feat: 后端架构重构 — Endpoint→Service→Repository分层 + AI确认机制 + 异步任务持久化

- 核心业务拆分为 Endpoint → Application Service → Repository 三层
- AI写入操作必须用户确认后才写库(确认卡片机制)
- 报告/饮食/用药分析改为持久化任务队列(原子领取/重试/重启恢复)
- 运动计划修复: 连续真实日期替代周模板
- 用药提醒去重 + 通知Outbox预留
- 认证收拢到AuthService, 管理员收拢到AdminService
- AI会话加用户归属校验防串号
- 提示词调整为患者视角
- 开发假数据已关闭
- 21/21测试通过, 0警告0错误

backend/src/Health.Application/AI/AiConversationContracts.cs

@@ -0,0 +1,63 @@
+using Health.Domain.Entities;
+using Health.Domain.Enums;
+
+namespace Health.Application.AI;
+
+public sealed record AiConversationDto(
+    Guid Id,
+    string AgentType,
+    string? Title,
+    string? Summary,
+    int MessageCount,
+    DateTime CreatedAt,
+    DateTime UpdatedAt);
+
+public sealed record AiConversationMessageDto(
+    Guid Id,
+    string Role,
+    string Content,
+    string? Intent,
+    string? MetadataJson,
+    DateTime CreatedAt);
+
+public sealed record OpenConversationResult(
+    bool Found,
+    bool Created,
+    Guid ConversationId);
+
+public interface IAiConversationService
+{
+    Task<OpenConversationResult> OpenAsync(Guid userId, Guid? conversationId, AgentType agentType, string firstMessage, CancellationToken ct);
+    Task AddUserMessageAsync(Guid conversationId, string content, CancellationToken ct);
+    Task AddAssistantMessageAsync(Guid conversationId, string content, CancellationToken ct);
+    Task<IReadOnlyList<AiConversationMessageDto>> GetRecentMessagesAsync(Guid conversationId, int limit, CancellationToken ct);
+    Task<IReadOnlyList<AiConversationDto>> ListAsync(Guid userId, CancellationToken ct);
+    Task<IReadOnlyList<AiConversationMessageDto>> GetMessagesAsync(Guid userId, Guid conversationId, CancellationToken ct);
+    Task DeleteAsync(Guid userId, Guid conversationId, CancellationToken ct);
+}
+
+public interface IAiConversationRepository
+{
+    Task<Conversation?> GetOwnedAsync(Guid userId, Guid conversationId, CancellationToken ct);
+    Task<Conversation?> GetAsync(Guid conversationId, CancellationToken ct);
+    Task<IReadOnlyList<Conversation>> ListAsync(Guid userId, CancellationToken ct);
+    Task<IReadOnlyList<ConversationMessage>> GetMessagesAsync(Guid conversationId, CancellationToken ct);
+    Task<IReadOnlyList<ConversationMessage>> GetRecentMessagesAsync(Guid conversationId, int limit, CancellationToken ct);
+    Task AddConversationAsync(Conversation conversation, CancellationToken ct);
+    Task AddMessageAsync(ConversationMessage message, CancellationToken ct);
+    void Delete(Conversation conversation);
+    Task SaveChangesAsync(CancellationToken ct);
+}
+
+public interface IPatientContextService
+{
+    Task<string> BuildAsync(Guid userId, CancellationToken ct);
+}
+
+public sealed record AiConfirmedWriteResult(int Code, object? Data, string? Message);
+
+public interface IAiToolExecutionService
+{
+    Task<object> ExecuteAsync(string toolName, string arguments, Guid userId, CancellationToken ct);
+    Task<AiConfirmedWriteResult> ConfirmAsync(Guid commandId, Guid userId, CancellationToken ct);
+}

backend/src/Health.Application/AI/AiConversationService.cs

@@ -0,0 +1,111 @@
+using Health.Domain.Entities;
+using Health.Domain.Enums;
+
+namespace Health.Application.AI;
+
+public sealed class AiConversationService(IAiConversationRepository conversations) : IAiConversationService
+{
+    private readonly IAiConversationRepository _conversations = conversations;
+
+    public async Task<OpenConversationResult> OpenAsync(
+        Guid userId,
+        Guid? conversationId,
+        AgentType agentType,
+        string firstMessage,
+        CancellationToken ct)
+    {
+        if (conversationId.HasValue)
+        {
+            var existing = await _conversations.GetOwnedAsync(userId, conversationId.Value, ct);
+            return existing == null
+                ? new OpenConversationResult(false, false, conversationId.Value)
+                : new OpenConversationResult(true, false, existing.Id);
+        }
+
+        var conversation = new Conversation
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            AgentType = agentType,
+            Title = firstMessage.Length > 30 ? firstMessage[..30] : firstMessage,
+            CreatedAt = DateTime.UtcNow,
+            UpdatedAt = DateTime.UtcNow,
+        };
+        await _conversations.AddConversationAsync(conversation, ct);
+        await _conversations.SaveChangesAsync(ct);
+        return new OpenConversationResult(true, true, conversation.Id);
+    }
+
+    public async Task AddUserMessageAsync(Guid conversationId, string content, CancellationToken ct) =>
+        await AddMessageAsync(conversationId, MessageRole.User, content, updateSummary: false, ct);
+
+    public async Task AddAssistantMessageAsync(Guid conversationId, string content, CancellationToken ct) =>
+        await AddMessageAsync(conversationId, MessageRole.Assistant, content, updateSummary: true, ct);
+
+    public async Task<IReadOnlyList<AiConversationMessageDto>> GetRecentMessagesAsync(Guid conversationId, int limit, CancellationToken ct)
+    {
+        var messages = await _conversations.GetRecentMessagesAsync(conversationId, limit, ct);
+        return messages.OrderBy(m => m.CreatedAt).Select(ToMessageDto).ToList();
+    }
+
+    public async Task<IReadOnlyList<AiConversationDto>> ListAsync(Guid userId, CancellationToken ct)
+    {
+        var conversations = await _conversations.ListAsync(userId, ct);
+        return conversations.Select(ToDto).ToList();
+    }
+
+    public async Task<IReadOnlyList<AiConversationMessageDto>> GetMessagesAsync(Guid userId, Guid conversationId, CancellationToken ct)
+    {
+        var conversation = await _conversations.GetOwnedAsync(userId, conversationId, ct);
+        if (conversation == null) return [];
+
+        var messages = await _conversations.GetMessagesAsync(conversationId, ct);
+        return messages.Select(ToMessageDto).ToList();
+    }
+
+    public async Task DeleteAsync(Guid userId, Guid conversationId, CancellationToken ct)
+    {
+        var conversation = await _conversations.GetOwnedAsync(userId, conversationId, ct);
+        if (conversation == null) return;
+
+        _conversations.Delete(conversation);
+        await _conversations.SaveChangesAsync(ct);
+    }
+
+    private async Task AddMessageAsync(Guid conversationId, MessageRole role, string content, bool updateSummary, CancellationToken ct)
+    {
+        var conversation = await _conversations.GetAsync(conversationId, ct)
+            ?? throw new InvalidOperationException("会话不存在");
+        await _conversations.AddMessageAsync(new ConversationMessage
+        {
+            Id = Guid.NewGuid(),
+            ConversationId = conversationId,
+            Role = role,
+            Content = content,
+            CreatedAt = DateTime.UtcNow,
+        }, ct);
+
+        conversation.MessageCount++;
+        conversation.UpdatedAt = DateTime.UtcNow;
+        if (updateSummary)
+            conversation.Summary = content.Length > 100 ? content[..100] : content;
+        await _conversations.SaveChangesAsync(ct);
+    }
+
+    private static AiConversationDto ToDto(Conversation conversation) => new(
+        conversation.Id,
+        conversation.AgentType.ToString(),
+        conversation.Title,
+        conversation.Summary,
+        conversation.MessageCount,
+        conversation.CreatedAt,
+        conversation.UpdatedAt);
+
+    private static AiConversationMessageDto ToMessageDto(ConversationMessage message) => new(
+        message.Id,
+        message.Role.ToString(),
+        message.Content,
+        message.Intent,
+        message.MetadataJson,
+        message.CreatedAt);
+}

