H19 can inhibit the binding of transcription factor p53 to the promoter region of Notch1, upregulating the expression of the calcification-promoting genes BMP2 and RUNX2 by inhibiting the Notch1 signaling pathway and promoting the occurrence of CAVD (38). This evidence concerns the gene NOTCH1 and congenital bilateral aplasia of vas deferens from CFTR mutation.