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Objective@#To create a model for early prediction of essential hypertension (EH) based on the TreeNet algorithm, so as to provide a tool for early monitoring of EH. @*Methods@#The health examination data were collected from individuals receiving health examinations in Hangzhou Haiqin Health Examination Center or Shanghai Yibao Health Management Co., Ltd from 2014 to 2016, and a predictive model for EH was created based on the TreeNet algorithm. The effectiveness of the model for early prediction of EH was evaluated using root mean square error (RMSE), mean absolute deviation (MAD), coefficient of determination (R2) and receiver operating characteristic (ROC) curve. @*Results@#A total of 12 variables were included in the model, and the highest contributing variable was body mass index (BMI), followed by BMI difference, two-year BMI difference, two-year triglyceride (TG) difference, two-year total cholesterol (TC) difference, high-density lipoprotein cholesterol (HDL-C) in 2014, TG in 2014, low-density lipoprotein cholesterol (LDL-C) in 2014, body weight in 2015, fasting blood glucose in 2015, TG in 2015, urea nitrogen difference and platelet in 2015. The highest predictive accuracy was 100.00%, and the lowest was 56.89%. The risk of EH significantly increased among individuals with BMI in 2015 of >25 kg/m2, two-year BMI difference of >0.5 kg/m2, two-year TG difference ranging from 1.3 to 3.3 mmol/L, TC in 2015 of 2.0 to 2.4 mmol/L and HDL-C in 2014 of <0.52 mmol/L. The model presented RMSE of 0.082, MAD of 0.064, R2 of 0.811, area under the ROC curve of 0.788 (95%CI: 0.741-0.815), sensitivity of 69.05% and specificity of 66.21% for prediction of EH@*Conclusion@# The TreeNet algorithm-based model is effective for early monitoring of high-risk individuals for EH.
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<p><b>BACKGROUND</b>This retrospective study aimed to investigate the difference of the intra-dural reserving space for spinal cord in magnetic resonance imaging (MRI) between patients with and without developmental cervical stenosis and its clinical significance.</p><p><b>METHODS</b>A total of 264 patients with cervical spondylotic myelopathy who had decompression surgeries were recruited. The average follow-up was 29 months. Based on their lateral radiographs, they were divided into stenosis group and non-stenosis group. On the magnetic resonance images, the ratio of the sagittal diameter of the dural sac to that of the vertebral body was measured and calculated as MRI Pavlov ratio at the mid-vertebral level on T2-weighted sagittal images from C3 to C7. The ratio of the transverse area of the spinal cord to that of the dural sac was measured and calculated as occupation ratio on T2-weighted axial images at the same levels. The MRI Pavlov ratio and occupation ratio were compared between the two groups. The stenosis group was further divided into space-reserving and non-space-reserving subgroups based on the occupation ratios; then clinical parameters were compared between the two subgroups to determine the clinical significance of the reserving space.</p><p><b>RESULTS</b>The MRI Pavlov ratio of the stenosis group was significantly smaller than that of the non-stenosis group at C3-C7 (P < 0.01), while the occupation ratio was significantly larger only at C7 (P < 0.05). For the space-reserving subgroup, the postoperative recovery rate was lower (P < 0.05). The postoperative recovery rate was (23 ± 6)% in anterior approach, larger than (-23±15)% in posterior approach (P < 0.05).</p><p><b>CONCLUSIONS</b>Developmental cervical stenosis is associated with a smaller sagittal diameter of the dural sac, but does not lead to a significant decrease in intra-dural space available for the cord. For patients with normal intra-dural space, the recovery after anterior decompression surgery was better than posterior approach.</p>