backend/src/Health.Application/AI/AiWriteConfirmationContracts.cs

@@ -0,0 +1,15 @@
+namespace Health.Application.AI;
+
+public sealed record PendingAiWriteCommand(
+    Guid Id,
+    Guid UserId,
+    string ToolName,
+    string Arguments,
+    DateTime ExpiresAt);
+
+public interface IAiWriteConfirmationStore
+{
+    Task<PendingAiWriteCommand> CreateAsync(Guid userId, string toolName, string arguments, TimeSpan lifetime, CancellationToken ct);
+    Task<PendingAiWriteCommand?> TakeAsync(Guid commandId, Guid userId, CancellationToken ct);
+    Task CompleteAsync(PendingAiWriteCommand command, CancellationToken ct);
+}

backend/src/Health.Application/AI/PatientContextService.cs

@@ -0,0 +1,65 @@
+using System.Text;
+using Health.Application.HealthArchives;
+using Health.Application.HealthRecords;
+using Health.Application.Medications;
+
+namespace Health.Application.AI;
+
+public sealed class PatientContextService(
+    IHealthArchiveService archives,
+    IHealthRecordService healthRecords,
+    IMedicationService medications) : IPatientContextService
+{
+    private readonly IHealthArchiveService _archives = archives;
+    private readonly IHealthRecordService _healthRecords = healthRecords;
+    private readonly IMedicationService _medications = medications;
+
+    public async Task<string> BuildAsync(Guid userId, CancellationToken ct)
+    {
+        var archive = await _archives.GetAsync(userId, ct);
+        var recentRecords = (await _healthRecords.GetRecordsAsync(userId, null, 30, ct)).Take(10).ToList();
+        var activeMedications = await _medications.ListActiveAsync(userId, ct);
+
+        var sb = new StringBuilder();
+        if (archive != null)
+        {
+            if (!string.IsNullOrEmpty(archive.Diagnosis)) sb.AppendLine($"诊断: {archive.Diagnosis}");
+            if (!string.IsNullOrEmpty(archive.SurgeryType)) sb.AppendLine($"手术: {archive.SurgeryType} ({archive.SurgeryDate})");
+            if (archive.ChronicDiseases.Count > 0) sb.AppendLine($"慢病史: {string.Join(", ", archive.ChronicDiseases)}");
+            if (!string.IsNullOrEmpty(archive.FamilyHistory)) sb.AppendLine($"家族病史: {archive.FamilyHistory}");
+            if (archive.Allergies.Count > 0) sb.AppendLine($"过敏: {string.Join(", ", archive.Allergies)}");
+            if (archive.DietRestrictions.Count > 0) sb.AppendLine($"饮食限制: {string.Join(", ", archive.DietRestrictions)}");
+        }
+
+        if (activeMedications.Count > 0)
+        {
+            sb.AppendLine("当前用药:");
+            foreach (var medication in activeMedications.Take(20))
+            {
+                var times = medication.TimeOfDay.Count > 0
+                    ? string.Join("/", medication.TimeOfDay.Select(t => t.ToString("HH:mm")))
+                    : "未设置时间";
+                sb.AppendLine($"  {medication.Name} {medication.Dosage ?? ""} {medication.Frequency} {times}");
+            }
+        }
+
+        if (recentRecords.Count > 0)
+        {
+            sb.AppendLine("近期健康数据:");
+            foreach (var record in recentRecords)
+                sb.AppendLine($"  {record.Type}: {RecordValue(record)} ({record.RecordedAt:MM-dd HH:mm})");
+        }
+
+        return sb.ToString();
+    }
+
+    private static string RecordValue(HealthRecordDto record) => record.Type switch
+    {
+        "BloodPressure" => $"{record.Systolic}/{record.Diastolic}",
+        "HeartRate" => $"{record.Value}次/分",
+        "Glucose" => $"{record.Value}",
+        "SpO2" => $"{record.Value}%",
+        "Weight" => $"{record.Value}kg",
+        _ => "—"
+    };
+}

backend/src/Health.Application/Admin/AdminContracts.cs

@@ -0,0 +1,15 @@
+namespace Health.Application.Admin;
+
+public sealed record AdminResult(int Code, object? Data, string? Message = null);
+public sealed record AddDoctorCommand(string Phone, string Name, string? Title, string? Department, string? ProfessionalDirection);
+public sealed record UpdateDoctorCommand(string? Phone, string? Name, string? Title, string? Department, string? ProfessionalDirection);
+
+public interface IAdminService
+{
+    Task<AdminResult> ListDoctorsAsync(CancellationToken ct);
+    Task<AdminResult> AddDoctorAsync(AddDoctorCommand command, CancellationToken ct);
+    Task<AdminResult> UpdateDoctorAsync(Guid id, UpdateDoctorCommand command, CancellationToken ct);
+    Task<AdminResult> ToggleDoctorAsync(Guid id, CancellationToken ct);
+    Task<AdminResult> DeleteDoctorAsync(Guid id, CancellationToken ct);
+    Task<AdminResult> ListPatientsAsync(string? search, int page, int pageSize, CancellationToken ct);
+}

backend/src/Health.Application/Auth/AuthContracts.cs

@@ -0,0 +1,13 @@
+namespace Health.Application.Auth;
+
+public sealed record AuthResult(int Code, object? Data, string? Message = null);
+public sealed record RegisterCommand(string Phone, string SmsCode, string Name, Guid DoctorId);
+
+public interface IAuthService
+{
+    Task<AuthResult> SendCodeAsync(string phone, bool revealDevelopmentCode, CancellationToken ct);
+    Task<AuthResult> RegisterAsync(RegisterCommand command, CancellationToken ct);
+    Task<AuthResult> LoginAsync(string phone, string smsCode, CancellationToken ct);
+    Task<AuthResult> RefreshAsync(string refreshToken, CancellationToken ct);
+    Task LogoutAsync(string refreshToken, CancellationToken ct);
+}

