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive dysfunction and behavioral impairments. Currently, the treatment mainly relies on pharmacotherapy, yet its effectiveness is limited and accompanied by adverse reactions. Multimodal non-pharmacological interventions (MNPI), which combine two or more non-pharmacological intervention approaches, can synergistically improve cognitive function, neuropsychiatric symptoms, activities of daily living, and quality of life in AD patients, and offers advantages of safety, cost-effectiveness and simplicity. This article reviews MNPI-related literature published domestically and internationally from 2018 to 2024, and focuses on the application of cognitive training, physical activity, and other combined intervention methods in MNPI, providing the reference for developing personalized interventions for AD.

Abstract： Schizophrenia is a common serious mental disorder, and genetic and environmental factors jointly contribute to the pathogenesis of schizophrenia. A correlation has been found between atmospheric particulate matter and the risk of schizophrenia, and short-term exposure to fine particulate matter (PM2.5) and inhalable particulate matter (PM10) may pose lagged and cumulative effects on the development of schizophrenia. Based on review of national and international publications, this review summarizes the associations between exposure to PM2.5 and PM10 and the risk of schizophrenia, so as to provide insights into the management of schizophrenia.

Objective: To investigate the mental health literacy levels among residents in Ningbo City, so as to provide the evidence for implementing the mental health service policy and targeted mental health education. Methods: Permanent residents at ages of 12 years and older were recruited in Ningbo City using the multi-stage stratified random sampling method from August to December, 2020. Subjects' mental health literacy levels were evaluated using the national mental health literacy survey of China, and the gender-, age-, region- and educational level-specific levels of mental health literacy were investigated. Results: A total of 6 654 questionnaires were allocated, and 6 392 valid questionnaires were recovered, with an effective recovery rate of 96.06%. The respondents included 2 967 men ( 46.42% ) and 3 425 women ( 53.58% ). The respondents were predominantly at ages of 18 to 44 years ( 2 705 residents, 40.19%) , lived in urban areas ( 3 823 residents, 59.81% ), and had an educational level of junior high school and below ( 3 195 residents, 49.98% ). The level of mental health literacy was 19.06%, and the score of mental health knowledge was ( 64.06±18.39 ) points. In the dimension of mental health skills, the scores of interpersonal support, cognitive reappraisal and transferred attention were ( 2.58±0.51 ), ( 2.45±0.57 ) and ( 2.82±0.49 ) points, and the score of mental health awareness was ( 3.63±0.47 ) points. A higher level of mental health literacy was seen in women than in men ( 20.64% vs. 17.22%, P<0.05 ) and in urban residents than in rural residents (20.95% vs. 16.23%, P<0.05 ). In addition, there were age- and educational level-specific levels of mental health literacy among residents ( P<0.05 ), and a higher level was seen in residents at ages of 18 to 45 years ( 28.98% ) and with a bachelor degree (40.89% ). Conclusions A high level of mental health literacy is found in residents in Ningbo City. Mental health promotion campaigns are recommended among men, rural elderly residents with a low educational level.

Objective: To investigate the preliminary screening results of Alzheimer's disease (AD) among the elderly in Ningbo City, Zhejiang Province and analyze the influencing factors, so as to provide insights into prevention and control of AD in the elderly. Methods: A multi-stage stratified proportional sampling method was used to select the registered residents aged 60 years and older in Ningbo City as subjects. Demographic characteristics, lifestyle factors, physical conditions and social activities of the subjects was evaluated with questionnaires. AD was screened using the Mini-Mental State Examination (MMSE), and factors affecting the positive rate of AD preliminary screening were identified using a multivariable logistic regression model. Results: A total of 34 027 elderly residents were investigated, with an mean age of (71.71±6.89) years. There were 15 115 males (44.42%) and 18 912 females (55.58%), 16 146 residents living in rural areas (47.45%) and 17 881 residents living in urban areas (52.55%). The positive rate of AD preliminary screening was 7.28% (2 476 cases). Multivariable logistic regression analysis showed that age (70 to 74 years, OR=1.357; 75 to 79 years, OR=1.807; 80 to 84 years, OR=2.782; 85 years and older, OR=4.907), gender (female, OR=1.118), residence (urban areas, OR=0.713), marital status (unmarried, OR=3.078; widowed/separated/divorced, OR=1.301), educational level (primary school, OR=0.629; junior high school and above, OR=0.609), occupation before retirement (others, OR=0.741), family genetic history (no, OR=0.651), household disposable monthly income (1 000 to 1 999 Yuan, OR=0.636; 2 000 to 2 999 Yuan, OR=0.569; 3 000 Yuan and above, OR=0.448), exercise (seldom, OR=0.855; regular, OR=0.780), number of chronic diseases (2~5, OR=1.328), hearing loss (no, OR=0.764), smell loss (no, OR=0.615), chronic constipation (no, OR=0.696), major negative life events (no, OR=0.804), subjective memory loss (no, OR=0.583), sleep quality (general, OR=0.640; good, OR=0.616), living style (living with spouse, OR=0.300; living alone, OR=0.315; living with children, OR=0.350) and social activities (2-3 times/week, OR=0.584; 4 times/week and more, OR=0.409) were factors affecting the positive rate of AD preliminary screening. Conclusions The positive rate of AD preliminary screening among the elderly in Ningbo City is relatively high. Age, gender, economic conditions, exercise, social activities and physical conditions were factors affecting the positive rate of AD preliminary screening.

