Chemoradiotherapy plus tislelizumab for mismatch repair proficient rectal cancer with supraclavicular lymph node metastasis: A case report.

BACKGROUND: According to the latest report, colorectal cancer is still one of the most prevalent cancers, with the third highest incidence and mortality worldwide. Treatment of advanced rectal cancer with distant metastases is usually unsatisfactory, especially for mismatch repair proficient (pMMR) rectal cancer, which leads to poor prognosis and recurrence. CASE SUMMARY: We report a case of a pMMR rectal adenocarcinoma with metastases of multiple lymph nodes, including the left supraclavicular lymph node, before treatment in a 70-year-old man. He received full courses of chemoradiotherapy (CRT) followed by 4 cycles of programmed death 1 inhibitor Tislelizumab, and a pathologic complete response (pCR) was achieved, and the lesion of the left supraclavicular lymph node also disappeared. CONCLUSION: pMMR advanced rectal cancer with preserved intact distant metastatic lymph nodes may benefit from full-course CRT combined with immunotherapy.

Intradermal Lactate Monitoring Based on a Microneedle Sensor Patch for Enhanced In Vivo Accuracy.

Lactate is an important diagnostic and prognostic biomarker of several human pathological conditions, such as sepsis, malaria, and dengue fever. Unfortunately, due to the lack of reliable analytical decentralized platforms, the determination of lactate yet relies on discrete blood-based assays, which are invasive and inefficient and may cause tension and pain in the patient. Herein, we demonstrate the potential of a fully integrated microneedle (MN) sensing system for the minimally invasive transdermal detection of lactate in an interstitial fluid (ISF). The originality of this analytical technology relies on: (i) a strategy to provide a uniform coating of a doped polymer-based membrane as a diffusion-limiting layer on the MN structure, optimized to perform full-range lactate detection in the ISF (linear range of response: 0.25-35 mM, 30 s assay time, 8 h operation), (ii) double validation of ex vivo and in vivo results based on ISF and blood measurements in rats, (iii) monitoring of lactate level fluctuations under the administration of anesthesia to mimic bedside clinical scenarios, and (iv) in-house design and fabrication of a fully integrated and portable sensing device in the form of a wearable patch including a custom application and user-friendly interface in a smartphone for the rapid, routine, continuous, and real-time lactate monitoring. The main analytical merits of the lactate MN sensor include appropriate selectivity, reversibility, stability, and durability by using a two-electrode amperometric readout. The ex-vivo testing of the MN patch of preconditioned rat skin pieces and euthanized rats successfully demonstrated the accuracy in measuring lactate levels. The in vivo measurements suggested the existence of a positive correlation between ISF and blood lactate when a lag time of 10 min is considered (Pearson's coefficient = 0.85, mean difference = 0.08 mM). The developed MN-based platform offers distinct advantages over noncontinuous blood sampling in a wide range of contexts, especially where access to laboratory services is limited or blood sampling is not suitable. Implementation of the wearable patch in healthcare could envision personalized medicine in a variety of clinical settings.

Cause Analysis and Surgical Treatment of Aponeurotic Ptosis With Upper Eyelid Depression.

BACKGROUND: Ptosis and upper eyelid depression were previously diagnosed as 2 separate diseases. The authors found that in patients with aponeurotic ptosis accompanied by upper eyelid depression, the main cause of upper eyelid depression was impaired dynamic transmission of the levator aponeurosis. OBJECTIVE: To analyze the causes of upper eyelid depression in patients with aponeurotic ptosis accompanied by upper eyelid depression and to introduce the best treatment methods. METHODS: The authors enrolled 15 eyes (11 patients) with aponeurotic ptosis accompanied by upper eyelid depression from October 2021 to August 2022. The authors analyzed the causes of upper eyelid depression in those patients and performed aponeurotic ptosis correction surgery and orbital septum fat release surgery. After 6 to 12 months of follow-up, the authors reviewed the patient's medical records and photographs to evaluate the treatment outcomes. RESULTS: After surgery, ptosis was corrected and upper eyelid depression significantly improved in all the patients. One patient had poor eyelid morphology and upper eyelid depression due to habitual brow lifting, which was relieved after an injection of botulinum toxin into the frontalis muscle. One patient had overcorrection of the upper eyelid depression on the affected side and no other complications. CONCLUSION: The main cause of upper eyelid depression in patients with aponeurotic ptosis is impaired dynamic transmission of the levator aponeurosis. Aponeurotic ptosis repair surgery and orbital septum fat release surgery are simple surgical procedures that restore the normal anatomy and physiology of the upper eyelid and maintain the normal structure of the eyelid, with good post-operative outcomes.

