Effect of Health Management in Raising Awareness Rate of Disease Prevention and Treatment in Patients with Prehypertension

Objective: To analyze the effect of health management on improving the awareness rate of disease prevention and treatment in patients with prehypertension, so as to provide guidance for clinical management of patients with prehypertension. Methods: 108 patients diagnosed with prehypertension in our hospital were divided into a control group and an experimental group. The control group was not given management measures, while the experimental group was given health management. The incidence of hypertension and cognition level of hypertension knowledge were compared between the two groups after management. Results: The incidence of hypertension in the experimental group was 7.41% lower than that in the control group 29.63%. The cognitive level of hypertension in the patients (66.54 ± 1.25) was significantly higher than that in the patients without health management (41.45 ± 2.45), and P < 0.05;Conclusion: For patients with prehypertension, the implementation of health management is helpful to improve their cognition of hypertension, master related prevention knowledge, and reduce the incidence of hypertension.

Is the whole greater than the sum of the parts? Self-rated health and transdisciplinarity

Self-rated health (SRH)—a person’s subjective evaluation of his general health—is a more valid and powerful predictor of morbidity and mortality than any other combination of objective and self-reported measures. However, current theoretical frameworks fail to explain this association. Here, we sought to investigate SRH in relation to health outcomes from a transdisciplinary perspective. Using a selective review of epidemiological, clinical and qualitative SRH literature, we analyzed the relationships between this global subjective self-perception of health (the whole) and its directly measurable constituents (the parts). Although SRH often predicts major health outcomes, its underpinnings vary from person to person. Factors influencing individual’s health interact in complex ways evade reductionist methods assessing the parts, and may be best captured by global self-perceptions of health. The study of SRH from a transdisciplinary perspective exemplifies the notion that the whole is greater than the sum of its parts. Insight into individual’s experience of “health”, their association with physiological processes, and impact on the health/disease continuum may contribute to the development of individualized strategies for health care and promotion with aging. In particular, this should be most valuable for addressing non-communicable health conditions where cross-talk between health domains (biological, psychological, social, behavioral, spiritual) may significantly contribute to pathophysiology.

Social, Clinical and Psychometric Factors Affecting Self-Rated Oral Health, Self-Rated Health and Wellbeing in Adults: A Cross-Sectional Survey

Background: Many studies examined and reported oral and general health inequalities in clinical health, SROH and SRH. Objectives: The study aims to explore the social influences, gradients and predictors of self-rated oral health (SROH) and self-rated health (SRH) and wellbeing in Greek adults. Methods: Cross-sectional study, of men and women, aged 65 years and over (N = 743) in Greece. Descriptive and statistical analyses were performed for dentate and edentulous participants. For the association between socioeconomic exposures and binary outcomes, logistic regression was performed to estimate Odds Ratios and 95% Confidence Intervals (OR, 95% CI);levels of association and Cramer’s V were applied to calculate associations and p-values. Results: The objective socioeconomic measures, such as household income, education level and last main occupation were significant predictors and determinants of both SROH and self-rated health (SRH). For Satisfaction with life (SWL), there was a diversity in the results analogous to the dental status of the participants. Household income and SSS were predictors of SWL in dentate participants. In the total sample Household income, occupation and SSS, were predictors of SWL, while in edentulous participants only occupation and SSS were statistically significant (p < 0.05). Subjective social status was statistically significant for SROH, SRH and SWL (p < 0.01). More men than women reported their SROH and SRH as good. Household income and SSS were predictors of SWL, in dentate participants, thus the better the income and the higher the relative social status, the higher feeling of SWL was recorded. Place of residence had significant associations only with SWL. Household income, education, occupation and SSS had significant levels of association with SROH and SRH in dentate participants (p < 0.05). Conclusion: There are socioeconomic gradient inequalities in SROH and SRH in Greek adults living in Attica area. Subjective social status is a predictor of SROH, SRH and SWL. The need to prioritize interventions to eliminate disparities and inequalities in oral and general health and wellbeing of elders is evident.

