1.Mediating effect of job burnout on occupational stress and subjective well-being among research and development enterprise employees in Minhang of Shanghai
Yixuan SUN ; Minqi WEI ; Qiuwen ZHAO ; Jinfeng YANG ; Junming DAI
Journal of Environmental and Occupational Medicine 2024;41(5):489-496
Background Under the backdrop of the national innovation-driven development strategy, the increasing occupational stress and job burnout among employees are noteworthy for their impact on employees' subjective well-being. Objective To clarify the status, distribution characteristics, and the relationship between subjective well-being, occupational stress, and job burnout of employees in research and development (R&D) enterprises, in order to improve their subjective well-being. Methods A total of 3366 employees from R&D departments at 7 enterprises in Minhang District of Shanghai were selected. The well-being level of the research subjects was investigated by using the World Health Organization Well-Being Index (WHO-5) that yielded total scores from 0 to 25, and a higher total score indicated a higher well-being level; the levels of occupational stress and job burnout were investigated by using the Chinese version of the Job Content Questionnaire, and the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS). The scores of WHO-5, JDC, and MBI-GS were incorporated into structural equation modeling (SEM) as numerical variables to analyze their relationship. Results The scores of subjective well-being, occupational stress, and job burnout of employees in the R&D enterprises were 13.30±6.09, 1.12±0.45, and 2.18±1.12, respectively. The positive rates of occupational stress and job burnout were 44.4% and 70.9% respectively, and the positive rate of severe job burnout was 11.7%. There were statistically significant differences in the score of subjective well-being among the participants by gender, age, educational level, marital status, registered residence, working seniority, and jobs (P<0.05); there were statistically significant differences in the positive rate of occupational stress by gender, educational level, marital status, working seniority, and jobs (P<0.05); there were statistically significant differences in the positive rate of job burnout by gender, age, educational level, marital status, registered residence, working seniority, and jobs (P<0.05). There was a negative correlation between subjective well-being and occupational stress (r=−0.1747, P < 0.01), a negative correlation between subjective well-being and job burnout (r=−0.2987, P < 0.01), and a positive correlation between occupational stress and job burnout (r=0.3342, P < 0.01). A structural equation containing partial mediating effect of job burnout on the relationship between occupational stress and subjective well-being was established, and the partial effect accounting for 52.5% of the total effect. Conclusion The job burnout among employees in R&D companies partially mediates the impact of occupational stress on subjective well-being. Reducing the level of job burnout will help alleviate occupational stress and thus improve employees' subjective well-being.
2.Ultrasonography assistance in reconstruction of soft tissue defect in ankle and foot with perforator pedicled propeller flap: a report of 26 cases
Junming LI ; Yanfang ZHUANG ; Guanghui MA ; Pengwei DAI ; Lei WAN ; Yanhua LI ; Daoxuan LI ; Hejun HUANG ; Shichuang YING ; Yi ZHANG
Chinese Journal of Microsurgery 2024;47(3):273-279
Objective:To explore the clinical effect of perforator pedicled propeller flap (PPPF) in reconstruction of soft tissue defect in ankle and foot, as well as the role of preoperative ultrasonography in assistance of the location of perforators in donor site.Methods:From January 2017 to June 2023, the Department of Microorthopedics of the Second Affiliated Hospital of Luohe Medical College of Higher Education applied PPPF to reconstruct small and medium-sized soft tissue defects in the ankle and foot for 26 patients. The patients were 17 males, 9 females, aged 18 to 68 years old with 46 years old in average. The defect sites were 3 in forefoot and 6 in midfoot and combined with different degrees of tendon and bone exposure, 17 in ankle and heel and combined with various degrees of bone exposure, 12 with ankle open injury and 5 with Achilles tendon exposure. The area of soft tissue defects ranged from 2.5 cm×1.5 cm to 16.0 cm × 6.5 cm. The width of injury was measured before surgery, and a HHD was used to detect the perforators proximal to the defect site, and then high-frequency CDU was used to locate and confirm the location of the perforator and its alignment, blood flow and diameter. The line drawn between the 2 perforators was set as the axis of flap. The donor site was assessed by a "pinching and lifting" method to determine a direct closure of donor site or to have it closed by a flap transfer. The sizes of flap were from 2.8 cm×1.5 cm to 24.0 cm×7.5 cm. Twenty-two donor sites were directly closed and 4 received flap transfers. Four flaps had sutures with the skin nerves in the recipient site. Masquelet technique was performed in 6 patients with bone defects in the