backend/src/Health.Application/Calendars/CalendarContracts.cs

@@ -0,0 +1,19 @@
+using Health.Domain.Entities;
+
+namespace Health.Application.Calendars;
+
+public sealed record CalendarDataSnapshot(
+    IReadOnlyList<Medication> Medications,
+    IReadOnlyList<ExercisePlan> ExercisePlans,
+    IReadOnlyList<FollowUp> FollowUps);
+
+public interface ICalendarService
+{
+    Task<IReadOnlyList<object>> GetMonthAsync(Guid userId, int year, int month, CancellationToken ct);
+    Task<object> GetDayAsync(Guid userId, DateOnly date, CancellationToken ct);
+}
+
+public interface ICalendarRepository
+{
+    Task<CalendarDataSnapshot> GetSnapshotAsync(Guid userId, DateOnly start, DateOnly end, CancellationToken ct);
+}

backend/src/Health.Application/Calendars/CalendarService.cs

@@ -0,0 +1,92 @@
+namespace Health.Application.Calendars;
+
+public sealed class CalendarService(ICalendarRepository calendar) : ICalendarService
+{
+    private readonly ICalendarRepository _calendar = calendar;
+
+    public async Task<IReadOnlyList<object>> GetMonthAsync(Guid userId, int year, int month, CancellationToken ct)
+    {
+        var start = new DateOnly(year, month, 1);
+        var end = start.AddMonths(1);
+        var snapshot = await _calendar.GetSnapshotAsync(userId, start, end, ct);
+        var result = new List<object>();
+
+        for (var date = start; date < end; date = date.AddDays(1))
+        {
+            var entries = BuildEntries(snapshot, date);
+            if (entries.Count == 0) continue;
+
+            result.Add(new
+            {
+                date = date.ToString("yyyy-MM-dd"),
+                events = entries.Select(entry => entry.Type).Distinct().ToList(),
+                details = entries.Select(entry => entry.Value).ToList()
+            });
+        }
+
+        return result;
+    }
+
+    public async Task<object> GetDayAsync(Guid userId, DateOnly date, CancellationToken ct)
+    {
+        var snapshot = await _calendar.GetSnapshotAsync(userId, date, date.AddDays(1), ct);
+        var medications = snapshot.Medications
+            .Where(m => IsMedicationActiveOn(m, date))
+            .Select(m => new { m.Name, m.Dosage, timeOfDay = m.TimeOfDay.Select(t => t.ToString(@"hh\:mm")).ToList() })
+            .ToList();
+        var exercises = snapshot.ExercisePlans
+            .SelectMany(p => p.Items)
+            .Where(i => i.ScheduledDate == date && !i.IsRestDay)
+            .Select(i => new { type = i.ExerciseType, duration = i.DurationMinutes, isCompleted = i.IsCompleted, scheduledDate = i.ScheduledDate })
+            .ToList();
+        var followUps = snapshot.FollowUps
+            .Where(f => DateOnly.FromDateTime(f.ScheduledAt) == date)
+            .Select(f => new { f.Title, f.DoctorName, f.Department, status = f.Status.ToString() })
+            .ToList();
+
+        return new { medications, exercises, followUps };
+    }
+
+    private static List<CalendarEntry> BuildEntries(CalendarDataSnapshot snapshot, DateOnly date)
+    {
+        var entries = new List<CalendarEntry>();
+        foreach (var medication in snapshot.Medications.Where(m => IsMedicationActiveOn(m, date)))
+        {
+            entries.Add(new CalendarEntry("medication", new
+            {
+                type = "medication",
+                name = medication.Name,
+                dosage = medication.Dosage,
+                timeOfDay = medication.TimeOfDay.Select(t => t.ToString(@"hh\:mm")).ToList()
+            }));
+        }
+
+        foreach (var plan in snapshot.ExercisePlans)
+        {
+            foreach (var item in plan.Items.Where(i => i.ScheduledDate == date && !i.IsRestDay))
+                entries.Add(new CalendarEntry("exercise", new { type = "exercise", name = item.ExerciseType, duration = item.DurationMinutes, isCompleted = item.IsCompleted, scheduledDate = item.ScheduledDate }));
+        }
+
+        foreach (var followUp in snapshot.FollowUps.Where(f => DateOnly.FromDateTime(f.ScheduledAt) == date))
+        {
+            entries.Add(new CalendarEntry("followup", new
+            {
+                type = "followup",
+                title = followUp.Title,
+                doctorName = followUp.DoctorName,
+                department = followUp.Department,
+                status = followUp.Status.ToString()
+            }));
+        }
+
+        return entries;
+    }
+
+    private static bool IsMedicationActiveOn(Health.Domain.Entities.Medication medication, DateOnly date) =>
+        medication.IsActive
+        && medication.TimeOfDay.Count > 0
+        && (medication.StartDate == null || medication.StartDate <= date)
+        && (medication.EndDate == null || medication.EndDate >= date);
+
+    private sealed record CalendarEntry(string Type, object Value);
+}

backend/src/Health.Application/Diets/DietContracts.cs

@@ -0,0 +1,51 @@
+using Health.Domain.Entities;
+using Health.Domain.Enums;
+
+namespace Health.Application.Diets;
+
+public sealed record DietFoodItemInput(
+    string Name,
+    string? Portion,
+    int? Calories,
+    int SortOrder);
+
+public sealed record DietRecordCreateRequest(
+    MealType MealType,
+    int? TotalCalories,
+    int? HealthScore,
+    DateOnly RecordedAt,
+    IReadOnlyList<DietFoodItemInput> FoodItems);
+
+public sealed record DietRecordPatchRequest(
+    int? TotalCalories,
+    int? HealthScore);
+
+public sealed record DietFoodItemDto(
+    string Name,
+    string? Portion,
+    int? Calories);
+
+public sealed record DietRecordDto(
+    Guid Id,
+    string MealType,
+    int? TotalCalories,
+    int? HealthScore,
+    DateOnly RecordedAt,
+    IReadOnlyList<DietFoodItemDto> FoodItems);
+
+public interface IDietService
+{
+    Task<IReadOnlyList<DietRecordDto>> ListAsync(Guid userId, string? date, string? mealType, CancellationToken ct);
+    Task<Guid> CreateAsync(Guid userId, DietRecordCreateRequest request, CancellationToken ct);
+    Task<bool> DeleteAsync(Guid userId, Guid recordId, CancellationToken ct);
+    Task<bool> UpdateAsync(Guid userId, Guid recordId, DietRecordPatchRequest request, CancellationToken ct);
+}
+
+public interface IDietRepository
+{
+    Task<IReadOnlyList<DietRecord>> ListAsync(Guid userId, DateOnly? recordedAt, MealType? mealType, CancellationToken ct);
+    Task<DietRecord?> GetOwnedAsync(Guid userId, Guid recordId, CancellationToken ct);
+    Task AddAsync(DietRecord record, CancellationToken ct);
+    void Delete(DietRecord record);
+    Task SaveChangesAsync(CancellationToken ct);
+}