Objective: To investigate the factors affecting depression and anxiety symptoms among the elderly, so as to provide the basis for promoting mental health among the elderly. Methods: The elderly aged 60 years and above in Ningbo City, Zhejiang Province were recruited using the multistage stratified random sampling method from June to August 2022, and demographic information, lifestyle and self-rated health status were collected by questionnaires. The symptoms of depression and anxiety were assessed by the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7), respectively. The presence of depressive and anxiety symptoms was determined when both the PHQ-9 score and the GAD-7 score were 10 points and higher. Factors affecting depressive and anxiety symptoms were identified using a multivariable logistic regression model. Results: A total of 7 771 individuals were surveyed, including 3 490 males (44.91%) and 4 281 females (55.09%), and had a mean age of (72.11±6.79) years. The prevalence of depression and anxiety symptoms was 2.05%. Multivariable logistic regression analysis identified residence (urban area, OR=0.316, 95%CI: 0.201-0.498), sedentary duration (<3 h/d, OR=0.349, 95%CI: 0.232-0.525; 3-5 h/d, OR=0.458, 95%CI: 0.313-0.671), physical activity (≥3 times/week, OR=0.551, 95%CI: 0.373-0.815), sleep quality (poor, OR=2.491, 95%CI: 1.738-3.571), social isolation (OR=1.688, 95%CI: 1.148-2.481) and self-rated health (poor, OR=5.857, 95%CI: 3.547-9.671; normal, OR=1.903, 95%CI: 1.234-2.937) as the influencing factors for depression and anxiety symptoms among the elderly. Conclusion The prevalence of depression and anxiety symptoms among the elderly is associated with residence, sedentary duration, sleep quality, physical activity, social interactions and self-rated health status.

Objective To evaluate the effect of hydrogen on mitochondrial dynamics during endotoxin-induced damage to human umbilical vein endothelial cells (HUVECs).Methods HUVECs cultured in vitro were seeded in the culture plate and divided into 4 groups using a random number table:control group (group C),hydrogen-saturated culture medium group (H group),endotoxin group (group E) and endotoxin + hydrogen-saturated culture medium group (group E+H).The cells were cultured in the plain culture medium in C and E groups.The cells were cultured in the hydrogen-saturated culture medium containing lipopolysaccharide (LPS) with the final concentration of 10 μg/ml in H and E+H groups.At 2,8 and 24 h of culture or incubation with LPS,the cell viability was detected by methyl thiazolyl tetrazolium assay,the intracellular ATP content was measured using the phosphomolybdic acid colorimetric method,and the expression of dynamin-related protein 1 (DRP1) was detected by using Western blot.The expression of DRP1 was detected by immunofluorescence at 8 h of incubation with LPS.Results Compared with group C,the cell viability and ATP content were significantly decreased,and the expression of DRP1 was up-regulated at each incubation time point in E and E +H groups (P＜0.05),and no significant change was found in the parameters mentioned above in group H (P＞0.05).Compared with group E,the cell viability and ATP content were significantly increased,and the expression of DRP1 was down-regulated at each incubation time point in group E+H (P＜0.05).Conclusion The mechanism by which hydrogen reduces endotoxin-induced damage to HUVECs is related to down-regulation of DRP1 expression and inhibition of excessive mitochondrial fission.

Objective: To investigate the incidence, distribution features, and incidence trend of occupational diseases in Ningbo, China, from 2006 to 2015. Methods: In February 2016, the data on occupational disease report cards in the occupational disease and occupational health information system from 2006 to 2015 were collected to perform a comprehensive analysis of the types, incidence trend, population characteristics, and enterprise characteristics of occupational diseases. Results: There were 845 new cases of occupational diseases in Ningbo from 2006 to 2015, among which 596 (70.53%) were pneumoconiosis; there were 445 (74.66%) cases of stage I pneumoconiosis, 73 (12.25%) cases of stage II pneumoconiosis, and 78 (13.09%) cases of stage III pneumoconiosis; silicosis (59.76%) was the most common type of pneumoconiosis. Of all patients with occupational diseases, 84.97% were male, 64.50%were aged 35-55 years, and 63.67% had 5-20 working years. Most of the patients with occupational diseases worked in small and medium-sized private (or foreign) enterprises; the most common industries were black metal smelting and rolling (38.76%) , construction (17.11%) , and non-metallic ore mining (13.09%) . A total of 51.28%, 10.26%, and 7.69% of the patients with occupational poisoning worked in the electric apparatus manufacturing industry, furniture manufacturing industry, and chemical raw material and chemical product manufacturing industry, respectively. The cases of occupational diseases are mainly distributed in Yuyao City (24.62%) , Yinzhou District (23.91%) , and Ninghai County (15.62%) . Conclusion Pneumoconiosis is the most common type of occupational disease in Ningbo and most of these patients work in small and medium-sized private (or foreign) enterprises. The supervision of small and medium-sized private enterprises should be enhanced to protect workers’ health.