Self-Rated Health in University Students from Rio Branco in the Western Brazilian Amazon

The objective of this study was to determine the prevalence and associated factors of unsatisfactory self-rated health in university students. A cross-sectional study was conducted in graduate students of a Public University in the city of Rio Branco in the Western Brazilian Amazon. The overall prevalence of unsatisfactory self-rated health was 23.0%. After adjusting for gender and age, the factors associated with unsatisfactory self-rated health were as follows: sedentarism during leisure time (prevalence ratio (PR): 2.26;95% CI: 1.56 - 3.29), consuming meals only in restaurants (PR: 1.48;95% CI: 1.14 - 1.94), insomnia (PR: 1.86;95% CI: 1.50 - 2.30), headaches (PR: 2.17;95% CI: 1.52 - 3.09), and back pain (PR: 2.03;95% CI: 1.58 - 2.60). Thus, a high prevalence of unsatisfactory self-rated health was identified in this group of university students. The findings suggest immediate implementation of programs to promote healthy behaviors and to prevent headaches, back pain and insomnia.

Understanding the Lifestyle Correlates with Chronic Constipation and Self-Rated Health

The objective of this study is to evaluate the healthy and unhealthy behaviors as risk factors for chronic constipation and self-rated health status. Eight hundred tenth students enrolled from a university in Miaoli city, Taiwan. Chronic constipation was assessed using Chinese questionnaire. Information of unhealthy and healthy lifestyles was interviewed by constructed questionnaire. Thirty-six percentage of university students were assessed as chronic constipation. Using multivariate logistic regression adjusted for age, sex, race and BMI, we found chronic constipation significantly correlated with frequency of consumption from snack, fast food, fried food, daily consumption of water, physical activity and junk food used as regular food. Moreover, these unhealthy behaviors significantly correlated with self-rated health status. Students with chronic constipation had poor self-rated health status. It is urgent to create healthy behaviors to reduce the risk for chronic constipation or upgrade self-rated health status in university students.

Modification in self-rated health in patients discharged by a geriatric rehabilitation ward

Self-rated health is a valuable outcome in geriatric rehabilitation besides objective results. The present work aims at measuring and analyzing overall health as it is perceived at admission into and at discharge from a geriatric rehabilitation ward. Overall health was self-appraised through a visual-analogue scale (VAS), spanning from 0 (worst) to 10 (best). We studied 1997 patients (70% females), aged 79 (standard deviation, s.d. 8.7) years;most were frail, either functionally, clinically and cognitively. 80% of patients were discharged to home after a length of stay lasting 47.5 (s.d. 22.7) days. At admission, 3/5 patients appraised favorably their overall health (VAS ≥ 6/10): at discharge, the proportion rose to 3/4, with a mean (s.d.) gain = 2 (2) points. The improvement in self-perceived health score positively correlates with the grade expressing clients’ overall satisfaction for the stay (p 0.001), and with discharge versus admission differences in: Barthel Index (BI) total score (p < 0.001), Tinetti total score, Mini Mental State Examination (MMSE), Geriatric Depression Scale (5?items GDS), pain (VAS 0 to 10). A Linear regression model predicting the changes in self-perceived health included changes in BI, MMSE, GDS, pain, dropping Tinetti test. Changes in self-rated health were positively correlated to functional gain adjusted for pre-morbid level, and to relative functional gain. By analysis of variance, health self-appraisal changed more favorably in patients discharged to home than for other social outcomes (all p < 0.001). As expected, trends in self-perceived health parallel improvements in objective functional gauges and subjective indicators.

Social integration: How is it related to self-rated health?

Social integration has well-established health benefits among older adults in observational studies. However, interventions designed to increase social integration have not improved health suggesting important knowledge gaps on how social integration influences health outcomes. This study developed a new measure of social integration, daily social contact, capturing the interpersonal nature of social integration and mobility of individuals, and providing a direct assessment of individuals’ real-time access to companionship and social support. The data used is the 2006-2007 American Time Use Survey (ATUS), which surveyed 25,191 individuals aged 15 years and older (n = 4378 aged 65 years and older). Generalized ordinal logistic regression analyses revealed positive, but non-parallel relationships between daily social contacts and the ordinal categories of self-rated health among older adults. This study may be used to identify populations that experience social exclusion, such that future research can determine more precisely how to intervene to improve health outcomes.