backend/src/Health.Application/Diets/DietImageAnalysisContracts.cs

@@ -0,0 +1,27 @@
+namespace Health.Application.Diets;
+
+public sealed record DietImageUploadFile(string FileName, long Length, Stream Content);
+
+public sealed record DietImageAnalysisJob(Guid Id, IReadOnlyList<string> FilePaths);
+
+public sealed record DietImageAnalysisResult(bool Success, int Code, string? Data, string? Message);
+
+public interface IDietImageAnalysisCoordinator
+{
+    Task<DietImageAnalysisResult> AnalyzeAsync(IReadOnlyList<DietImageUploadFile> files, CancellationToken ct);
+}
+
+public interface IDietImageAnalysisQueue
+{
+    Task<Guid> EnqueueAsync(IReadOnlyList<string> filePaths, CancellationToken ct);
+    Task RecoverStaleAsync(CancellationToken ct);
+    Task<DietImageAnalysisJob?> TryTakeAsync(CancellationToken ct);
+    Task<DietImageAnalysisResult> WaitForResultAsync(Guid jobId, CancellationToken ct);
+    Task CompleteAsync(Guid jobId, DietImageAnalysisResult result, CancellationToken ct);
+    Task<bool> RetryAsync(Guid jobId, string error, CancellationToken ct);
+}
+
+public interface IDietImageAnalyzer
+{
+    Task<DietImageAnalysisResult> AnalyzeAsync(DietImageAnalysisJob job, CancellationToken ct);
+}

backend/src/Health.Application/Diets/DietService.cs

@@ -0,0 +1,77 @@
+using Health.Domain.Entities;
+using Health.Domain.Enums;
+
+namespace Health.Application.Diets;
+
+public sealed class DietService(IDietRepository diets) : IDietService
+{
+    private readonly IDietRepository _diets = diets;
+
+    public async Task<IReadOnlyList<DietRecordDto>> ListAsync(Guid userId, string? date, string? mealType, CancellationToken ct)
+    {
+        var recordedAt = DateOnly.TryParse(date, out var d) ? d : (DateOnly?)null;
+        var parsedMealType = Enum.TryParse<MealType>(mealType, ignoreCase: true, out var mt) ? mt : (MealType?)null;
+
+        var records = await _diets.ListAsync(userId, recordedAt, parsedMealType, ct);
+        return records.Select(ToDto).ToList();
+    }
+
+    public async Task<Guid> CreateAsync(Guid userId, DietRecordCreateRequest request, CancellationToken ct)
+    {
+        var record = new DietRecord
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            MealType = request.MealType,
+            TotalCalories = request.TotalCalories,
+            HealthScore = request.HealthScore,
+            RecordedAt = request.RecordedAt,
+            CreatedAt = DateTime.UtcNow,
+        };
+
+        foreach (var item in request.FoodItems)
+        {
+            record.FoodItems.Add(new DietFoodItem
+            {
+                Id = Guid.NewGuid(),
+                Name = item.Name,
+                Portion = item.Portion,
+                Calories = item.Calories,
+                SortOrder = item.SortOrder,
+            });
+        }
+
+        await _diets.AddAsync(record, ct);
+        await _diets.SaveChangesAsync(ct);
+        return record.Id;
+    }
+
+    public async Task<bool> DeleteAsync(Guid userId, Guid recordId, CancellationToken ct)
+    {
+        var record = await _diets.GetOwnedAsync(userId, recordId, ct);
+        if (record == null) return false;
+
+        _diets.Delete(record);
+        await _diets.SaveChangesAsync(ct);
+        return true;
+    }
+
+    public async Task<bool> UpdateAsync(Guid userId, Guid recordId, DietRecordPatchRequest request, CancellationToken ct)
+    {
+        var record = await _diets.GetOwnedAsync(userId, recordId, ct);
+        if (record == null) return false;
+
+        if (request.TotalCalories.HasValue) record.TotalCalories = request.TotalCalories.Value;
+        if (request.HealthScore.HasValue) record.HealthScore = request.HealthScore.Value;
+        await _diets.SaveChangesAsync(ct);
+        return true;
+    }
+
+    private static DietRecordDto ToDto(DietRecord record) => new(
+        record.Id,
+        record.MealType.ToString(),
+        record.TotalCalories,
+        record.HealthScore,
+        record.RecordedAt,
+        record.FoodItems.OrderBy(f => f.SortOrder).Select(f => new DietFoodItemDto(f.Name, f.Portion, f.Calories)).ToList());
+}

backend/src/Health.Application/Exercises/ExerciseContracts.cs

@@ -0,0 +1,74 @@
+using Health.Domain.Entities;
+
+namespace Health.Application.Exercises;
+
+public sealed record ExercisePlanItemInput(
+    DateOnly ScheduledDate,
+    string? ExerciseType,
+    int DurationMinutes,
+    bool IsRestDay);
+
+public sealed record ExercisePlanCreateRequest(
+    DateOnly StartDate,
+    DateOnly EndDate,
+    string? ExerciseType,
+    int DurationMinutes,
+    TimeOnly? ReminderTime = null);
+
+public sealed record ExercisePlanItemDto(
+    Guid Id,
+    DateOnly ScheduledDate,
+    string ExerciseType,
+    int DurationMinutes,
+    bool IsCompleted,
+    DateTime? CompletedAt,
+    bool IsRestDay);
+
+public sealed record ExercisePlanDto(
+    Guid Id,
+    DateOnly StartDate,
+    DateOnly EndDate,
+    TimeOnly ReminderTime,
+    DateTime CreatedAt,
+    DateTime UpdatedAt,
+    IReadOnlyList<ExercisePlanItemDto> Items);
+
+public sealed record ExercisePlanSummaryDto(
+    Guid Id,
+    DateOnly StartDate,
+    DateOnly EndDate,
+    TimeOnly ReminderTime,
+    DateTime CreatedAt,
+    int TotalDays,
+    int CompletedDays,
+    IReadOnlyList<ExercisePlanItemDto> Items);
+
+public interface IExerciseService
+{
+    Task<ExercisePlanDto?> GetCurrentAsync(Guid userId, CancellationToken ct);
+    Task<Guid> CreateAsync(Guid userId, ExercisePlanCreateRequest request, CancellationToken ct);
+    Task<Guid> CreateFromItemsAsync(Guid userId, DateOnly startDate, DateOnly endDate, TimeOnly? reminderTime, IReadOnlyList<ExercisePlanItemInput> items, CancellationToken ct);
+    Task<IReadOnlyList<ExercisePlanSummaryDto>> ListAsync(Guid userId, CancellationToken ct);
+    Task<ExercisePlanDto?> GetByIdAsync(Guid userId, Guid planId, CancellationToken ct);
+    Task<bool> DeleteAsync(Guid userId, Guid planId, CancellationToken ct);
+    Task<bool?> ToggleCheckInAsync(Guid userId, Guid itemId, CancellationToken ct);
+    Task<bool> CheckInAsync(Guid userId, Guid itemId, CancellationToken ct);
+    Task<ExercisePlanDto?> GetLatestAsync(Guid userId, CancellationToken ct);
+}
+
+public interface IExerciseRepository
+{
+    Task<IReadOnlyList<ExercisePlan>> ListActiveOnAsync(Guid userId, DateOnly date, CancellationToken ct);
+    Task<IReadOnlyList<ExercisePlan>> ListAsync(Guid userId, int limit, CancellationToken ct);
+    Task<ExercisePlan?> GetOwnedPlanAsync(Guid userId, Guid planId, CancellationToken ct);
+    Task<ExercisePlan?> GetLatestAsync(Guid userId, CancellationToken ct);
+    Task<ExercisePlanItem?> GetOwnedItemAsync(Guid userId, Guid itemId, CancellationToken ct);
+    Task AddAsync(ExercisePlan plan, CancellationToken ct);
+    void Delete(ExercisePlan plan);
+    Task SaveChangesAsync(CancellationToken ct);
+}
+
+public interface IExerciseReminderProducer
+{
+    Task<int> ProduceDueAsync(DateTime utcNow, CancellationToken ct);
+}

