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.

Acute carbon monoxide poisoning can cause hypoxic injury to multiple organs. Neurological impairment and cardiac dysfunction are common manifestations of severe poisoning patients, but hemorrhagic complications are rare in clinic. The clinical diagnosis and treatment of a case of massive intrathecal hematoma of the rectus abdominis secondary to acute severe carbon monoxide poisoning was reported. The pathophysiological mechanism and treatment strategy of rectus sheath hematoma secondary to acute severe carbon monoxide poisoning was analyzed, in order to improve the understanding of hemorrhagic complications of carbon monoxide poisoning. This case suggests that for patients with a history of cardiovascular disease and taking anticoagulants, clinicians should be alert for the risk of bleeding when making medical decisions.

Acute carbon monoxide poisoning can cause hypoxic injury to multiple organs. Neurological impairment and cardiac dysfunction are common manifestations of severe poisoning patients, but hemorrhagic complications are rare in clinic. The clinical diagnosis and treatment of a case of massive intrathecal hematoma of the rectus abdominis secondary to acute severe carbon monoxide poisoning was reported. The pathophysiological mechanism and treatment strategy of rectus sheath hematoma secondary to acute severe carbon monoxide poisoning was analyzed, in order to improve the understanding of hemorrhagic complications of carbon monoxide poisoning. This case suggests that for patients with a history of cardiovascular disease and taking anticoagulants, clinicians should be alert for the risk of bleeding when making medical decisions.

Objective: To select the optimum extraction procedure for Buqiyangxuecuiru Oral Liquid. Methods: The water extraction, water extraction and alcohol precipitation, and alcohol percolation procedures were designed. Taking contents of ferulic acid and astragalus saponins I, and the lactation quantity of normal lactation mice as markers, the rational preparation procedure was selected. Results: The oral liquid prepared by the procedure of alcohol percolation. Both ferulic acid and astragalus saponins I contents in this preparation were the highest, and it could remarkably increase the lactation quantity of normal mice. Conclusion: The alcohol percolation procedure was the optimum extraction procedure for Buqiyangxuecuira Oral Liquid.