Background Accurate T-staging is critical for esophageal cancer therapy,but CT-based assessment has significant limitations.Large vision models(LVMs)hold promise,yet their zero-shot clinical diagnostic capability without fine-tuning remains unvalidated.Methods A retrospective analysis was conducted on the chest CT images from 98 esophageal cancer patients and 50 normal controls.Using radiologist-consensus as the gold standard,the zero-shot T-staging performance of 3 LVMs(GPT-5,Gemini,and MedGemma)was evaluated with prompts of varying complexity.Results GPT-5 exhibited the highest accuracy and stability.Significant biases were observed among models:Gemini tended to over-stage,while MedGemma showed a tendency to under-stage.All models faced challenges in identifying early-stage tumors,but structured prompts improved diagnostic performance for mid-to-late stage lesions.Conclusion LVMs have potential for zero-shot T-staging,but their performance highly depends on model choice and prompt design.The generic model GPT-5 show superior zero-shot generalization.However,current model performance is not yet clinically viable,especially for early diagnosis.Future work should focus on fine-tuning with high-quality clinical data and developing standardized prompt frameworks.

Background Accurate T-staging is critical for esophageal cancer therapy,but CT-based assessment has significant limitations.Large vision models(LVMs)hold promise,yet their zero-shot clinical diagnostic capability without fine-tuning remains unvalidated.Methods A retrospective analysis was conducted on the chest CT images from 98 esophageal cancer patients and 50 normal controls.Using radiologist-consensus as the gold standard,the zero-shot T-staging performance of 3 LVMs(GPT-5,Gemini,and MedGemma)was evaluated with prompts of varying complexity.Results GPT-5 exhibited the highest accuracy and stability.Significant biases were observed among models:Gemini tended to over-stage,while MedGemma showed a tendency to under-stage.All models faced challenges in identifying early-stage tumors,but structured prompts improved diagnostic performance for mid-to-late stage lesions.Conclusion LVMs have potential for zero-shot T-staging,but their performance highly depends on model choice and prompt design.The generic model GPT-5 show superior zero-shot generalization.However,current model performance is not yet clinically viable,especially for early diagnosis.Future work should focus on fine-tuning with high-quality clinical data and developing standardized prompt frameworks.

Objective To explore the correlation between the genetic dissimilarity and heterozygosity of mates and the patho?genicity of Schistosoma japonicum in the definitive host. Methods By using seven microsatellite loci markers,S. japonicum genotyping of sixteen pairs randomly mated was performed,the genetic dissimilarity and heterozygosity were calculated between the mates,and the correlation between the genetic dissimilarity and heterozygosity of the mates and the pathogenicity of S. japon?icum in the definitive host was evaluated. Results There was a significant correlation between the genetic similarity of S. ja?ponicum mates and the mean number of eggs per worm pair in the liver and intestinal tissue (r = 0.501 6 ,P < 0.05;r =0.796 5,P<0.01,respectively)and the hatching rate of deposited eggs in the liver(r=0.508 3,P<0.05),respectively. There was no correlation between the genetic similarity of the mates and hepatosplenomegaly per worm pair(r=0.109 5,P>0.05;r=0.265 3,P>0.05,respectively)and the average diameter of granuloma in the liver(r=-0.272 7,P>0.05),respec?tively. There was no correlation between the heterozygosity of the mates and all the pathological parameters of S. japonicum in the definitive host(P > 0.05). Conclusions There is the correlation between the genetic dissimilarity of the mates and the pathogenicity of S. japonicum in the definitive host,and the genetic dissimilarity is greater,pathogenicity is weaker. There is no correlation between heterozygosity of the mates and the pathogenicity of S. japonicum in the definitive host.

Objective To compare effects of both ends of the injection cesarean section anesthesia differ-ences.Methods ASAⅠ-Ⅱgrade cesarean section 226 cases were selected and randomly divided into the observa-tion group and control group on the basis of number characterization.Observation group:After the success of epidural puncture needle oblique injection of 1.7% for the end of lidocaine carbonate 5mL,then needle bevel steering head end 3-5min without observing all spinal abnormalities such as re-injection of 5mL of 1.7% lidocaine carbonate,fol-lowed by epidural catheter inserted,modified supine position to continue after injection of 1.7% lidocaine carbonate 5mL;Control group:after the success of epidural catheter tip administered by traditional teaching methods.Two groups of maternal range block plane , intraoperative pain intensity and time of delivery of the fetus were recorded .intraoperative changes in vital signs and Apgar score after the fetus were observed.Results The block wide range for anesthesia of the observation group[(14.43 ±1.21)points]were significantly higher than that of the control group,and intraopera-tive pain was (1.61 ±0.92)points,fetal childbirth lengthwas (1.8 ±0.6)minutes,which were better than those in the control group(t=12.76,13.07,12.86,all P<0.05);The MAP,HR,R,SpO2 between the two groups showed no significant differences(F=4.32,2.73,3.54,3.06,all P<0.05);Intraoperative vital signs and Apgar score was con-firmed no difference between the two groups(all P>0.05).Conclusion Both ends of the epidural injection for ce-sarean section is better than the traditional mode of administration of anesthesia.

Objective To evaluate the clinical effect of itraconazole in prevention of invasive fungal infections in allogeneic hema-topoietic stem cell transplantion .Methods In this retrospective study ,110 patients receiving allogeneic hematopoietic stem cell transplants were administed itraconazole or fluconazole for prevention of fungal infection .The occurrence and prognosis of invasive fungal infection ,and the side effect of both pyrroles were observed .Results Proven and probable invasive fungal infections occurred in 5 of 69 itraconazole recipients(7 .2% ) and in 8 of 41 fluconazole recipients(19 .5% ) during the first 180 days after transplanta-tion ,the difference had statistical significance(P<0 .05) .The fatality rate related to fungal infection had no statistical difference be-tween the two groups(2 .9% vs .7 .3% ) .The occurrence of itraconazole adverse reactions were more than fluconazole (26 .9% vs . 7 .0% ) ,and both itraconazole and fluconazole were well tolerated .Conclusion Itraconazole significantly reduces the incidence of inva-sive fungal infection in the patients receiving allogeneic hematopoietic stem cell transplants ,and it is a effective and safe prophylaxis .