Zhitao Zeng

Zhitao Zeng, Mengya Xu, Jian Jiang et al.

Surgical intelligence has the potential to improve the safety and consistency of surgical care, yet most existing surgical AI frameworks remain task-specific and struggle to generalize across procedures and institutions. Although multimodal foundation models, particularly multimodal large language models, have demonstrated strong cross-task capabilities across various medical domains, their advancement in surgery remains constrained by the lack of large-scale, systematically curated multimodal data. To address this challenge, we introduce Surg$Σ$, a spectrum of large-scale multimodal data and foundation models for surgical intelligence. At the core of this framework lies Surg$Σ$-DB, a large-scale multimodal data foundation designed to support diverse surgical tasks. Surg$Σ$-DB consolidates heterogeneous surgical data sources (including open-source datasets, curated in-house clinical collections and web-source data) into a unified schema, aiming to improve label consistency and data standardization across heterogeneous datasets. Surg$Σ$-DB spans 6 clinical specialties and diverse surgical types, providing rich image- and video-level annotations across 18 practical surgical tasks covering understanding, reasoning, planning, and generation, at an unprecedented scale (over 5.98M conversations). Beyond conventional multimodal conversations, Surg$Σ$-DB incorporates hierarchical reasoning annotations, providing richer semantic cues to support deeper contextual understanding in complex surgical scenarios. We further provide empirical evidence through recently developed surgical foundation models built upon Surg$Σ$-DB, illustrating the practical benefits of large-scale multimodal annotations, unified semantic design, and structured reasoning annotations for improving cross-task generalization and interpretability.

Xun Huang, Simeng Qin, Xiaoshuang Jia et al.

As Large Language Models (LLMs) are increasingly used, their security risks have drawn increasing attention. Existing research reveals that LLMs are highly susceptible to jailbreak attacks, with effectiveness varying across language contexts. This paper investigates the role of classical Chinese in jailbreak attacks. Owing to its conciseness and obscurity, classical Chinese can partially bypass existing safety constraints, exposing notable vulnerabilities in LLMs. Based on this observation, this paper proposes a framework, CC-BOS, for the automatic generation of classical Chinese adversarial prompts based on multi-dimensional fruit fly optimization, facilitating efficient and automated jailbreak attacks in black-box settings. Prompts are encoded into eight policy dimensions-covering role, behavior, mechanism, metaphor, expression, knowledge, trigger pattern and context; and iteratively refined via smell search, visual search, and cauchy mutation. This design enables efficient exploration of the search space, thereby enhancing the effectiveness of black-box jailbreak attacks. To enhance readability and evaluation accuracy, we further design a classical Chinese to English translation module. Extensive experiments demonstrate that effectiveness of the proposed CC-BOS, consistently outperforming state-of-the-art jailbreak attack methods.

Jian Jiang, Chenxi Lin, Yiming Gu et al.

Surgical scene understanding demands not only accurate predictions but also interpretable reasoning that surgeons can verify against clinical expertise. However, existing surgical vision-language models generate predictions without reasoning chains, and general-purpose reasoning models fail on compositional surgical tasks without domain-specific knowledge. We present Surg-R1, a surgical Vision-Language Model that addresses this gap through hierarchical reasoning trained via a four-stage pipeline. Our approach introduces three key contributions: (1) a three-level reasoning hierarchy decomposing surgical interpretation into perceptual grounding, relational understanding, and contextual reasoning; (2) the largest surgical chain-of-thought dataset with 320,000 reasoning pairs; and (3) a four-stage training pipeline progressing from supervised fine-tuning to group relative policy optimization and iterative self-improvement. Evaluation on SurgBench, comprising six public benchmarks and six multi-center external validation datasets from five institutions, demonstrates that Surg-R1 achieves the highest Arena Score (64.9%) on public benchmarks versus Gemini 3.0 Pro (46.1%) and GPT-5.1 (37.9%), outperforming both proprietary reasoning models and specialized surgical VLMs on the majority of tasks spanning instrument localization, triplet recognition, phase recognition, action recognition, and critical view of safety assessment, with a 15.2 percentage point improvement over the strongest surgical baseline on external validation.