Bone marrow-derived mesenchymal stem cells (BMSCs) have a superior potential of osteogenic differentiation (OD) and a promising stem cell type to treat bone defects. This study sought to investigate the molecular mechanism of long noncoding RNA small nucleolar RNA host gene 14 (SNHG14) in OD of BMSCs. Western blot analysis or RT-qPCR showed that SNHG14, neural precursor cell expressed developmentally downregulated 4-like (NEDD4L), and Purkinje cell protein 4 (PCP4) were upregulated whereas forkhead box A2 (FOXA2) was declined in OD of BMSCs. RT-qPCR and cell staining showed that SNHG14 downregulation repressed OD of BMSCs, as manifested by reductions in osteopontin and osteocalcin levels, the mineralization degree, and alkaline phosphatase activity. RNA/Co/chromatin immunoprecipitation and dual-luciferase assays and determination of mRNA stability and ubiquitination level showed that SNHG14 bound to human antigen R improves NEDD4L mRNA stability and expression, further promoted FOXA2 ubiquitination to inhibit FOXA2 expression, and then reduced FOXA2 enrichment on the PCP4 promoter to upregulate PCP4 transcription. Functional rescue experiments showed that the overexpression of NEDD4L or PCP4 and knockdown of FOXA2 both attenuated the inhibition of SNHG14 downregulation on OD of BMSCs. Overall, our findings suggested that SNHG14 promoted OD of BMSCs through the NEDD4L/FOXA2/PCP4 axis.

Background Vertebral Compression Fractures and dislocation is usually treated by posterior open reduction nail or internal fixation system, but the high altitude lumbar surgery carries great risks. When the collapse of the vertebra fails to return to the normal height, kyphosis will occur in the later stage of the spine. For the patients with thoracolumbar vertebral compression fracture with pyramidal collapse, preoperative reduction of lumbar support pad was adopted, and good clinical results were obtained.Case presentation: According to the strict screening criteria, 19 patients with thoracolumbar compressibility fracture who will be treated in our hospital in 2021 were selected. All the selected patients were confirmed by imaging examination and the cone front height of compression fracture was measured before surgery. All patients received preoperative reduction treatment with lumbar support pads, and were reexamined after the treatment. The results showed that all patients had significant recovery in their lumbar spine, with VAS scores and activity function scores significantly superior to those before the treatment (p < 0.05). The height between vertebrae in all patients returned to the normal range, with 67.3% of patients having the best pyramidal recovery.Clinical discussion: The plateau has high altitude, low atmospheric pressure, and low oxygen content. It is extremely difficult to perform surgery on thoracic and lumbar vertebral compression fractures at high altitude. Preoperative adjuvant treatment is usually required to alleviate the condition, and then the patient is transferred to a low altitude area for surgery. In this study, lumbar support pads were used as an adjunct treatment to significantly improve the lumbar spine.Conclusion Preoperative reduction of lumbar support pad can effectively relieve the pain of patients with thoracolumbar compressibility fracture, effectively restore the height of compressed vertebral body before surgery, and effectively improve the patients' limited mobility. This treatment method is worth promoting in plateau medical institutions.

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