Impact of simulation-based training on bougie-assisted cricothyrotomy technique: a quasi-experimental study.

BACKGROUND: Cricothyrotomy is a lifesaving surgical technique in critical airway events. However, a large proportion of anesthesiologists have little experience with cricothyrotomy due to its low incidence. This study aimed to develop a multisensory, readily available training curriculum for learning cricothyrotomy and evaluate its training effectiveness. METHODS: Seventy board-certificated anesthesiologists were recruited into the study. Participants first viewed an instructional video and observed an expert performing the bougie-assisted cricothyrotomy on a self-made simulator. They were tested before and after a one-hour practice on their cricothyrotomy skills and evaluated by a checklist and a global rating scale (GRS). Additionally, a questionnaire survey regarding participants' confidence in performing cricothyrotomy was conducted during the training session. RESULTS: The duration to complete cricothyrotomy was decreased from the pretest (median = 85.0 s, IQR = 72.5-103.0 s) to the posttest (median = 59.0 s, IQR = 49.0-69.0 s). Furthermore, the median checklist score was increased significantly from the pretest (median = 30.0, IQR = 27.0-33.5) to the posttest (median = 37.0, IQR = 35.5-39.0), as well as the GRS score (pretest median = 22.5, IQR = 18.0-25.0, posttest median = 32.0, IQR = 31.0-33.5). Participants' confidence levels in performing cricothyrotomy also improved after the curriculum. CONCLUSION: The simulation-based training with a self-made simulator is effective for teaching anesthesiologists to perform cricothyrotomy.

Tertiary lymphoid structures predict survival and response to neoadjuvant therapy in locally advanced rectal cancer.

Tertiary lymphoid structure (TLS) contributes to the anti-tumor immune response, and predicts the prognosis of colorectal cancer patients. However, the potential impact of TLS in shaping the immune status of rectal adenocarcinoma, and the intrinsic relationship between TLS and neoadjuvant therapies (neoTx) remain unclear. We performed hematoxylin-eosin staining, immunohistochemical and biomolecular analyses to investigate TLS and tumor-infiltrating lymphocytes (TILs) in 221 neoTx-treated and 242 treatment-naïve locally advanced rectal cancer (LARC) patients. High TLS density was significantly associated with the absence of vascular invasion, a lower neutrophil-to-lymphocyte ratio, increased TLS maturity, a longer recurrence-free survival (RFS) (hazard ratio [HR] 0.2985 95% confidence interval [CI] 0.1894-0.4706, p < 0.0001) and enhanced infiltration of adaptive immune cells. Biomolecular analysis showed that high TLS-score was strongly associated with more infiltration of immune cells and increased activation of immune-related pathways. TLS+ tumors in pre-treatment specimens were associated with a higher proportion of good respond (62.5% vs. 29.8%, p < 0.0002) and pathological complete remission (pCR) (40.0% vs. 11.1%, p < 0.0001), and significantly increased RFS (HR 0.3574 95%CI 0.1489-0.8578 p = 0.0213) compared with TLS- tumors in the neoTx cohort, which was confirmed in GSE119409 and GSE150082. Further studies showed that neoTx significantly reduced TLS density and maturity, and abolished the prognostic value of TLS. Our study illustrates that TLS may have a key role in mediating the T-cell-inflamed tumor microenvironment, which also provides a new direction for neoTx, especially neoadjuvant immunotherapy, in LRAC patients.