backend/src/Health.Application/Exercises/ExerciseService.cs

@@ -0,0 +1,132 @@
+using Health.Domain.Entities;
+
+namespace Health.Application.Exercises;
+
+public sealed class ExerciseService(IExerciseRepository exercises) : IExerciseService
+{
+    private static readonly TimeOnly DefaultReminderTime = new(19, 0);
+    private readonly IExerciseRepository _exercises = exercises;
+
+    public async Task<ExercisePlanDto?> GetCurrentAsync(Guid userId, CancellationToken ct)
+    {
+        var today = BeijingToday();
+        var plans = await _exercises.ListActiveOnAsync(userId, today, ct);
+        var plan = plans.FirstOrDefault(p => p.Items.Any(i => i.ScheduledDate == today));
+        return plan == null ? null : ToDto(plan);
+    }
+
+    public async Task<Guid> CreateAsync(Guid userId, ExercisePlanCreateRequest request, CancellationToken ct)
+    {
+        var startDate = request.StartDate;
+        var endDate = request.EndDate < startDate ? startDate : request.EndDate;
+        if (endDate.DayNumber - startDate.DayNumber > 365)
+            endDate = startDate.AddDays(365);
+
+        var exerciseType = string.IsNullOrWhiteSpace(request.ExerciseType) ? "运动" : request.ExerciseType.Trim();
+        var duration = request.DurationMinutes > 0 ? request.DurationMinutes : 30;
+        var plan = NewPlan(userId, startDate, endDate, request.ReminderTime);
+        for (var date = startDate; date <= endDate; date = date.AddDays(1))
+        {
+            plan.Items.Add(new ExercisePlanItem
+            {
+                Id = Guid.NewGuid(), ScheduledDate = date, ExerciseType = exerciseType,
+                DurationMinutes = duration, IsRestDay = false,
+            });
+        }
+        await SaveNewAsync(plan, ct);
+        return plan.Id;
+    }
+
+    public async Task<Guid> CreateFromItemsAsync(Guid userId, DateOnly startDate, DateOnly endDate, TimeOnly? reminderTime, IReadOnlyList<ExercisePlanItemInput> items, CancellationToken ct)
+    {
+        var normalizedEnd = endDate < startDate ? startDate : endDate;
+        var plan = NewPlan(userId, startDate, normalizedEnd, reminderTime);
+        foreach (var item in items.Where(x => x.ScheduledDate >= startDate && x.ScheduledDate <= normalizedEnd).GroupBy(x => x.ScheduledDate).Select(x => x.First()))
+        {
+            plan.Items.Add(new ExercisePlanItem
+            {
+                Id = Guid.NewGuid(), ScheduledDate = item.ScheduledDate,
+                ExerciseType = string.IsNullOrWhiteSpace(item.ExerciseType) ? "散步" : item.ExerciseType.Trim(),
+                DurationMinutes = item.DurationMinutes > 0 ? item.DurationMinutes : 30,
+                IsRestDay = item.IsRestDay,
+            });
+        }
+        await SaveNewAsync(plan, ct);
+        return plan.Id;
+    }
+
+    public async Task<IReadOnlyList<ExercisePlanSummaryDto>> ListAsync(Guid userId, CancellationToken ct)
+    {
+        var plans = await _exercises.ListAsync(userId, 20, ct);
+        return plans.Select(p => new ExercisePlanSummaryDto(
+            p.Id, p.StartDate, p.EndDate, p.ReminderTime, p.CreatedAt,
+            p.Items.Count, p.Items.Count(i => i.IsCompleted),
+            p.Items.OrderBy(i => i.ScheduledDate).Select(ToItemDto).ToList())).ToList();
+    }
+
+    public async Task<ExercisePlanDto?> GetByIdAsync(Guid userId, Guid planId, CancellationToken ct)
+    {
+        var plan = await _exercises.GetOwnedPlanAsync(userId, planId, ct);
+        return plan == null ? null : ToDto(plan);
+    }
+
+    public async Task<bool> DeleteAsync(Guid userId, Guid planId, CancellationToken ct)
+    {
+        var plan = await _exercises.GetOwnedPlanAsync(userId, planId, ct);
+        if (plan == null) return false;
+        _exercises.Delete(plan);
+        await _exercises.SaveChangesAsync(ct);
+        return true;
+    }
+
+    public async Task<bool?> ToggleCheckInAsync(Guid userId, Guid itemId, CancellationToken ct)
+    {
+        var item = await _exercises.GetOwnedItemAsync(userId, itemId, ct);
+        if (item == null) return null;
+        item.IsCompleted = !item.IsCompleted;
+        item.CompletedAt = item.IsCompleted ? DateTime.UtcNow : null;
+        item.Plan.UpdatedAt = DateTime.UtcNow;
+        await _exercises.SaveChangesAsync(ct);
+        return item.IsCompleted;
+    }
+
+    public async Task<bool> CheckInAsync(Guid userId, Guid itemId, CancellationToken ct)
+    {
+        var item = await _exercises.GetOwnedItemAsync(userId, itemId, ct);
+        if (item == null) return false;
+        item.IsCompleted = true;
+        item.CompletedAt = DateTime.UtcNow;
+        item.Plan.UpdatedAt = DateTime.UtcNow;
+        await _exercises.SaveChangesAsync(ct);
+        return true;
+    }
+
+    public async Task<ExercisePlanDto?> GetLatestAsync(Guid userId, CancellationToken ct)
+    {
+        var plan = await _exercises.GetLatestAsync(userId, ct);
+        return plan == null ? null : ToDto(plan);
+    }
+
+    private async Task SaveNewAsync(ExercisePlan plan, CancellationToken ct)
+    {
+        await _exercises.AddAsync(plan, ct);
+        await _exercises.SaveChangesAsync(ct);
+    }
+
+    private static ExercisePlan NewPlan(Guid userId, DateOnly startDate, DateOnly endDate, TimeOnly? reminderTime) => new()
+    {
+        Id = Guid.NewGuid(), UserId = userId, StartDate = startDate, EndDate = endDate,
+        ReminderTime = reminderTime ?? DefaultReminderTime,
+        CreatedAt = DateTime.UtcNow, UpdatedAt = DateTime.UtcNow,
+    };
+
+    private static ExercisePlanDto ToDto(ExercisePlan plan) => new(
+        plan.Id, plan.StartDate, plan.EndDate, plan.ReminderTime, plan.CreatedAt, plan.UpdatedAt,
+        plan.Items.OrderBy(i => i.ScheduledDate).Select(ToItemDto).ToList());
+
+    private static ExercisePlanItemDto ToItemDto(ExercisePlanItem item) => new(
+        item.Id, item.ScheduledDate, item.ExerciseType, item.DurationMinutes,
+        item.IsCompleted, item.CompletedAt, item.IsRestDay);
+
+    private static DateOnly BeijingToday() => DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8));
+}

