feat: 应用内通知系统 + 结构化手术史/用药等相关改动

- 新增用户通知 outbox 流水线(EfUserNotificationPipeline)与后台投递 worker
- 通知中心页面及前端通知服务接入
- 健康指标异常、用药/运动提醒等事件统一产出站内通知
- 健康档案结构化手术史、用药提醒扫描、医生/用户端点等配套调整
- AppDbContext 注册通知相关实体

backend/src/Health.Application/HealthArchives/HealthArchiveContracts.cs

@@ -2,12 +2,22 @@ using Health.Domain.Entities;
 
 namespace Health.Application.HealthArchives;
 
+public sealed record HealthArchiveSurgeryDto(
+    Guid Id,
+    string Type,
+    DateOnly? Date);
+
+public sealed record HealthArchiveSurgeryInput(
+    string Type,
+    DateOnly? Date);
+
 public sealed record HealthArchiveDto(
     Guid Id,
     Guid UserId,
     string? Diagnosis,
     string? SurgeryType,
     DateOnly? SurgeryDate,
+    IReadOnlyList<HealthArchiveSurgeryDto> Surgeries,
     IReadOnlyList<string> Allergies,
     IReadOnlyList<string> DietRestrictions,
     IReadOnlyList<string> ChronicDiseases,
@@ -21,7 +31,8 @@ public sealed record HealthArchiveUpdateRequest(
     IReadOnlyList<string>? Allergies,
     IReadOnlyList<string>? DietRestrictions,
     IReadOnlyList<string>? ChronicDiseases,
-    string? FamilyHistory);
+    string? FamilyHistory,
+    IReadOnlyList<HealthArchiveSurgeryInput>? Surgeries = null);
 
 public interface IHealthArchiveService
 {

backend/src/Health.Application/HealthArchives/HealthArchiveService.cs

@@ -42,7 +42,8 @@ public sealed class HealthArchiveService(IHealthArchiveRepository archives) : IH
             "update_diagnosis" => request with
             {
                 SurgeryType = null, SurgeryDate = null, Allergies = null,
-                DietRestrictions = null, ChronicDiseases = null, FamilyHistory = null
+                DietRestrictions = null, ChronicDiseases = null, FamilyHistory = null,
+                Surgeries = null
             },
             "update_surgery" => request with
             {
@@ -77,8 +78,41 @@ public sealed class HealthArchiveService(IHealthArchiveRepository archives) : IH
     private static void Apply(HealthArchive archive, HealthArchiveUpdateRequest request)
     {
         if (request.Diagnosis != null) archive.Diagnosis = request.Diagnosis;
-        if (request.SurgeryType != null) archive.SurgeryType = request.SurgeryType;
-        if (request.SurgeryDate.HasValue) archive.SurgeryDate = request.SurgeryDate.Value;
+        if (request.Surgeries != null)
+        {
+            archive.Surgeries.Clear();
+            var items = request.Surgeries
+                .Where(s => !string.IsNullOrWhiteSpace(s.Type))
+                .Select((s, index) => new HealthArchiveSurgery
+                {
+                    Id = Guid.NewGuid(),
+                    HealthArchiveId = archive.Id,
+                    Type = s.Type.Trim(),
+                    Date = s.Date,
+                    SortOrder = index,
+                })
+                .ToList();
+            foreach (var item in items) archive.Surgeries.Add(item);
+            SyncLegacySurgeryFields(archive);
+        }
+        else if (request.SurgeryType != null)
+        {
+            SeedLegacySurgeryIfNeeded(archive);
+            var type = request.SurgeryType.Trim();
+            if (type.Length > 0 && !archive.Surgeries.Any(s =>
+                    s.Type == type && s.Date == request.SurgeryDate))
+            {
+                archive.Surgeries.Add(new HealthArchiveSurgery
+                {
+                    Id = Guid.NewGuid(),
+                    HealthArchiveId = archive.Id,
+                    Type = type,
+                    Date = request.SurgeryDate,
+                    SortOrder = archive.Surgeries.Count,
+                });
+            }
+            SyncLegacySurgeryFields(archive);
+        }
         if (request.Allergies != null) archive.Allergies = request.Allergies.ToList();
         if (request.DietRestrictions != null) archive.DietRestrictions = request.DietRestrictions.ToList();
         if (request.ChronicDiseases != null) archive.ChronicDiseases = request.ChronicDiseases.ToList();
@@ -91,6 +125,7 @@ public sealed class HealthArchiveService(IHealthArchiveRepository archives) : IH
         archive.Diagnosis,
         archive.SurgeryType,
         SurgeryDate = archive.SurgeryDate?.ToString("yyyy-MM-dd"),
+        surgeries = archive.Surgeries.Select(s => new { s.Type, date = s.Date?.ToString("yyyy-MM-dd") }),
         archive.Allergies,
         archive.DietRestrictions,
         archive.ChronicDiseases,
@@ -103,9 +138,41 @@ public sealed class HealthArchiveService(IHealthArchiveRepository archives) : IH
         archive.Diagnosis,
         archive.SurgeryType,
         archive.SurgeryDate,
+        GetSurgeries(archive),
         archive.Allergies,
         archive.DietRestrictions,
         archive.ChronicDiseases,
         archive.FamilyHistory,
         archive.UpdatedAt);
+
+    private static IReadOnlyList<HealthArchiveSurgeryDto> GetSurgeries(HealthArchive archive)
+    {
+        var surgeries = archive.Surgeries
+            .OrderBy(s => s.SortOrder)
+            .Select(s => new HealthArchiveSurgeryDto(s.Id, s.Type, s.Date))
+            .ToList();
+        if (surgeries.Count == 0 && !string.IsNullOrWhiteSpace(archive.SurgeryType))
+            surgeries.Add(new HealthArchiveSurgeryDto(Guid.Empty, archive.SurgeryType, archive.SurgeryDate));
+        return surgeries;
+    }
+
+    private static void SyncLegacySurgeryFields(HealthArchive archive)
+    {
+        var first = archive.Surgeries.OrderBy(s => s.SortOrder).FirstOrDefault();
+        archive.SurgeryType = first?.Type;
+        archive.SurgeryDate = first?.Date;
+    }
+
+    private static void SeedLegacySurgeryIfNeeded(HealthArchive archive)
+    {
+        if (archive.Surgeries.Count > 0 || string.IsNullOrWhiteSpace(archive.SurgeryType)) return;
+        archive.Surgeries.Add(new HealthArchiveSurgery
+        {
+            Id = Guid.NewGuid(),
+            HealthArchiveId = archive.Id,
+            Type = archive.SurgeryType,
+            Date = archive.SurgeryDate,
+            SortOrder = 0,
+        });
+    }
 }