Polymorphism in F pocket affects peptide selection and stability of type 1 diabetes-associated HLA-B39 allotypes.

HLA-B*39:06, HLA-B*39:01, and HLA-B*38:01 are closely related HLA allotypes differentially associated with type 1 diabetes (T1D) risk and progression. B*39:06 is highly predisposing, while B*39:01 and B*38:01 are weakly predisposing and protective allotypes, respectively. Here, we aimed to decipher molecular mechanisms underlying the differential association of these allotypes with T1D pathogenesis. We addressed peptide binding and conformational stability of HLA-B allotypes using computational and experimental approaches. Computationally, we found that B*39:06 and B*39:01 allotypes had more rigid peptide-binding grooves and were more promiscuous in binding peptides than B*38:01. Peptidomes of B*39:06 and B*39:01 contained fewer strong binders and were of lower affinity than that of B*38:01. Experimentally, we demonstrated that B*39:06 and B*39:01 had a higher capacity to bind peptides and exit to the cell surface but lower surface levels and were degraded faster than B*38:01. In summary, we propose that promiscuous B*39:06 and B*39:01 may bind suboptimal peptides and transport them the cell surface, where such unstable complexes may contribute to the pathogenesis of T1D.

Predictive Value of Combined Detection of Serum PSA, PCA3, and Apparent Diffusion Coefficient of Magnetic Resonance Imaging in Bone Metastasis of Prostate Cancer.

Objective: The objective of this study was to examine the utility of combining the detection of serum prostate-specific antigen (PSA), prostate cancer antigen 3 (PCA3), and apparent diffusion coefficient (ADC) of magnetic resonance imaging for predicting bone metastases in prostate cancer. Methods: We looked back at 67 men with prostate cancer who were admitted to our hospital between December 2015 and December 2022. Based on the results of bone metastasis in ECT, men with prostate cancer were split into two groups: those with metastasis (26 cases) and those without (41 cases). The Gleason score, the levels of serum PSA and PCA3, and the difference between ADCmean and the difference between ADCmax and ADCmin (ADCdiff) were compared between the two groups. Results: Patients with bone metastases of prostate cancer exhibited significantly higher levels of PSA, PCA3, ADCmean, and ADCdiffer compared to the control group (P < .05). ADCmean and ADCdiffer were statistically significant (P < .05) greater in the metastatic group compared to the control group. Prostate cancer bone metastasis risk variables were shown to be elevated PSA, PCA3, ADCmean, and big ADCdiffer by logistic regression analysis (P < .05). ROC analysis showed that the AUC curves of PSA, PCA3, ADCmean, ADCmean, and their combination had certain predictive value. Conclusion: Patients with bone metastases of prostate cancer will have drastically different PSA and PCA3 serum values. Risk factors for prostate cancer bone metastases include elevated PSA and PCA3 levels as well as elevated ADCmean and big ADCdiffer. The combination of PSA, PCA3, and MRI ADC values demonstrated a strong predictive value for bone metastasis in prostate cancer patients.

Nacre-Inspired Aramid Nanofibers/Basalt Fibers Composite Paper with Excellent Flame Retardance and Thermal Stability by Constructing an Organic-Inorganic Fiber Alternating Layered Structure.

