Osteogenic differentiation and bone regeneration are complex processes involving multiple genes and multiple steps. In this review, we summarize the effects of the long noncoding RNA (lncRNA) H19 on osteogenic differentiation.Osteogenic differentiation includes matrix secretion and calcium mineralization as hallmarks of osteoblast differentiation and the absorption of calcium and phosphorus as hallmarks of osteoclast differentiation. Mesenchymal stem cells (MSCs) form osteoprogenitor cells, pre-osteoblasts, mature osteoblasts, and osteocytes through induction and differentiation. lncRNAs regulate the expression of coding genes and play essential roles in osteogenic differentiation and bone regeneration. The lncRNA H19 is known to have vital roles in osteogenic induction.This review highlights the role of H19 as a novel target for osteogenic differentiation and the promotion of bone regeneration.
BackgroundAcute febrile reaction often occurs though zoledronic acid is a widely used first-line drug for osteoporosis. This study aimed to investigate the characteristics and risk factors of acute febrile reaction after zoledronic acid in the orthopaedic field, including surgical intervention.Methodsa total of 517 patients diagnosed with primary osteoporosis and treated with zoledronic acid from January 2012 to December 2020 were collected, including 40 males and 477 females, 262 patients with type I, 255 patients with type II, 230 patients with fresh fracture, and 209 patients with the operation. Summarize the characteristics of overall fever rate, fever degree, occurrence time, and duration of the acute febrile reaction. The effects of gender, white blood cell, neutrophil, lymphocyte, neutrophil-lymphocyte ratio (NLR), type of osteoporosis, degree of osteoporosis, fresh fracture, operation, and zoledronic acid medication history on acute febrile reaction were analyzed by univariate, logistic regression, ROC curve analysis. The differences in fever rate in different fracture operation sites were further compared.ResultsIn 517 patients, 175 cases (33.85%) developed acute febrile reaction within 36h after medication with less than 60h duration. Univariate analysis showed significant differences in NLR, type and degree of osteoporosis, fresh fracture, operation, and zoledronic acid history between the fever and non-fever groups (P<0.05). Logistic regression and ROC curve analysis further showed that the fever rate of patients with the operation was higher (OR = 1.975, P < 0.01, area under ROC curve was 0.654). The fever rate of patients with type I osteoporosis was higher ((OR = 2.137, P < 0.01, area under ROC curve was 0.437), and the fever rate of patients with zoledronic acid history was lower ((OR = 0.124, P < 0.01, area under ROC curve was 0.340). The fever rate of joint fracture patients (56.60%) was significantly higher than that of spine fracture patients (38.54%) (P < 0.05).ConclusionWhen zoledronic acid was used to treat primary osteoporosis in orthopaedic patients, the rate of acute febrile reaction was 33.85%, orthopaedic surgical intervention, type I osteoporosis, and the first zoledronic acid treatment might be independent risk factors.
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