surgery. Patients received outpatient reviews with 1-2 weeks of intervals in the first 2 months after surgery, and X-ray reviews per 1-2 months for those with bone implants until bone healing.Results:All flaps survived successfully without any special treatment after surgery, except 1 flap that had blood vessel congestion and showed swelling and poor blood supply to the distal flap at 24 hours after surgery. The blood vessel congestion was revised by removal of part of the suture at the tip of flap pedicle. One week later, the tip of the flap remained with a small area of necrosis, which was then healed after dressing changes. A total of 21 patients were included in postoperative follow-up with 4 months to 3 years. All of the flaps had satisfactory appearance, colour and texture, and without any ulceration. Three cases of nerve suture were also included in follow-up. According to the assessment criteria of British Medical Research Council (BMRC), the sensory recovery of the flaps was found of S 2 in 1 flap and S 3 in 2 flaps. According to the American Orthopaedic Foot and Ankle Society (AOFAS), the ankle-hindfoot function scores, there were excellent in 16 patient and good in 5 patients. Conclusion:With the assistance of ultrasound, the PPPF can be effectively used in reconstruction of soft tissue defects in ankle and foot.
3.The role of group 3 innate lymphoid cells(ILC3) in the evolution of the immune system: An update.
Yin XIAN ; Xiaodong LYU ; Junming CHENG ; Ming HE ; Zhengnan DAI ; Yixing REN
Chinese Journal of Cellular and Molecular Immunology 2023;39(6):558-563
Group 3 innate lymphoid cells (ILC3) are an ILC subset that is characterized by the expression of retinoic acid-related orphan nuclear receptor γt (RORγt) and interleukin 22 (IL-22). This review summarizes the role of ILC3 in coordinating innate immunity and adaptive immunity based on current research and elaborate the significance of ILC3 from the perspective of immune system evolution. In addition, based on immune-related functions, we propose a possible time when ILC3 appears in the evolution of the immune system. And then, the research limitations and prospects are discussed.
Immunity, Innate
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Lymphocytes
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Tretinoin
4.Association between job burnout and health-related productivity loss among enterprise staff in Minhang District of Shanghai
Jinfeng YANG ; Minqi WEI ; Qiuwen ZHAO ; Yixuan SUN ; Zhen HU ; Junming DAI
Journal of Environmental and Occupational Medicine 2023;40(3):273-280
Background At present, domestic research on job burnout and health-related productivity is limited to medical workers, and the impact of job burnout on health-related productivity of enterprise staff deserves attention. Objective To explore the association between job burnout and health-related productivity loss among enterprise staff. Methods A cross-sectional online questionnaire survey was conducted among enterprise staff who were selected from seven enterprises in Minhang District of Shanghai. The Chinese version of Maslach Burnout Inventory-General Survey (MBI-GS) was used to assess job burnout, and a questionnaire based on and modified from the WHO Health and Work Performance Questionnaire was used to assess the loss of health-related productivity. Logistic regression was used to analyze the impact of job burnout on health-related productivity under the control of selected demographic characteristics, socio-economic factors, and occupational factors. Results A total of 3489 questionnaires were recovered, and 3156 valid questionnaires were included in the statistical analysis. Among the 3156 valid questionnaires, 2228 (70.8%) respondents were assessed as suffering from job burnout, in which 1858 (59.0%) were mild to moderate job burnout, and 370 (11.7%) were severe job burnout; the median score (interquartile range) of MBI-GS was 2.18(2.69), the median rates (interquartile range) of absenteeism and presenteeism were 0.00% (0.00%) and 20.00% (50.00%), respectively. The prevalence of presenteeism significantly varied by gender, education, marital status, working years, job category, exhaustion, cynicism, professional efficacy, and job burnout (P<0.05). The prevalence of absenteeism significantly varied by education, marital status, working years, job category, exhaustion, cynicism, professional efficacy, and job burnout (P<0.05). Job burnout was positively correlated with absenteeism (r=0.157) and presenteeism (r=0.412) (P<0.01). After controlling for selected demographic characteristics, social economic factors, and occupational factors, the logistic regression showed that job burnout was associated with health-related productivity loss, the OR value remained relatively stable, and referring to negative job burnout, the OR (95%CI) of severe job burnout was 6.35 (4.52-8.92). Conclusion Job burnout of enterprise staff has a negative impact on health-related productivity. Severer job burnout associates with higher health-related productivity loss. Enterprises should pay attention to the prevention and control of job burnout to reduce health-related productivity loss.