The flame-retardant paper has gradually evolved into a necessary material in various industries as a result of the rising importance of fire safety, energy efficiency, and environmental preservation. Traditional cellulose paper requires the addition of a large amount of flame retardants to achieve flame retardancy, which poses a serious threat to mechanical quality and the environment. Therefore, there is an urgent need to develop inorganic fiber flame-retardant paper with good flexibility, high thermal stability, and inherent flame retardancy. Herein, inspired by the "brick-and-mortar" layered structure of nature nacre, we developed a layered composite paper with a unique alternating arrangement of organic-inorganic fibers by synergistically integrating environmentally sustainable basalt fiber (BF) and high-performance aramid nanofibers (ANFs) through a vacuum-assisted filtration process. The as-prepared ANFs/BF composite paper exhibited low thermal conductivity (0.024 W m-1 K-1), high tensile strength (54.22 MPa), and excellent flexibility. Thanks to its excellent thermal stability, the mechanical strength remains at a high level (92%) after heat treatment at 300 °C for 60 min. Furthermore, the peak heat release rate and smoke generation of ANFs/BF composite paper decreased by 44.6 and 95.3%, respectively. Therefore, the composite paper is promising for applications as a protective layer in flexible electronic devices, cables, and fire-retardant and high-temperature fields.

Demonstrating the Analytical Potential of a Wearable Microneedle-Based Device for Intradermal CO2 Detection.

Monitoring of carbon dioxide (CO2) body levels is crucial under several clinical conditions (e.g., human intensive care and acid-base disorders). To date, painful and risky arterial blood punctures have been performed to obtain discrete CO2 measurements needed in clinical setups. Although noninvasive alternatives have been proposed to assess CO2, these are currently limited to benchtop devices, requiring trained personnel, being tedious, and providing punctual information, among other disadvantages. To the best of our knowledge, the literature and market lack a wearable device for real-time, on-body monitoring of CO2. Accordingly, we have developed a microneedle (MN)-based sensor array, labeled as CO2-MN, comprising a combination of potentiometric pH- and carbonate (CO32-)-selective electrodes together with the reference electrode. The CO2-MN is built on an epidermal patch that allows it to reach the stratum corneum of the skin, measuring pH and CO32- concentrations directly into the interstitial fluid (ISF). The levels for the pH-CO32- tandem are then used to estimate the PCO2 in the ISF. Assessing the response of each individual MN, we found adequate response time (t95 < 5s), sensitivity (50.4 and -24.6 mV dec-1 for pH and CO32-, respectively), and stability (1.6 mV h-1 for pH and 2.1 mV h-1 for CO32-). We validated the intradermal measurements of CO2 at the ex vivo level, using pieces of rat skin, and then, with in vivo assays in anesthetized rats, showing the suitability of the CO2-MN wearable device for on-body measurements. A good correlation between ISF and blood CO2 concentrations was observed, demonstrating the high potential of the developed MN sensing technology as an alternative to blood-based analysis in the near future. Moreover, these results open new horizons in the noninvasive, real-time monitoring of CO2 as well as other clinically relevant gases.

Nacre-inspired composite paper of PVA crosslinked basalt scale and nanocellulose with enhanced mechanical, electrical insulating and ultraviolet-resistant aging performance.

Silicate scales are commonly incorporated into cellulose nanofiber (CNF) as functional fillers to enhance electrical insulation and UV-shielding properties. Nevertheless, the addition of substantial quantities of silicate scales in the quest for enhanced functional properties results in reduced interface bonding capability and compromised mechanical properties, thereby restricting their application. Here, inspired from nacre, layered composite paper with excellent mechanical strength, electrical insulation and UV-resistance properties was fabricated through vacuum assisted self-assembly using CNF, PVA and basalt scales (BS). Unlike the conventional blending strategy, the pre-mixed PVA and BS suspension facilitates the formation of Al-O-C bond, thereby enhancing the interfacial bonding between BS and CNF. Consequently, the composite paper (BS@PVA/PVA/CNF) containing 60 wt% BS demonstrates higher mechanical strength-approximately 140 % higher than that of BS/CNF composite paper, achieving a strength of 33.5 MPa. Additionally, it demonstrates enhanced dielectric properties, surpassing those of CNF paper by up to 107 %. Moreover, it exhibits robust ultraviolet-resistant aging performance, retaining ~87 % of its tensile strength after undergoing a simulated two-year aging period. As a result, this work presents a simple and innovative design strategy for enhancing interfacial bonding and optimizing layer structure, providing essential guidelines for large-scale production of high-performance insulation and aging-resistant composite paper.