Comparative analysis of breast and lung cancer survival rates and clinical trial enrollments among rural and urban patients in Georgia

Objectives:Rural patients have poor cancer outcomes and clinical trial(CT)enrollment compared to urban patients due to attitudinal,awareness,and healthcare access differential.Knowledge of cancer survival disparities and CT enrollment is important for designing interventions and innovative approaches to address the stated barriers.The study explores the potential disparities in cancer survival rates and clinical trial enrollments in rural and urban breast and lung cancer patients.Our hypotheses are that for both cancer types,urban cancer patients will have longer 5-year survival rates and higher enrollment rates in clinical trials than those in rural counties.Methods:We compared breast and lung cancer patients’survival rates and enrollment ratios in clinical trials between rural(RUCC 4-9)and urban counties in Georgia at a Comprehensive Cancer Center(CCC).To assess these differences,we carried out a series of independent samples t-tests and Chi-Square tests.Results:The outcomes indicate comparable 5-year survival rates across rural and urban counties for breast and lung cancer patients,failing to substantiate our hypothesis.While clinical trial enrollment rates demonstrated a significant difference between breast and lung cancer patients at CCC,no significant variation was observed based on rural or urban classification.Conclusion:These findings underscore the need for further research into the representation of rural patients with diverse cancer types at CCC and other cancer centers.Further,the findings have considerable implications for the initiation of positive social change to improve CT participation and reduce cancer survival disparities.

Machine Learning Prediction of Fetal Health Status from Cardiotocography Examination in Developing Healthcare Contexts

Reducing neonatal mortality is a critical global health objective,especially in resource-constrained developing countries.This study employs machine learning(ML)techniques to predict fetal health status based on cardiotocography(CTG)examination findings,utilizing a dataset from the Kaggle repository due to the limited comprehensive healthcare data available in developing nations.Features such as baseline fetal heart rate,uterine contractions,and waveform characteristics were extracted using the RFE wrapper feature engineering technique and scaled with a standard scaler.Six ML models—Logistic Regression(LR),Decision Tree(DT),Random Forest(RF),Gradient Boosting(GB),Categorical Boosting(CB),and Extended Gradient Boosting(XGB)—are trained via cross-validation and evaluated using performance metrics.The developed models were trained via cross-validation and evaluated using ML performance metrics.Eight out of the 21 features selected by GB returned their maximum Matthews Correlation Coefficient(MCC)score of 0.6255,while CB,with 20 of the 21 features,returned the maximum and highest MCC score of 0.6321.The study demonstrated the ability of ML models to predict fetal health conditions from CTG exam results,facilitating early identification of high-risk pregnancies and enabling prompt treatment to prevent severe neonatal outcomes.

Impact of Village-based Health Education of Tobacco Control on the Current Smoking Rate in Chinese Rural Areas

The number of smokers in Chinese rural areas is more than 200 million, which is twice that in cities. It is very significant to carry out tobacco control interventions in rural areas. We performed this community intervention study to evaluate the efficacy of village-based health education of tobacco control on the male current smoking rate in rural areas. The population of this study was the males above 15 years old from 6 villages in rural areas. The villages were randomly assigned to intervention group or control group（3 villages in each group）. Self-designed smoking questionnaire was applied. The intervention group received the village-based health education of tobacco control for one year. The primary outcome measurement was the male current smoking rate. In the baseline investigation, completed surveys were returned by 814 male residents from the control group and 831 male residents from the intervention group. The male current smoking rate in the control group and the intervention group was 61.2% and 58.5%, respectively, before intervention. There was no significant difference between these two groups（P〉0.05）. After one-year intervention, the current smoking rate in the intervention group（51.2%） was significantly lower than that in the control group（62.8%）（P〈0.001）. Our study suggested that the village-based health education of tobacco control was effective in lowering the male current smoking rate in rural areas, which could be a suitable and feasible way for tobacco control in the Chinese rural areas.