5.Sleeping quality in civil aviation pilots and associated influence factors
Zhen HU ; Fang WANG ; Bao YANG ; Qiuwen ZHAO ; Li FU ; Junming DAI
Journal of Environmental and Occupational Medicine 2023;40(9):1063-1067
Background Civil aviation pilots are actual operators of civil aircraft. Their job operations are directly associated with passenger safety and flight safety. Unsafe aviation operations are related to fatigue caused by poor sleep quality. Recently, with the promotion of China's air transportation business, irregular working hours of civil aviation pilots rise gradually. However, there is still a lack of relevant research on the influence of working conditions on sleep quality in this group. Objective To explore potential impact factors of sleep quality among civil aviation pilots, for the purposes of improving sleep quality and health level of this group and ensuring aviation flight safety by formulating health management suggestions in a targeted manner. Methods All pilots of an aviation company were approached when they visited the Shanghai Hospital of Civil Aviation Administration of China for their health examinations. After informed consent, an online questionnaire survey was conducted. Self-made questionnaires were used to collect information on general conditions, lifestyle, and subjective work stress levels. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. A total of 1204 valid questionnaires were recovered. Statistical analysis was conducted using SPSS 26.0 software. Results There were 410 pilots (16.8%) who reported sleep disorders, including insufficient sleep time, difficulty falling asleep, and poor sleep quality, and 894 pilots (74.3%) who reported moderate to severe work stress. Associations were identified between sleep quality of pilots and work stress or lifestyle indicators (P<0.05), while work stress showed the strongest association (r=0.28). Further multiple-factor analysis results showed that severe work stress (OR=4.25, 95%CI: 2.89, 6.30) and alcohol use (OR=1.72, 95%CI: 1.31, 2.27) associated with an increased risk of sleep disorders. Regular breakfast (OR=0.62, 95%CI: 0.42, 0.91) and physical exercise (OR=0.68, 95%CI: 0.45, 1.03) associated with a lower risk of sleep disorders. Conclusion A certain degree of sleep disturbance is reported in the civil aviation pilot group, which is closely related to work stress and lifestyle indicators. Targeted measures must be taken to effectively improve the quality of their sleep.