Improvement of the YOLOv5 Model in the Optimization of the Brown Spot Disease Recognition Algorithm of Kidney Bean.

The kidney bean is an important cash crop whose growth and yield are severely affected by brown spot disease. Traditional target detection models cannot effectively screen out key features, resulting in model overfitting and weak generalization ability. In this study, a Bi-Directional Feature Pyramid Network (BiFPN) and Squeeze and Excitation (SE) module were added to a YOLOv5 model to improve the multi-scale feature fusion and key feature extraction abilities of the improved model. The results show that the BiFPN and SE modules show higher heat in the target location region and pay less attention to irrelevant environmental information in the non-target region. The detection Precision, Recall, and mean average Precision (mAP@0.5) of the improved YOLOv5 model are 94.7%, 88.2%, and 92.5%, respectively, which are 4.9% higher in Precision, 0.5% higher in Recall, and 25.6% higher in the mean average Precision compared to the original YOLOv5 model. Compared with the YOLOv5-SE, YOLOv5-BiFPN, FasterR-CNN, and EfficientDet models, detection Precision improved by 1.8%, 3.0%, 9.4%, and 9.5%, respectively. Moreover, the rate of missed and wrong detection in the improved YOLOv5 model is only 8.16%. Therefore, the YOLOv5-SE-BiFPN model can more effectively detect the brown spot area of kidney beans.

[Research Progress in Adjacent Anatomical Structure and Location of Cricothyroid Membrane].

Cricothyroid membrane puncture and incision,the key techniques to save the lives of the patients in the Can't Intubate,Can't Oxygenate (CICO) emergency,need to be mastered by all the airway management staff.However,the decision to carry out cricothyroid membrane puncture or incision is often delayed due to the unfamiliarity with the adjacent anatomical structure of the cricothyroid membrane and the inability to accurately locate the cricothyroid membrane.As a result,serious complications and rescue failure occur.Therefore,airway management staff should be familiar with the adjacent structure and positioning methods of the cricothyroid membrane,so as to improve the success rate of emergency airway rescue,reduce complications,and protect the airway and life safety of the patients.

The combination of DNA methylation and positive regulation of anthocyanin biosynthesis by MYB and bHLH transcription factors contributes to the petal blotch formation in Xibei tree peony.

Xibei tree peony is a distinctive cultivar group that features red-purple blotches in petals. Interestingly, the pigmentations of blotches and non-blotches are largely independent of one another. The underlying molecular mechanism had attracted lots of attention from investigators, but was still uncertain. Our present work demonstrates the factors that are closely related to blotch formation in Paeonia rockii 'Shu Sheng Peng Mo'. Non-blotch pigmentation is prevented by the silencing of anthocyanin structural genes, among which PrF3H, PrDFR, and PrANS are the three major genes. We characterized two R2R3-MYBs as the key transcription factors that control the early and late anthocyanin biosynthetic pathways. PrMYBa1, which belongs to MYB subgroup 7 (SG7) was found to activate the early biosynthetic gene (EBG) PrF3H by interacting with SG5 member PrMYBa2 to form an 'MM' complex. The SG6 member PrMYBa3 interacts with two SG5 (IIIf) bHLHs to synergistically activate the late biosynthetic genes (LBGs) PrDFR and PrANS, which is essential for anthocyanin accumulation in petal blotches. The comparison of methylation levels of the PrANS and PrF3H promoters between blotch and non-blotch indicated a correlation between hypermethylation and gene silencing. The methylation dynamics of PrANS promoter during flower development revealed a potential early demethylating reaction, which may have contributed to the particular expression of PrANS solely in the blotch area. We suggest that the formation of petal blotch may be highly associated with the cooperation of transcriptional activation and DNA methylation of structural gene promoters.

Flexible Basalt Fiber/Aramid Nanofiber/Carbon Nanotube Electromagnetic Shielding Paper with Outstanding Environmental Stability and Joule Heating Performance.