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

@@ -0,0 +1,39 @@
+using Health.Domain.Entities;
+
+namespace Health.Application.HealthArchives;
+
+public sealed record HealthArchiveDto(
+    Guid Id,
+    Guid UserId,
+    string? Diagnosis,
+    string? SurgeryType,
+    DateOnly? SurgeryDate,
+    IReadOnlyList<string> Allergies,
+    IReadOnlyList<string> DietRestrictions,
+    IReadOnlyList<string> ChronicDiseases,
+    string? FamilyHistory,
+    DateTime UpdatedAt);
+
+public sealed record HealthArchiveUpdateRequest(
+    string? Diagnosis,
+    string? SurgeryType,
+    DateOnly? SurgeryDate,
+    IReadOnlyList<string>? Allergies,
+    IReadOnlyList<string>? DietRestrictions,
+    IReadOnlyList<string>? ChronicDiseases,
+    string? FamilyHistory);
+
+public interface IHealthArchiveService
+{
+    Task<HealthArchiveDto?> GetAsync(Guid userId, CancellationToken ct);
+    Task<HealthArchiveDto> GetOrCreateAsync(Guid userId, CancellationToken ct);
+    Task<HealthArchiveDto> UpdateAsync(Guid userId, HealthArchiveUpdateRequest request, CancellationToken ct);
+    Task<object> ExecuteAiActionAsync(Guid userId, string action, HealthArchiveUpdateRequest request, CancellationToken ct);
+}
+
+public interface IHealthArchiveRepository
+{
+    Task<HealthArchive?> GetByUserIdAsync(Guid userId, CancellationToken ct);
+    Task AddAsync(HealthArchive archive, CancellationToken ct);
+    Task SaveChangesAsync(CancellationToken ct);
+}

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

@@ -0,0 +1,111 @@
+using Health.Domain.Entities;
+
+namespace Health.Application.HealthArchives;
+
+public sealed class HealthArchiveService(IHealthArchiveRepository archives) : IHealthArchiveService
+{
+    private readonly IHealthArchiveRepository _archives = archives;
+
+    public async Task<HealthArchiveDto?> GetAsync(Guid userId, CancellationToken ct)
+    {
+        var archive = await _archives.GetByUserIdAsync(userId, ct);
+        return archive == null ? null : ToDto(archive);
+    }
+
+    public async Task<HealthArchiveDto> GetOrCreateAsync(Guid userId, CancellationToken ct)
+    {
+        var archive = await GetOrCreateEntityAsync(userId, ct);
+        await _archives.SaveChangesAsync(ct);
+        return ToDto(archive);
+    }
+
+    public async Task<HealthArchiveDto> UpdateAsync(Guid userId, HealthArchiveUpdateRequest request, CancellationToken ct)
+    {
+        var archive = await GetOrCreateEntityAsync(userId, ct);
+        Apply(archive, request);
+        archive.UpdatedAt = DateTime.UtcNow;
+        await _archives.SaveChangesAsync(ct);
+        return ToDto(archive);
+    }
+
+    public async Task<object> ExecuteAiActionAsync(Guid userId, string action, HealthArchiveUpdateRequest request, CancellationToken ct)
+    {
+        if (action == "query")
+        {
+            var archive = await GetAsync(userId, ct);
+            return archive == null ? new { found = false } : ToAiResult(archive);
+        }
+
+        var current = await GetOrCreateEntityAsync(userId, ct);
+        var scopedRequest = action switch
+        {
+            "update_diagnosis" => request with
+            {
+                SurgeryType = null, SurgeryDate = null, Allergies = null,
+                DietRestrictions = null, ChronicDiseases = null, FamilyHistory = null
+            },
+            "update_surgery" => request with
+            {
+                Diagnosis = null, Allergies = null, DietRestrictions = null,
+                ChronicDiseases = null, FamilyHistory = null
+            },
+            "update_allergies" => new HealthArchiveUpdateRequest(null, null, null, request.Allergies, null, null, null),
+            "update_chronic_diseases" => new HealthArchiveUpdateRequest(null, null, null, null, null, request.ChronicDiseases, null),
+            "update_diet_restrictions" => new HealthArchiveUpdateRequest(null, null, null, null, request.DietRestrictions, null, null),
+            _ => null
+        };
+
+        if (scopedRequest == null)
+            return new { success = false, message = $"未知档案操作: {action}" };
+
+        Apply(current, scopedRequest);
+        current.UpdatedAt = DateTime.UtcNow;
+        await _archives.SaveChangesAsync(ct);
+        return new { success = true };
+    }
+
+    private async Task<HealthArchive> GetOrCreateEntityAsync(Guid userId, CancellationToken ct)
+    {
+        var archive = await _archives.GetByUserIdAsync(userId, ct);
+        if (archive != null) return archive;
+
+        archive = new HealthArchive { Id = Guid.NewGuid(), UserId = userId, UpdatedAt = DateTime.UtcNow };
+        await _archives.AddAsync(archive, ct);
+        return archive;
+    }
+
+    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.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();
+        if (request.FamilyHistory != null) archive.FamilyHistory = request.FamilyHistory;
+    }
+
+    private static object ToAiResult(HealthArchiveDto archive) => new
+    {
+        found = true,
+        archive.Diagnosis,
+        archive.SurgeryType,
+        SurgeryDate = archive.SurgeryDate?.ToString("yyyy-MM-dd"),
+        archive.Allergies,
+        archive.DietRestrictions,
+        archive.ChronicDiseases,
+        archive.FamilyHistory,
+    };
+
+    private static HealthArchiveDto ToDto(HealthArchive archive) => new(
+        archive.Id,
+        archive.UserId,
+        archive.Diagnosis,
+        archive.SurgeryType,
+        archive.SurgeryDate,
+        archive.Allergies,
+        archive.DietRestrictions,
+        archive.ChronicDiseases,
+        archive.FamilyHistory,
+        archive.UpdatedAt);
+}