6.Correlations of long working hours and shift work with sleep of migrant workers
Qiuwen ZHAO ; Junming DAI ; Zan LI ; Yang YU ; Xiaoxi LIU ; Junling GAO ; Hua FU
Journal of Environmental and Occupational Medicine 2022;39(2):147-152
Background Long working hours (LWH) and shift work are harmful to the physical and mental health of occupational groups. Objective To understand the status quo of LWH and shift work of migrant workers in Shanghai, and to analyze the influence of the above two factors on sleep of the population. Methods From July to September 2018, a cross-sectional survey using questionnaires was conducted among 3215 in-service employees at seven workplaces with more than 300 employees in six selected districts of Shanghai using multi-stage random sampling method. A total of 2976 valid questionnaires were collected, with a valid response rate of 92.6%. The questionnaires included general demographic characteristics, personal health behavior, work-related factors, weekly working hours, shift work, and sleep. Univariate analysis and logistic regression analysis were used to investigate the relationships of LWH and shift work with sleep, and an interaction item was included to evaluate potential interaction between LWH and shift work. Result The average age of the subjects was (30.98±9.49) years old, the male to female ratio was 1∶1.20, and 2382 workers were reported without local residency (80.0%). Among the migrant workers, the average weekly working hours was (57.23±13.14) h, the proportions of LWH (weekly working hours>40 h), extra LWH (weekly working hours>55 h), and shift work were 80.6% (1919/2382), 60.3% (1436/2382), and 25.4% (600/2366), respectively, all above were significantly higher than those of local workers. The prevalence rates of insomnia and lack of sleep among the migrant workers were 46.3% (1091/2356) and 25.4% (597/2354), respectively. The results of logistic regression model showed that after adjusting demographic characteristics such as gender, age, education level, and monthly income, as well as occupation and personal health behavior, compared with working hours ≤40 h per week, working 55-60 h per week was a risk factor for insomnia of migrant workers (OR=1.33, 95%CI: 1.02-1.72), while working >60 h per week was a risk factor for both insomnia (OR=1.37, 95%CI: 1.05-1.78) and insufficient sleep (OR=1.73, 95%CI: 1.28-2.35) of migrant workers. Shift work was only associated with insomnia (OR=1.37, 95%CI: 1.11-1.69). Meanwhile, working hours>60 h per week and shift work had an interaction effect on insomnia of migrant workers (OR=2.35, 95%CI: 1.20-4.60). Conclusion LWH and shift work are prominent among migrant workers, and there is an interaction between LWH and shift work with insomnia.
7.Influence of community environmental factors on residents' subjective well-being: A case study of Pudong, Shanghai
Xiaoxi LIU ; Junming DAI ; Yifeng SHEN ; Xuelian FU ; Xiaomei LI ; Yang YU ; Qiuwen ZHAO ; Junling GAO ; Hua FU
Journal of Environmental and Occupational Medicine 2022;39(7):769-774
Background The community is the main place for people's daily activities. A livable environment will improve the subjective well-being of residents. Objective To understand the current status of subjective well-being of residents in Pudong, Shanghai, and explore the impact of community environmental factors on residents' subjective well-being. Methods Using quota sampling, 6000 permanent residents from 12 sub-districts or towns in Pudong, Shanghai were selected to participate in an questionnaire survey. The questionnaire included three parts: participants' basic information, community environmental factors (neighborhood aesthetics, fitness environment, public service and security, natural environment), and subjective well-being. Using a multiple regression model, the influence of community environmental factors on the subjective well-being of residents was analyzed. Results A total of 5887 questionnaires were recovered, and the valid recovery rate was 98.1%. The subjective well-being score of the survey respondents was (7.03±1.61) points. There was no statistical difference in the subjective well-being score of study subjects of different gender and marital status groups; while those with different ages, education levels, occupations, and self-evaluated economic status showed statistical differences in their subjective well-being score (P<0.05). The multiple logistic regression analysis results showed that after controlling general demographic characteristics, with the low level as the control group (according predetermined cut-off values of 33.3% and 66.7%, the community environmental factors were divided into high-, medium-, and low-level groups), the OR values of subjective well-being of the high- and medium-level neighborhood aesthetics groups were 1.393 (95%CI: 1.173-1.654) and 1.235 (95%CI: 1.080-1.412); the OR values of the high- and medium-level fitness environment groups were 2.297 (95%CI: 1.929-2.734) and 1.349 (95%CI: 1.166-1.560); the OR values of the high- and medium-level public service and security groups were 1.101 (95%CI: 0.943-1.285) and 1.039 (95%CI: 0.905-1.193); the OR values of the high- and medium-level natural environment groups were 4.248 (95%CI: 3.321-5.434) and 1.652 (95%CI: 1.374-1.986), respectively. Conclusion Community environment factors could affect residents' subjective well-being, and good neighborhood aesthetics, fitness environment, natural environment have positive effects.