健康体检人群甲状腺结节检出情况及发病的影响因素

目的调查健康体检人群甲状腺结节(TNs)检出情况,并分析其影响因素,为早期防治TNs提供参考依据。方法选取2022年1月1日至2023年4月30日15393例健康体检人群,均进行多普勒超声检查,按年龄分层及性别统计TNs患病率,通过单因素及多因素logistic回归方程分析TNs影响因素。结果15393例健康体检者,共检查出5001例TNs,检出率为32.49%(5001/15393)。男性不同年龄组TNs检出率均低于女性(P<0.05)。健康人群随着年龄增长TNs检出率呈升高趋势(P<0.05)。两组体重指数、收缩压、舒张压、空腹血糖(FPG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、性别、年龄、吸烟、饮酒、高脂血症、糖尿病、代谢综合征、脂肪肝、焦虑、抑郁比较,差异有统计学意义(P<0.05)。年龄、性别、糖尿病、脂代谢综合征、脂肪肝、焦虑、抑郁均为TNs独立影响因素(P<0.05)。结论健康体检人群TNs检出率较高,主要与年龄、性别、糖尿病、脂代谢综合征、脂肪肝、焦虑、抑郁等因素有关,临床应在健康体检中普及甲状腺彩超检查项目,以实现对甲状腺疾病的尽早防治。

2018—2022年浙江省羊布鲁氏菌病血清学监测分析

为掌握浙江省羊布鲁氏菌病(以下简称“布病”)流行情况,2018—2022年累计在6810个场点采集375433份血清学样品,使用虎红平板凝集试验和试管凝集试验对羊血清布病抗体进行检测。结果显示:2018—2022年浙江省羊布病群体阳性率分别为0.16%、0.41%、0.29%、0.13%、0.07%,个体阳性率分别为0.090%、0.080%、0.280%、0.010%、0.004%,种羊场、商品代养殖场、散养户和流通场所个体阳性率分别为0、0.09%、0.01%、0.19%,温州、湖州、衢州、金华、嘉兴等5个地市个体阳性率分别为0.29%、0.16%、0.10%、0.03%和0.02%。结果表明,5年来浙江省羊布病防控成效明显,阳性率呈整体下降趋势,但羊养殖量大、交易频繁地区的防控形势不容乐观,流通场所仍是羊布病防控的薄弱环节。建议坚持检测、扑杀、无疫小区和净化场建设等措施,探索使用先进科技手段有效打击违规调运行为,进一步降低羊群布病流行率,维护畜牧业生产安全和公共卫生安全。

内蒙古自治区社区5类精神障碍患者精神卫生服务利用现状

目的:描述内蒙古自治区社区5类精神障碍终生患者精神卫生服务利用现况,为健康教育和制定相关政策提供参考。方法:采用分层多阶段不等概率抽样方法抽取内蒙古自治区18岁及以上常住居民共12 315名,采用复合性国际诊断交谈表调查心境障碍、焦虑障碍、物质使用障碍、间歇爆发性障碍、进食障碍等5类精神障碍及精神卫生服务利用现况,以单因素分析方法进行描述性统计。结果:5类精神障碍中,任何一种精神障碍终生患者咨询率为18.7%,治疗率为10.2%,患者接受非医务工作者治疗的比例最高(31.4%),其次是接受精神科或心理科医生治疗;患者中有1.1%的患者接受药物治疗,有2.5%的患者接受心理治疗。结论:内蒙古自治区精神障碍患者精神卫生服务利用率较低,要广泛开展正确求医的健康教育。

雄安新区普通人群精神卫生知识知晓现状调查

目的了解雄安新区普通人群心理健康状况和精神卫生知识知晓率及相关影响因素。方法动员雄安新区20个社区卫生服务中心和33个乡镇卫生院工作人员通过发送二维码海报、网址链接等方式邀请所辖范围内15~70周岁居民参与填写在线问卷。问卷由自编一般人口学资料和精神卫生与心理保健知识问卷两部分构成。结果2591份问卷中2517份问卷有效。总知晓率为77.22%,平均得分(15.44±2.61)分。问卷四个模块中,精神疾病知识方面正确率(67.95%)、精神卫生相关节日部分正确率(55.51%)较低。单因素分析结果显示,不同年龄、职业、婚姻状况、受教育程度、月收入、心理健康自我评价的精神卫生与心理保健知识问卷得分比较,差异均有统计学意义(P<0.01)。回归分析结果显示,年龄、受教育程度、职业、婚姻状况、对自己心理健康程度的评价是精神卫生知识知晓率的影响因素(P<0.01)。结论雄安新区普通人群精神卫生知识知晓率仍需进一步提高。应着重加强精神卫生节日相关节日的宣传,高年龄段、低受教育程度、离异/丧偶、无收入、对自己心理健康程度评价不健康的居民应该是今后精神卫生知识宣教的重点。