In the field of electromagnetic shielding, it has become an important trend to manufacture thinner and better-performing electromagnetic interference (EMI) shielding materials. However, EMI shielding materials that are recyclable and resistant to extreme environments are of great significance for sustainable development and expanding their application areas. In this study, a composite paper with a "rebar-concrete" layered structure through the vacuum-assisted filtration approach by utilizing basalt fibers (BF) and aramid nanofibers (ANFs) with excellent temperature resistance and multiwalled carbon nanotubes with high electrical conductivity was prepared. The composite paper not only delivers a high electrical conductivity of 15.9 S cm-1 and a high electromagnetic interference shielding efficiency (EMI SE) of 24.6 dB but also exhibits a high specific shielding efficiency (SSE/t) of 12,504 dB cm2 g-1 at a thickness of 48 µm. Thanks to the excellent thermal stability of basalt fibers and aramid nanofibers, the composite paper exhibits long-term stable EMI shielding performance and structural integrity in various extreme environments, including fire, high/low temperature (-196 to 300 °C), and acid-base corrosion. Furthermore, the BF/ANF/CNT composite paper also shows excellent Joule heating performance, rapid electrothermal response, and good temperature controllability. Based on these excellent properties, the BF/ANF/CNT composite paper shows tremendous potential for practical applications to meet the requirements of various extreme environments.

The emerging role of neutrophil extracellular traps in cancer: from lab to ward.

Neutrophil extracellular traps (NETs) are web-like structures derived from neutrophils, which typically consist of DNA, released from the nucleus or mitochondria, and decorated with histones and granule proteins. They are well known as an important structure in innate immunity to eliminate pathogenic bacteria, similar to neutrophils. Initially, NETs are reported to take part in the progression of inflammatory diseases; now, they have also been implicated in the progression of sterile inflammation such as autoimmune disease, diabetes, and cancer. In this review, we will describe the recent studies which have investigated the role of NETs in the development of cancer, especially metastasis. We also prescribe the strategies for targeting NETs in the multiple cancer types, which suggest that NETs are a promising treatment for cancer patients.

Competitive Coordination-Oriented Monodispersed Cobalt Sites on a N-Rich Porous Carbon Microsphere Catalyst for High-Performance Zn-Air Batteries.

Metal/nitrogen-doped carbon single-atom catalysts (M-N-C SACs) show excellent catalytic performance with a maximum atom utilization and customizable tunable electronic structure. However, precisely modulating the M-Nx coordination in M-N-C SACs remains a grand challenge. Here, we used a N-rich nucleobase coordination self-assembly strategy to precisely regulate the dispersion of metal atoms by controlling the metal ratio. Meanwhile, the elimination of Zn during pyrolysis produced porous carbon microspheres with a specific surface area of up to 1151 m2 g-1, allowing maximum exposure of Co-N4 sites and facilitating charge transport in the oxygen reduction reaction (ORR) process. Thereby, the monodispersed cobalt sites (Co-N4) in N-rich (18.49 at%) porous carbon microspheres (CoSA/N-PCMS) displayed excellent ORR activity under alkaline conditions. Simultaneously, the Zn-air battery (ZAB) assembled with CoSA/N-PCMS outperformed Pt/C+RuO2-based ZABs in terms of power density and capacity, proving that they have good prospects for practical application.

The estimation and partitioning of evapotranspiration in a coniferous plantation in subtropical China.