8.Epidemiological characteristics, diagnosis, treatment and prognosis of gallbladder cancer in China: a report of 6 159 cases
Xuheng SUN ; Yijun WANG ; Wei ZHANG ; Yajun GENG ; Yongsheng LI ; Tai REN ; Maolan LI ; Xu'an WANG ; Xiangsong WU ; Wenguang WU ; Wei CHEN ; Tao CHEN ; Min HE ; Hui WANG ; Linhua YANG ; Lu ZOU ; Peng PU ; Mingjie YANG ; Zhaonan LIU ; Wenqi TAO ; Jiayi FENG ; Ziheng JIA ; Zhiyuan ZHENG ; Lijing ZHONG ; Yuanying QIAN ; Ping DONG ; Xuefeng WANG ; Jun GU ; Lianxin LIU ; Yeben QIAN ; Jianfeng GU ; Yong LIU ; Yunfu CUI ; Bei SUN ; Bing LI ; Chenghao SHAO ; Xiaoqing JIANG ; Qiang MA ; Jinfang ZHENG ; Changjun LIU ; Hong CAO ; Xiaoliang CHEN ; Qiyun LI ; Lin WANG ; Kunhua WANG ; Lei ZHANG ; Linhui ZHENG ; Chunfu ZHU ; Hongyu CAI ; Jingyu CAO ; Haihong ZHU ; Jun LIU ; Xueyi DANG ; Jiansheng LIU ; Xueli ZHANG ; Junming XU ; Zhewei FEI ; Xiaoping YANG ; Jiahua YANG ; Zaiyang ZHANG ; Xulin WANG ; Yi WANG ; Jihui HAO ; Qiyu ZHANG ; Huihan JIN ; Chang LIU ; Wei HAN ; Jun YAN ; Buqiang WU ; Chaoliu DAI ; Wencai LYU ; Zhiwei QUAN ; Shuyou PENG ; Wei GONG ; Yingbin LIU
Chinese Journal of Digestive Surgery 2022;21(1):114-128
Objective:To investigate the epidemiological characteristics, diagnosis, treat-ment and prognosis of gallbladder cancer in China from 2010 to 2017.Methods:The single disease retrospective registration cohort study was conducted. Based on the concept of the real world study, the clinicopathological data, from multicenter retrospective clinical data database of gallbladder cancer of Chinese Research Group of Gallbladder Cancer (CRGGC), of 6 159 patients with gallbladder cancer who were admitted to 42 hospitals from January 2010 to December 2017 were collected. Observation indicators: (1) case resources; (2) age and sex distribution; (3) diagnosis; (4) surgical treatment and prognosis; (5) multimodality therapy and prognosis. The follow-up data of the 42 hospitals were collected and analyzed by the CRGGC. The main outcome indicator was the overall survival time from date of operation for surgical patients or date of diagnosis for non-surgical patients to the end of outcome event or the last follow-up. Measurement data with normal distribu-tion were represented as Mean±SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range), and com-parison between groups was conducted using the U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis was performed using the Logistic forced regression model, and variables with P<0.1 in the univariate analysis were included for multivariate analysis. Multivariate analysis was performed using the Logistic stepwise regression model. The life table method was used to calculate survival rates and the Kaplan-Meier method was used to draw survival curves. Log-rank test was used for survival analysis. Results:(1) Case resources: of the 42 hospitals, there were 35 class A of tertiary hospitals and 7 class B of tertiary hospitals, 16 hospitals with high admission of gallbladder cancer and 26 hospitals with low admission of gallbladder cancer, respectively. Geographical distribution of the 42 hospitals: there were 9 hospitals in central China, 5 hospitals in northeast China, 22 hospitals in eastern China and 6 hospitals in western China. Geographical distribution of the 6 159 patients: there were 2 154 cases(34.973%) from central China, 705 cases(11.447%) from northeast China, 1 969 cases(31.969%) from eastern China and 1 331 cases(21.611%) from western China. The total average number of cases undergoing diagnosis and treatment in hospitals of the 6 159 patients was 18.3±4.5 per year, in which the average number of cases undergoing diagnosis and treatment in hospitals of 4 974 patients(80.760%) from hospitals with high admission of gallbladder cancer was 38.8±8.9 per year and the average number of cases undergoing diagnosis and treatment in hospitals of 1 185 patients(19.240%) from hospitals with low admission of gallbladder cancer was 5.7±1.9 per year. (2) Age and sex distribution: the age of 6 159 patients diagnosed as gallbladder cancer was 64(56,71) years, in which the age of 2 247 male patients(36.483%) diagnosed as gallbladder cancer was 64(58,71)years and the age of 3 912 female patients(63.517%) diagnosed as gallbladder cancer was 63(55,71)years. The sex ratio of female to male was 1.74:1. Of 6 159 patients, 