backend/src/Health.Application/HealthRecords/HealthRecordContracts.cs

@@ -0,0 +1,45 @@
+using Health.Domain.Enums;
+using Health.Domain.Entities;
+
+namespace Health.Application.HealthRecords;
+
+public sealed record HealthRecordUpsertRequest(
+    HealthMetricType Type,
+    int? Systolic,
+    int? Diastolic,
+    decimal? Value,
+    string? Unit,
+    HealthRecordSource Source,
+    DateTime? RecordedAt);
+
+public sealed record HealthRecordDto(
+    Guid Id,
+    string Type,
+    int? Systolic,
+    int? Diastolic,
+    decimal? Value,
+    string? Unit,
+    string Source,
+    bool IsAbnormal,
+    DateTime RecordedAt);
+
+public interface IHealthRecordService
+{
+    Task<IReadOnlyList<HealthRecordDto>> GetRecordsAsync(Guid userId, string? type, int? days, CancellationToken ct);
+    Task<Guid> CreateAsync(Guid userId, HealthRecordUpsertRequest request, CancellationToken ct);
+    Task<bool> UpdateAsync(Guid userId, Guid id, HealthRecordUpsertRequest request, CancellationToken ct);
+    Task<bool> DeleteAsync(Guid userId, Guid id, CancellationToken ct);
+    Task<Dictionary<string, object?>> GetLatestAsync(Guid userId, CancellationToken ct);
+    Task<IReadOnlyList<object>> GetTrendAsync(Guid userId, HealthMetricType type, int period, CancellationToken ct);
+}
+
+public interface IHealthRecordRepository
+{
+    Task<IReadOnlyList<HealthRecord>> ListAsync(Guid userId, HealthMetricType? type, DateTime? recordedAfter, int limit, CancellationToken ct);
+    Task<HealthRecord?> GetOwnedAsync(Guid userId, Guid id, CancellationToken ct);
+    Task<HealthRecord?> GetLatestByTypeAsync(Guid userId, HealthMetricType type, CancellationToken ct);
+    Task<IReadOnlyList<HealthRecord>> GetTrendAsync(Guid userId, HealthMetricType type, DateTime recordedAfter, CancellationToken ct);
+    Task AddAsync(HealthRecord record, CancellationToken ct);
+    void Delete(HealthRecord record);
+    Task SaveChangesAsync(CancellationToken ct);
+}

backend/src/Health.Application/HealthRecords/HealthRecordRules.cs

@@ -0,0 +1,16 @@
+using Health.Domain.Enums;
+
+namespace Health.Application.HealthRecords;
+
+public static class HealthRecordRules
+{
+    public static bool CheckAbnormal(HealthRecordUpsertRequest request) => request.Type switch
+    {
+        HealthMetricType.BloodPressure => request.Systolic >= 140 || request.Diastolic >= 90 || request.Systolic <= 89 || request.Diastolic <= 59,
+        HealthMetricType.HeartRate => request.Value > 100 || request.Value < 60,
+        HealthMetricType.Glucose => request.Value >= 7.0m || request.Value <= 3.8m,
+        HealthMetricType.SpO2 => request.Value <= 94,
+        HealthMetricType.Weight => false,
+        _ => false
+    };
+}

backend/src/Health.Application/HealthRecords/HealthRecordService.cs

@@ -0,0 +1,116 @@
+using Health.Domain.Entities;
+using Health.Domain.Enums;
+
+namespace Health.Application.HealthRecords;
+
+public sealed class HealthRecordService(IHealthRecordRepository records) : IHealthRecordService
+{
+    private readonly IHealthRecordRepository _records = records;
+
+    public async Task<IReadOnlyList<HealthRecordDto>> GetRecordsAsync(Guid userId, string? type, int? days, CancellationToken ct)
+    {
+        HealthMetricType? metricType = null;
+        if (!string.IsNullOrEmpty(type) && Enum.TryParse<HealthMetricType>(type, ignoreCase: true, out var parsed))
+            metricType = parsed;
+
+        var recordedAfter = days.HasValue ? DateTime.UtcNow.AddDays(-days.Value) : (DateTime?)null;
+        var result = await _records.ListAsync(userId, metricType, recordedAfter, 100, ct);
+        return result.Select(ToDto).ToList();
+    }
+
+    public async Task<Guid> CreateAsync(Guid userId, HealthRecordUpsertRequest request, CancellationToken ct)
+    {
+        var record = new HealthRecord
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            MetricType = request.Type,
+            Systolic = request.Systolic,
+            Diastolic = request.Diastolic,
+            Value = request.Value,
+            Unit = request.Unit,
+            Source = request.Source,
+            RecordedAt = request.RecordedAt ?? DateTime.UtcNow,
+            CreatedAt = DateTime.UtcNow,
+            IsAbnormal = HealthRecordRules.CheckAbnormal(request),
+        };
+
+        await _records.AddAsync(record, ct);
+        await _records.SaveChangesAsync(ct);
+        return record.Id;
+    }
+
+    public async Task<bool> UpdateAsync(Guid userId, Guid id, HealthRecordUpsertRequest request, CancellationToken ct)
+    {
+        var record = await _records.GetOwnedAsync(userId, id, ct);
+        if (record == null) return false;
+
+        record.MetricType = request.Type;
+        record.Systolic = request.Systolic;
+        record.Diastolic = request.Diastolic;
+        record.Value = request.Value;
+        record.Unit = request.Unit;
+        record.Source = request.Source;
+        record.RecordedAt = request.RecordedAt ?? record.RecordedAt;
+        record.IsAbnormal = HealthRecordRules.CheckAbnormal(request);
+
+        await _records.SaveChangesAsync(ct);
+        return true;
+    }
+
+    public async Task<bool> DeleteAsync(Guid userId, Guid id, CancellationToken ct)
+    {
+        var record = await _records.GetOwnedAsync(userId, id, ct);
+        if (record == null) return false;
+
+        _records.Delete(record);
+        await _records.SaveChangesAsync(ct);
+        return true;
+    }
+
+    public async Task<Dictionary<string, object?>> GetLatestAsync(Guid userId, CancellationToken ct)
+    {
+        var types = new[]
+        {
+            HealthMetricType.BloodPressure,
+            HealthMetricType.HeartRate,
+            HealthMetricType.Glucose,
+            HealthMetricType.SpO2,
+            HealthMetricType.Weight
+        };
+
+        var result = new Dictionary<string, object?>();
+        foreach (var type in types)
+        {
+            var latest = await _records.GetLatestByTypeAsync(userId, type, ct);
+            result[type.ToString()] = latest == null ? null : new
+            {
+                latest.Systolic,
+                latest.Diastolic,
+                latest.Value,
+                latest.Unit,
+                latest.RecordedAt
+            };
+        }
+
+        return result;
+    }
+
+    public async Task<IReadOnlyList<object>> GetTrendAsync(Guid userId, HealthMetricType type, int period, CancellationToken ct)
+    {
+        var days = period switch { 7 => 7, 30 => 30, 90 => 90, _ => 7 };
+        var records = await _records.GetTrendAsync(userId, type, DateTime.UtcNow.AddDays(-days), ct);
+        return records.Select(r => new { r.Id, r.Systolic, r.Diastolic, r.Value, r.IsAbnormal, r.RecordedAt }).Cast<object>().ToList();
+    }
+
+    public static HealthRecordDto ToDto(HealthRecord record) => new(
+        record.Id,
+        record.MetricType.ToString(),
+        record.Systolic,
+        record.Diastolic,
+        record.Value,
+        record.Unit,
+        record.Source.ToString(),
+        record.IsAbnormal,
+        record.RecordedAt);
+}