Accurate estimations of forest evapotranspiration (ET) and its components, transpiration (T) and evaporation (E), are important for deep understanding and predicting the responses of forest water cycles to climate change. In this study, the improved Shuttleworth-Wallace model (SWH) was applied to estimate ET, T, and E during 2003-2014 in a subtropical planation, and the modeled results were verified using in situ measurements by the eddy covariance technique, sap flow, and micro-lysimeter method. The study aimed to clarify whether it is feasible and reliable to use the SWH model to estimate and partition ET in forests. In addition, depending on the long-term data, the specific performances in modeling ET under different climatic backgrounds were investigated, and the underlying mechanisms were explored. The results verified that the SWH performed relatively well in the subtropical forest, and the modeled ET, T and E could track the seasonal variations, although overestimations were found in the peak seasons. However, the model was relatively weaker in estimating the interannual variabilities. It performed well in modeling ET in normal years but showed larger model residuals in years with obvious climatic anomalies. In the severe summer-drought (2003) and cold-spring (2005) years, the model greatly overestimated ET. It also overestimated ET in summer since 2010, which may be ascribed to the less dependency of ET on VPD induced by the more humid microclimate in forest accompanied with forest development. For the ET partitioning results, the modeled and measured E and T values were all in reasonable ranges. The possible reasons for underestimations (overestimations) of E and T by measurements (SWH model) were discussed. In this study, the data obtained using different methods and from different scales matched each other and could be cross validated, and the discussion on discrepancies would be beneficial for understanding the advantages and flaws of different methods and could be the basis for optimizing the measurement and model methods. In sum, this study verified that it is feasible to use the SWH model in forests and provided a basis for further improving and optimizing the modeled results under different climate backgrounds.

New Staging System and Prognostic Model for Malignant Phyllodes Tumor Patients without Distant Metastasis: A Development and Validation Study.

PURPOSE: To build a new staging system and new prognostic models for MPTB. METHODS: We performed a comprehensive analysis of the data from the SEER database. RESULTS: We discussed the characteristics of MPTB by comparing 1085 MPTB cases with 382,718 invasive ductal carcinoma cases. We established a new stage- and age-stratification system for MPTB patients. Furthermore, we built two prognostic models for MPTB patients. The validity of these models was confirmed through multifaceted and multidata verification. CONCLUSIONS: Our study provided a staging system and prognostic models for MPTB patients, which can not only help to predict patient outcomes, but also enhance the understanding of the prognostic factors associated with MPTB.

Preliminary evaluation of SaCoVLM video laryngeal mask-guided intubation in airway management for anesthetized children.

BACKGROUNDS: To preliminary evaluate the application of novel SaCoVLM video laryngeal mask -guided intubation for anesthetized children. METHODS: One hundred twenty-four children with microtia (ages 5-15 years,) who required general intubation anaesthesia, were enrolled in the study. After induction of general anesthesia,guided tracheal intubation under direct vision of the SaCoVLM was performed. Our primary outcome was first-pass success rate of guided tracheal tube placement. Secondary outcome included glottic visualization grades, the first-attempt success rate of LMA placement, the time for LMA placement and time to endotracheal intubation as well as the time for LMA removal after successful intubation, the fiberoptic grade of laryngeal view, the baseline and postinduction hemodynamic parameters were also recorded,and the incidence 24 h complications after operation. RESULTS: The first-pass success rate of guided tracheal tube placement was 91.1% (95%CI = 1.04-1.14), the status of glottic visualization was classified: grade 1 in 27cases, grade 2 in 36 cases, grade 3 in 41 cases and grade 4 in 20 cases. The first success rate of LMA placement was 92.7% (95%CI = 1.03-1.13), the time for LMA insertion was 15.7 (±9.1) s, intubation time was 30.9 (±17.6) s and withdrawl time was 24.9 (±9.3) s. The incidence of postoperative sore throat at 2 h was 29%, and 16.1% at 24 h, without dysphagia and hypoxia. CONCLUSION: The SaCoVLM video laryngeal mask-guided intubation is feasible in children, with a high success rate, could be a new promising device to guide intubation in airway management. TRIAL REGISTRATION: This study was approved by the University's Institutional Review Board and written informed consent was obtained from all subjects participating in the trial. The trial was registered prior to patient enrollment at clinicaltrials.gov (ChiCTR2200061481, http://www.chictr.org.cn . Principal investigator: Juan Zhi; Date of registration: 26/06/2022.