Objective To evaluate the effect of hydrogen on autophagy during inflammatory responses following lung injury in burned mice.Methods Ninety-six clean-grade healthy male ICR mice,aged 6 weeks,weighing 20-25 g,were divided into 4 groups (n=24 each) using a random number table:sham operation group (SH group),H2 group (H2 group),burn group (B group) and burn plus H2 group (B+H2 group).Forty percent of the total body surface was shaved with 80 g/L sodium sulfide and then exposed to a 92 ℃ scald device for 18 s in B and B+H2 groups.Forty percent of the total body surface was shaved with 80 g/L sodium sulfide and then exposed to a scald device of skin temperature for 18 s in SH and H2 groups.Mice inhaled 2％ H2 for 1 h starting from 1 and 6 h after burn in H2 and B+H2 groups.The animals were sacrificed at 24 h after burn and lungs were removed for determination of wet/dry weight ratio (W/D rario),expression of autophagy-related microtubule-associated protein 1 light chain 3 (LC3) (by Western blot),activity of myeloperoxidase (MPO),and contents of interleukin-6 (IL-6) and high mobility group box 1 (HMGBI) (by enzyme-linked immunosorbent assay).The ratio of LC3-Ⅱ to LC3-Ⅰ expression (LC3-Ⅱ/LC3-Ⅰ) was calculated.The bronchoalveolar lavage fluid (BALF) was collected at 24 h after burn to detect the concentrations of IL-6 and HMGB1 and to count neutrophil.Results Compared with group SH,the W/D ratio,levels of LC3-Ⅱ/LC3-Ⅰ,MPO,IL-6 and HMGB1,concentrations of IL-6 and HMGB1 in BALF and neutrophil count were significantly increased at 24 h after scald in B and B+H2 groups (P＜0.05).Compared with group B,the W/D ratio,levels of LC3-Ⅱ/LC3-Ⅰ,MPO,IL-6 and HMGB1,concentrations of IL-6 and HMGBl in BALF and neutrophil count were significantly decreased at 24 h after scald in group B+H2 (P＜0.05).Conclusion Hydrogen can alleviate the lung injury in burned mice,and the mechanism is related to enhancing autophagy.

Objective To explore the applicability of 2 different models of occupational health risk assessment in wooden furniture manufacturing industry.Methods American EPA inhalation risk model and ICMM model of occupational health risk assessment were conducted to assess occupational health risk in a small wooden furniture enterprises,respectively.Results There was poor protective measure and equipment of occupational disease in the plant.The concentration of wood dust in the air of two workshops was over occupational exposure limit (OEL),and the CTWA was 8.9 mg/m3 and 3.6 mg/m3,respectively.According to EPA model,the workers who exposed to benzene in this plant had high risk (9.7×10-6～34.3×10-6) of leukemia,and who exposed to formaldehyde had high risk (11.4×10-6) of squamous cell carcinoma.There were inconsistent evaluation results using the ICMM tools of standard-based matrix and calculated risk rating.There were very high risks to be attacked by rhinocarcinoma of the workers who exposed to wood dust for the tool of calculated risk rating,while high risk for the tool of standard-based matrix.For the workers who exposed to noise,risk of noiseinduced deafness was unacceptable and medium risk using two tools,respectively.Conclusion Both EPA model and ICMM model can appropriately predict and assessthe occupational health risk in wooden furniture manufactory,ICMM due to the relatively simple operation,easy evaluation parameters,assessment of occupational-disease-inductive factors comprehensively,and more suitable for wooden furniture production enterprise.

Objective To explore the applicability of 2 different models of occupational health risk assessment in wooden furniture manufacturing industry.Methods American EPA inhalation risk model and ICMM model of occupational health risk assessment were conducted to assess occupational health risk in a small wooden furniture enterprises,respectively.Results There was poor protective measure and equipment of occupational disease in the plant.The concentration of wood dust in the air of two workshops was over occupational exposure limit (OEL),and the CTWA was 8.9 mg/m3 and 3.6 mg/m3,respectively.According to EPA model,the workers who exposed to benzene in this plant had high risk (9.7×10-6～34.3×10-6) of leukemia,and who exposed to formaldehyde had high risk (11.4×10-6) of squamous cell carcinoma.There were inconsistent evaluation results using the ICMM tools of standard-based matrix and calculated risk rating.There were very high risks to be attacked by rhinocarcinoma of the workers who exposed to wood dust for the tool of calculated risk rating,while high risk for the tool of standard-based matrix.For the workers who exposed to noise,risk of noiseinduced deafness was unacceptable and medium risk using two tools,respectively.Conclusion Both EPA model and ICMM model can appropriately predict and assessthe occupational health risk in wooden furniture manufactory,ICMM due to the relatively simple operation,easy evaluation parameters,assessment of occupational-disease-inductive factors comprehensively,and more suitable for wooden furniture production enterprise.