3 886 cases(63.095%) were diagnosed as gallbladder cancer at 56 to 75 years old. There was a significant difference on age at diagnosis between male and female patients ( Z=-3.99, P<0.001). (3) Diagnosis: of 6 159 patients, 2 503 cases(40.640%) were initially diagnosed as gallbladder cancer and 3 656 cases(59.360%) were initially diagnosed as non-gallbladder cancer. There were 2 110 patients(34.259%) not undergoing surgical treatment, of which 200 cases(9.479%) were initially diagnosed as gallbladder cancer and 1 910 cases(90.521%) were initially diagnosed as non-gallbladder cancer. There were 4 049 patients(65.741%) undergoing surgical treatment, of which 2 303 cases(56.878%) were initially diagnosed as gallbladder cancer and 1 746 cases(43.122%) were initial diagnosed as non-gallbladder cancer. Of the 1 746 patients who were initially diagnosed as non-gallbladder cancer, there were 774 cases(19.116%) diagnosed as gallbladder cancer during operation and 972 cases(24.006%) diagnosed as gallbladder cancer after operation. Of 6 159 patients, there were 2 521 cases(40.932%), 2 335 cases(37.912%) and 1 114 cases(18.087%) undergoing ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) examination before initial diagnosis, respec-tively, and there were 3 259 cases(52.914%), 3 172 cases(51.502%) and 4 016 cases(65.205%) undergoing serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis, respectively. One patient may underwent multiple examinations. Results of univariate analysis showed that geographical distribution of hospitals (eastern China or western China), age ≥72 years, gallbladder cancer annual admission of hospitals, whether undergoing ultrasound, CT, MRI, serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis were related factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.45, 1.98, 0.69, 0.68, 2.43, 0.41, 1.63, 0.41, 0.39, 0.42, 95% confidence interval as 1.21-1.74, 1.64-2.40, 0.59-0.80, 0.60-0.78, 2.19-2.70, 0.37-0.45, 1.43-1.86, 0.37-0.45, 0.35-0.43, 0.38-0.47, P<0.05). Results of multivariate analysis showed that geographical distribution of hospitals (eastern China or western China), sex, age ≥72 years, gallbladder cancer annual admission of hospitals and cases undergoing ultrasound, CT, serum CA19-9 examination before initially diagnosis were indepen-dent influencing factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.36, 1.42, 0.89, 0.67, 1.85, 1.56, 1.57, 0.39, 95% confidence interval as 1.13-1.64, 1.16-1.73, 0.79-0.99, 0.57-0.78, 1.60-2.14, 1.38-1.77, 1.38-1.79, 0.35-0.43, P<0.05). (4) Surgical treatment and prognosis. Of the 4 049 patients undergoing surgical treatment, there were 2 447 cases(60.435%) with complete pathological staging data and follow-up data. Cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb were 85(3.474%), 201(8.214%), 71(2.902%), 890(36.371%), 382(15.611%), 33(1.348%) and 785(32.080%), respectively. The median follow-up time and median postoperative overall survival time of the 2 447 cases were 55.75 months (95% confidence interval as 52.78-58.35) and 23.46 months (95% confidence interval as 21.23-25.71), respectively. There was a significant difference in the overall survival between cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb ( χ2=512.47, P<0.001). Of the 4 049 patients undergoing surgical treatment, there were 2 988 cases(73.796%) with resectable tumor, 177 cases(4.371%) with unresectable tumor and 884 cases(21.833%) with tumor unassessable for resectabi-lity. Of the 2 988 cases with resectable tumor, there were 2 036 cases(68.139%) undergoing radical resection, 504 cases(16.867%) undergoing non-radical resection and 448 cases(14.994%) with operation unassessable for curative effect. Of the 2 447 cases with complete pathological staging data and follow-up data who underwent surgical treatment, there were 53 cases(2.166%) with unresectable tumor, 300 cases(12.260%) with resectable tumor and receiving non-radical resection, 1 441 cases(58.888%) with resectable tumor and receiving radical resection, 653 cases(26.686%) with resectable tumor and receiving operation unassessable for curative effect. There were 733 cases not undergoing surgical treatment with complete pathological staging data and follow-up data. There was a significant difference in the overall survival between cases not undergoing