2019—2021年兰州市严重精神障碍患者管理治疗状况分析

目的:分析2019—2021年兰州市严重精神障碍患者管理治疗状况,为兰州市制定防治措施及精神卫生政策提供科学依据。方法:提取甘肃省严重精神障碍信息系统中2019—2021年兰州市严重精神障碍患者相关数据,并用Excel 2007进行统计分析。结果:甘肃省精神卫生监测信息系统显示2019—2021年兰州市在册严重精神障碍患者为11 310例、11 914例、12 295例,报告患病率为3.03‰、 3.19‰、 3.42‰,规范管理率为73.48%、 76.16%、 80.21%,患者面访率为72.25%、79.04%、81.53%,患者规律服药率为32.74%、43.76%、52.05%。结论:2019—2021年兰州市严重精神障碍患者报告患病率、规范管理率、患者面访率以及患者规律服药率均有提高,但报告患病率水平和患者规律服药率水平仍低于国家要求。严重精神障碍患者和家属的病耻感是导致报告患病率与规范管理率偏低的主要原因,而精神卫生资源分布的不均衡性导致远郊患者规律服药率偏低。

桂皮、八角和花椒中重金属的溶出及健康风险评估

为研究八角、桂皮和花椒中的重金属摄入风险,从主产区采集15份桂皮(广西藤县)、15份八角(广西浦北县)和15份花椒(贵州德江县)样品,采用电感耦合等离子体串联质谱仪测定8种重金属(砷、钡、镉、铬、铜、锰、镍和铅)的含量,结合日常食用习惯,分析了这3种香辛料中的重金属在不同煮沸时间下的溶出情况,采用溶出结果计算其靶标危害指数(THQ)和非致癌风险指数(HI)。结果表明,这3个地区采集的八角、桂皮和花椒样品均未超过GB 2762—2022《食品安全国家标准食品中污染物限量》要求,桂皮中Mn含量要显著高于其他香调料的含量。桂皮和八角中的As,八角中的Ba、Cd、Mn和Ni溶出率超过50%,Mn和Ni在16 h后溶出率超过了95%(分别为95%和96%)。桂皮和花椒的HI值在不同时间的煮沸浸提时间段没有显著性差异(P≥0.05),八角的HI值要显著高于桂皮和花椒(P≤0.05);通过计算发现:无论是单种香辛料摄入单个重金属的THQ值,还是单种香辛料摄入8种重金属的HI值或3种香辛料叠加摄入的HI值,正常摄入来自这些地区的八角、桂皮和花椒不会引起非致癌的健康风险。

徐汇区中学生精神卫生知识知晓率调查分析

目的 通过对徐汇区中学生精神卫生知识知晓率调查分析,探讨人群差异及知晓水平的影响因素,进而为优化中学生心理健康教育提供参考。方法 采用先典型后分层整群随机抽样,使用《中学生心理健康知识问卷》,对徐汇区504名中学生进行调查。以精神卫生知识得分和知晓率作为评价精神卫生知识知晓水平的依据,并就性别、年级、学校级别、家庭状况、是否接受过心理咨询或心理治疗、是否会担心别人误解而拒绝接受心理咨询这5个特征进行t检验和多元线性回归进行统计分析。结果 女生精神卫生知识知晓率为76.05%,高于男生的72.46%(P<0.05);高中生为78.14%,高于初中生的71.75%(P<0.05);接受过心理咨询或心理治疗的77.76%,高于未曾接受过心理咨询或心理治疗的73.72%(P<0.05);不会担心别人误解而拒绝接受心理咨询的中学生精神卫生知晓率为77.03%,高于会担心和不知道会不会担心别人误解的中学生的68.34%(P<0.05)。结论 不同学校类型、不同家庭状况的精神卫生知识知晓水平无差异;性别、年级、是否接受过心理咨询或心理治疗和会不会担心别人误解而拒绝接受心理咨询是精神卫生知识知晓水平的影响因素。

