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/tests/Health.Tests/application_service_tests.cs

@@ -1,6 +1,7 @@
 using Health.Application.AI;
 using Health.Application.Calendars;
 using Health.Application.HealthArchives;
+using Health.Application.HealthRecords;
 using Health.Application.Exercises;
 using Health.Domain.Entities;
 using Health.Domain.Enums;
@@ -34,6 +35,67 @@ public sealed class ApplicationServiceTests
         Assert.Equal(["青霉素"], repository.Archive.Allergies);
     }
 
+    [Fact]
+    public async Task HealthArchive_ManualUpdateStoresMultipleStructuredSurgeries()
+    {
+        var userId = Guid.NewGuid();
+        var repository = new FakeHealthArchiveRepository(new HealthArchive
+        {
+            Id = Guid.NewGuid(), UserId = userId,
+        });
+        var service = new HealthArchiveService(repository);
+
+        var result = await service.UpdateAsync(
+            userId,
+            new HealthArchiveUpdateRequest(
+                null, null, null, null, null, null, null,
+                [
+                    new HealthArchiveSurgeryInput("PCI", new DateOnly(2025, 3, 1)),
+                    new HealthArchiveSurgeryInput("Appendectomy", new DateOnly(2010, 6, 2)),
+                ]),
+            CancellationToken.None);
+
+        Assert.Equal(2, result.Surgeries.Count);
+        Assert.Equal("PCI", result.SurgeryType);
+        Assert.Equal(new DateOnly(2025, 3, 1), result.SurgeryDate);
+        Assert.Equal([0, 1], repository.Archive!.Surgeries.OrderBy(s => s.SortOrder).Select(s => s.SortOrder));
+    }
+
+    [Fact]
+    public async Task HealthTrend_365DaysUsesFullYearWindow()
+    {
+        var repository = new CapturingHealthRecordRepository();
+        var service = new HealthRecordService(repository);
+        var before = DateTime.UtcNow;
+
+        await service.GetTrendAsync(Guid.NewGuid(), HealthMetricType.Weight, 365, CancellationToken.None);
+
+        Assert.NotNull(repository.RecordedAfter);
+        Assert.InRange((before - repository.RecordedAfter!.Value).TotalDays, 364.99, 365.01);
+    }
+
+    [Fact]
+    public async Task HealthArchive_AiSurgeryUpdatePreservesLegacySurgery()
+    {
+        var userId = Guid.NewGuid();
+        var repository = new FakeHealthArchiveRepository(new HealthArchive
+        {
+            Id = Guid.NewGuid(), UserId = userId,
+            SurgeryType = "Legacy surgery", SurgeryDate = new DateOnly(2010, 1, 2),
+        });
+        var service = new HealthArchiveService(repository);
+
+        await service.ExecuteAiActionAsync(
+            userId,
+            "update_surgery",
+            new HealthArchiveUpdateRequest(null, "New surgery", new DateOnly(2026, 6, 20), null, null, null, null),
+            CancellationToken.None);
+
+        Assert.Equal(2, repository.Archive!.Surgeries.Count);
+        Assert.Contains(repository.Archive.Surgeries, s => s.Type == "Legacy surgery");
+        Assert.Contains(repository.Archive.Surgeries, s => s.Type == "New surgery");
+    }
+
     [Fact]
     public async Task Conversation_Open_DoesNotReturnAnotherUsersConversation()
     {
@@ -113,6 +175,23 @@ public sealed class ApplicationServiceTests
         public Task SaveChangesAsync(CancellationToken ct) => Task.CompletedTask;
     }
 
+    private sealed class CapturingHealthRecordRepository : IHealthRecordRepository
+    {
+        public DateTime? RecordedAfter { get; private set; }
+        public Task<IReadOnlyList<HealthRecord>> ListAsync(Guid userId, HealthMetricType? type, DateTime? recordedAfter, int limit, CancellationToken ct) =>
+            Task.FromResult<IReadOnlyList<HealthRecord>>([]);
+        public Task<HealthRecord?> GetOwnedAsync(Guid userId, Guid id, CancellationToken ct) => Task.FromResult<HealthRecord?>(null);
+        public Task<HealthRecord?> GetLatestByTypeAsync(Guid userId, HealthMetricType type, CancellationToken ct) => Task.FromResult<HealthRecord?>(null);
+        public Task<IReadOnlyList<HealthRecord>> GetTrendAsync(Guid userId, HealthMetricType type, DateTime recordedAfter, CancellationToken ct)
+        {
+            RecordedAfter = recordedAfter;
+            return Task.FromResult<IReadOnlyList<HealthRecord>>([]);
+        }
+        public Task AddAsync(HealthRecord record, CancellationToken ct) => Task.CompletedTask;
+        public void Delete(HealthRecord record) { }
+        public Task SaveChangesAsync(CancellationToken ct) => Task.CompletedTask;
+    }
+
     private sealed class FakeConversationRepository(Conversation conversation) : IAiConversationRepository
     {
         private readonly Conversation _conversation = conversation;