surgical treatment, cases undergoing surgical treatment for unresectable tumor, cases undergoing non-radical resection for resectable tumor and cases undergoing radical resection for resectable tumor ( χ2=121.04, P<0.001). (5) Multimodality therapy and prognosis: of 6 159 patients, there were 541 cases(8.784%) under-going postoperative adjuvant chemotherapy and advanced chemotherapy, 76 cases(1.234%) under-going radiotherapy. There were 1 170 advanced gallbladder cancer (pathological staging ≥stage Ⅲa) patients undergoing radical resection, including 126 cases(10.769%) with post-operative adjuvant chemotherapy and 1 044 cases(89.231%) without postoperative adjuvant chemo-therapy. There was no significant difference in the overall survival between cases with post-operative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.23, P=0.629). There were 658 patients with pathological staging as stage Ⅲa who underwent radical resection, including 66 cases(10.030%) with postoperative adjuvant chemotherapy and 592 cases(89.970%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.05, P=0.817). There were 512 patients with pathological staging ≥stage Ⅲb who underwent radical resection, including 60 cases(11.719%) with postoperative adjuvant chemotherapy and 452 cases(88.281%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemo-therapy and cases without post-operative adjuvant chemo-therapy ( χ2=1.50, P=0.220). Conclusions:There are more women than men with gallbladder cancer in China and more than half of patients are diagnosed at the age of 56 to 75 years. Cases undergoing ultrasound, CT, serum CA19-9 examination before initial diagnosis are independent influencing factors influencing initial diagnosis of gallbladder cancer patients. Preoperative resectability evaluation can improve the therapy strategy and patient prognosis. Adjuvant chemotherapy for gallbladder cancer is not standardized and in low proportion in China.
9.Job burnout and associated influencing factors in employees of 7 research and development enterprises in Minhang District of Shanghai
Minqi WEI ; Tao LIU ; Jiajie WU ; Qiuwen ZHAO ; Yixuan SUN ; Junming DAI
Journal of Environmental and Occupational Medicine 2022;39(12):1366-1372
Background Job burnout is an early mental health condition caused by job stress and contributes to many negative effects on work and life. Employees of research and development (R&D) enterprises are exposed to constant pressure from innovation, production speed and sales expansion, and they are prone to burnout symptoms if such factors are not under effective control. Objective To evaluate the current situation of job burnout among employees of R&D enterprises in Minhang District of Shanghai and explore its influencing factors. Methods During November to December 2021, a cross-sectional study was developed and a convenient sampling method was used to enroll employees from 7 R&D enterprises in Minhang District of Shanghai. On the basis of voluntary participation with informed consent, a survey was conducted by using a self-made questionnaire (collecting data about general demographic characteristics, occupational characteristics, behavior and lifestyle), the Chinese version of the Concise Occupational Stress Questionnaire, and the Chinese version of the Maslach Burnout Inventory-General Survey. Occupational stress and its dimensions (job demand, job control, and social support) were divided into high, medium, and low levels according to tertiles. The positive rate of job burnout was reported according to score categorization (<1.5 refers to no job burnout, ≥1.5 refers to job burnout, where ≥1.5 and <3.5 refer to mild and moderate job burnout, and ≥3.5 refers to severe job burnout). Potential influencing factors of job burnout were evaluated by using one-way ANOVA, chi-square test, forward stepwise regression, and non-conditional binary logistic regression (α=0.05, two-sided test). Results A total of 3153 subjects were enrolled and 3014 samples were included in the analysis, with a valid response rate of 95.6%. Among the included subjects, 888 (29.46%) reported no job burnout, 1775 (58.89%) reported mild to moderate job burnout, and 351 (11.64%) reported severe job burnout. The mean of total job burnout score was 2.17±1.12, and the dimentional mean scores were 2.78±1.61 for