活蛹缫丝对家蚕综合经济性状的影响

【目的】探明活蛹缫丝对家蚕杂交组合及其亲本的健康性、茧丝质量、品种特性等综合经济性状的影响,为家蚕新材料的创制、筛选和固定以及突破性新蚕品种的定向培育提供理论依据。【方法】2019—2022年,以亲本造A和兰B为试验材料,连续4代对亲本进行活蛹缫丝试验并进行继代保育,同时随代制备杂交组合,以未进行活蛹缫丝的亲本和杂交组合为对照,调查龄期经过、四龄病小蚕数量、产茧量、全茧量、茧层量,观测茧形情况并分粒计数、缫丝茧个体重量和范围、切断、纇节、丝长、丝干重,调查母蛾产卵量、不良卵粒数及孵化情况。【结果】活蛹缫丝亲本(造A和兰B)饲育成绩中结茧率、虫蛹率和全茧量3项指标与对照差异显著(P<0.05),部分指标的提升与饲育季节相关。亲本的纇节与切断次数随活蛹缫丝不断深入而逐代明显减少,茧丝长度明显增长。活蛹缫丝导致亲本的产卵量减少,产附变差。产卵量变化在亲本间及亲本与对照间差异均显著(P<0.05)。杂交组合(造A×兰B)饲育指标中发育经过(五龄和全龄经过)、普茧率和结茧率与对照无显著差异,健蛹率较对照有一定增加,万头蚕产茧量较对照有不同程度减少;全茧量和茧层率因季节呈动态变化,总平均与对照基本持平;万头蚕产茧量和虫蛹率与对照差异显著(P<0.05)。杂交组合缫丝成绩中清洁和净度与对照无差别,上车茧率和解舒率随活蛹缫丝不断深入而逐代提高,茧丝长、茧丝纤度和万米吊糙呈动态变化,总平均与对照基本持平;茧丝长和解舒率2项指标与对照差异显著(P<0.05)。【结论】经活蛹缫丝处理亲本(造A和兰B)的纇节与切断次数随缫丝不断深入而逐代明显减少,茧丝长明显增长,普茧率和茧层率与对照基本持平。亲本结茧率和健蛹率较对照均有不同程度提高,结茧率造A和兰B春季分别提升3.69%和3.76%,秋季分别提升8.13%和1.70%;健蛹率造A和兰B春季分别提升4.55%和6.19%,秋季分别提升8.23%和0.98%。亲本经活蛹缫丝的杂交组合(造A×兰B)的普茧率、健蛹率、茧质成绩较对照均有不同程度提升,春季的普茧率、健蛹率、解舒率和丝长分别较对照提高3.73%、0.84%、3.00%和4.34%;秋季的普茧率与对照基本持平,而健蛹率、解舒率和丝长分别较对照提高0.67%、3.90%和1.62%。

视频节点式健康教育在体外受精-胚胎移植宣教中的应用效果

目的探讨健康教育视频在体外受精-胚胎移植(IVF-ET)全程健康教育中的应用效果。方法将行IVF-ET治疗的106例患者按照入院时间顺序进行分组。2022年5月至2022年12月纳入的53例为对照组,治疗全过程接受常规健康教育;2023年1月至2023年5月纳入的53例为观察组,治疗全程接受集中观看健康教育视频的方法。对比两组的IVF-ET相关健康知识知晓率、患者满意率及负面情绪。结果干预后,观察组IVF-ET相关健康知识知晓率和患者满意率均高于对照组,焦虑及抑郁程度低于对照组(均P<0.05)。结论视频宣教应用于IVF-ET患者各个治疗节点的健康教育中,有助于患者掌握疾病治疗的相关健康知识,并能提高患者的满意率,能有效缓解患者术前紧张、焦虑的情绪,值得进一步应用。

共同富裕视角下国民健康福利发展研究——兼及体育锻炼的贡献率

健康是促进人的全面发展的必然要求。进入新时代,我国民生保障及福利制度的持续完善,人口健康水平不断提高,健康与福利之间的关系更加紧密。目前,对于人口健康福利发展的概念、测量和趋势仍缺乏共识性认识。基于健康与福利两个系统的协调耦合关系,通过CRITIC权重法构建国民健康福利发展指数,分析了近20年(2003—2021年)国民健康福利发展的基本趋势,发现2003—2012年的年均增长率约为1.17%,2012—2021年的年均增长率上升至3.33%。计算了体育锻炼对国民健康福利水平提升的贡献率,总贡献率为3.79%,高于家庭人均全年医疗保健支出(2.99%,第19位)和政府卫生支出(2.52%,第21位)。2003—2021年体育锻炼的贡献率总体呈现增长趋势,年均增长率约为1.18%。