emotional exhaustion, 1.60±1.60 for cynicism, and 4.05±1.57 for diminished personal accomplishment. Varied categories of sex, age, marital status, working position, sleep status, job demand, job control, and social support groups of workers resulted in significant differences in job burnout score. Compared with the low job demand group, the positive rate of job burnout was elevated in the medium and high job demand groups; the risk of job burnout in the medium job demand group was 1.42 (95%CI: 1.04-1.94) times higher, and that in the high job demand group was 2.64 (95% CI : 2.17-3.22) times higher versus the low job demand group. The risk of job burnout in the medium job control group was 1.35 (95%CI: 1.06-1.72) times higher versus the low job control group. Compared with the low social support group, job burnout was less reported in the other groups, and the OR (95%CI) values of the medium and high social support groups were 0.41 (0.31-0.53) and 0.15 (0.12-0.19) respectively. Conclusion The rate of reporting positive job burnout in R&D enterprises is high, which deserves sufficient attention. Relieving work pressure, increasing job control and social support, and maintaining adequate sleep are helpful to reduce job burnout.
10.Reliability and validity of Health and Safety Climate Survey
Yang YU ; Junming DAI ; Xiaomei LI ; Yifeng SHEN ; Xuelian FU ; Suhong CHEN
Journal of Environmental and Occupational Medicine 2021;38(11):1214-1218
Background The health and safety climate of workplace has an important impact on the physical and mental health of workers. There is no available scale for the evaluation of workplace health and safety climate in China at present. Objective This study aims to sinicize and evaluate the reliability and validity of the Health and Safety Climate Survey. Methods The English version of Health and Safety Climate Survey was translated to Chinese and back-translated to English, and followed by expert evaluation to develop a Chinese version. Quota sampling method was used to select 2600 employees from 16 enterprises and public institutions in Pudong New Area of Shanghai and to evaluate the reliability and validity of the Chinese version of the scale. Structural validity, convergent validity, and discriminant validity were included in validity evaluation. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to test structural validity. In EFA, an acceptable factor loading of items on their respective dimensions was > 0.60. In CFA, an acceptable root mean square error of approximation (RMSEA), a standard absolute fitness index, was < 0.05. Comparative fit index (CFI) and parsimony-adjusted non-normed fit index (PNFI), measures of incremental improvement and fit, > 0.90 indicated a good fit. Convergent validity was evaluated by average variance extracted (AVE), and an AVE > 0.50 indicated good convergent validity. Discriminant validity was determined as good by the square root of AVE greater than the correlation coefficient between latent variables. Cronbach’s α coefficient was used to evaluate the internal consistency of the scale; the internal consistency considered was very good with an α > 0.90. Cronbach’s α coefficient may cause underestimation of reliability in the case of error correlation. Therefore, composite reliability (CR) calculated based on structural equation model >0.70 indicated that the CR was good. Results The response rate was 95.69%. The Chinese version of Health and Safety Climate Survey included 22 items belonging to six dimensions which was extracted by the EFA, and the cumulative variance contribution rate was 74.79%. The corrected RMSEA was 0.045, the PNFI was 0.970, and the CFI was 0.975 in the CFA, indicating good fit. The dimensional AVE values were all greater than 0.50, indicating good CV. The square root of AVE was greater than the correlation coefficient between latent variables, indicating good DV. The Cronbach’s α was 0.90 for the total scale and were above 0.70 for all dimensions. The CR was 0.93 for the total scale and were above 0.70 for all dimensions, indicating that the overall reliability of the scale was good. Conclusion The Chinese version of Health and Safety Climate Survey has good reliability and validity, and can be further improved in field application.

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