backend/src/Health.Application/Maintenance/MaintenanceContracts.cs

@@ -0,0 +1,16 @@
+namespace Health.Application.Maintenance;
+
+public sealed record MaintenanceCleanupResult(
+    int Conversations,
+    int VerificationCodes,
+    int BackgroundTasks);
+
+public interface IMaintenanceService
+{
+    Task<MaintenanceCleanupResult> CleanupAsync(DateTime utcNow, CancellationToken ct);
+}
+
+public interface IMaintenanceRepository
+{
+    Task<MaintenanceCleanupResult> CleanupAsync(DateTime conversationCutoff, DateTime taskCutoff, DateTime utcNow, CancellationToken ct);
+}

backend/src/Health.Application/Maintenance/MaintenanceService.cs

@@ -0,0 +1,9 @@
+namespace Health.Application.Maintenance;
+
+public sealed class MaintenanceService(IMaintenanceRepository repository) : IMaintenanceService
+{
+    private readonly IMaintenanceRepository _repository = repository;
+
+    public Task<MaintenanceCleanupResult> CleanupAsync(DateTime utcNow, CancellationToken ct) =>
+        _repository.CleanupAsync(utcNow.AddDays(-30), utcNow.AddDays(-30), utcNow, ct);
+}

backend/src/Health.Application/Medications/MedicationContracts.cs

@@ -0,0 +1,106 @@
+using Health.Domain.Entities;
+using Health.Domain.Enums;
+
+namespace Health.Application.Medications;
+
+public sealed record MedicationUpsertRequest(
+    string Name,
+    string? Dosage,
+    MedicationFrequency Frequency,
+    IReadOnlyList<TimeOnly> TimeOfDay,
+    DateOnly? StartDate,
+    DateOnly? EndDate,
+    MedicationSource Source,
+    string? Notes);
+
+public sealed record MedicationPatchRequest(
+    string? Name,
+    string? Dosage,
+    MedicationFrequency? Frequency,
+    IReadOnlyList<TimeOnly>? TimeOfDay,
+    DateOnly? StartDate,
+    DateOnly? EndDate,
+    string? Notes);
+
+public sealed record MedicationDto(
+    Guid Id,
+    string Name,
+    string? Dosage,
+    string Frequency,
+    IReadOnlyList<TimeOnly> TimeOfDay,
+    DateOnly? StartDate,
+    DateOnly? EndDate,
+    bool IsActive,
+    string? Notes,
+    string Source,
+    DateTime CreatedAt,
+    DateTime UpdatedAt,
+    bool TodayTaken);
+
+public sealed record MedicationReminderDto(
+    Guid Id,
+    string Name,
+    string? Dosage,
+    string ScheduledTime,
+    string Status);
+
+public sealed record MedicationReminderTask(
+    Guid TaskId,
+    Guid UserId,
+    Guid MedicationId,
+    string Name,
+    string? Dosage,
+    DateOnly ScheduledDate,
+    TimeOnly ScheduledTime);
+
+public interface IMedicationService
+{
+    Task<IReadOnlyList<MedicationDto>> ListAsync(Guid userId, string? filter, CancellationToken ct);
+    Task<Guid> CreateAsync(Guid userId, MedicationUpsertRequest request, CancellationToken ct);
+    Task<bool> UpdateAsync(Guid userId, Guid medicationId, MedicationPatchRequest request, CancellationToken ct);
+    Task<bool> DeleteAsync(Guid userId, Guid medicationId, CancellationToken ct);
+    Task<bool?> ToggleTodayTakenAsync(Guid userId, Guid medicationId, CancellationToken ct);
+    Task<IReadOnlyList<MedicationReminderDto>> GetRemindersAsync(Guid userId, CancellationToken ct);
+    Task<bool?> ConfirmDoseAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, MedicationLogStatus status, CancellationToken ct);
+    Task<bool> CancelDoseAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, CancellationToken ct);
+    Task<IReadOnlyList<MedicationDto>> ListActiveAsync(Guid userId, CancellationToken ct);
+    Task<bool> ConfirmNowAsync(Guid userId, Guid medicationId, CancellationToken ct);
+}
+
+public interface IMedicationRepository
+{
+    Task<IReadOnlyList<Medication>> ListAsync(Guid userId, string? filter, CancellationToken ct);
+    Task<IReadOnlyList<Medication>> ListActiveForRemindersAsync(Guid userId, DateOnly today, CancellationToken ct);
+    Task<IReadOnlyList<MedicationLog>> ListLogsInWindowAsync(Guid userId, DateTime startUtc, DateTime endUtc, CancellationToken ct);
+    Task<Medication?> GetOwnedAsync(Guid userId, Guid medicationId, CancellationToken ct);
+    Task<bool> ExistsOwnedAsync(Guid userId, Guid medicationId, CancellationToken ct);
+    Task<MedicationLog?> GetTodayTakenLogAsync(Guid userId, Guid medicationId, DateTime startUtc, DateTime endUtc, CancellationToken ct);
+    Task<bool> DoseLogExistsAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, DateTime startUtc, DateTime endUtc, CancellationToken ct);
+    Task<MedicationLog?> GetDoseLogAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, DateTime startUtc, DateTime endUtc, CancellationToken ct);
+    Task<IReadOnlyList<Medication>> ListActiveForReminderScanAsync(CancellationToken ct);
+    Task<bool> HasTakenInWindowAsync(Guid userId, Guid medicationId, DateTime startUtc, DateTime endUtc, CancellationToken ct);
+    Task AddMedicationAsync(Medication medication, CancellationToken ct);
+    Task AddLogAsync(MedicationLog log, CancellationToken ct);
+    void DeleteMedication(Medication medication);
+    void DeleteLog(MedicationLog log);
+    Task SaveChangesAsync(CancellationToken ct);
+}
+
+public interface IMedicationReminderScanner
+{
+    Task<IReadOnlyList<MedicationReminderTask>> ScanAsync(DateTime utcNow, CancellationToken ct);
+}
+
+public interface IMedicationReminderQueue
+{
+    Task<bool> EnqueueAsync(MedicationReminderTask task, CancellationToken ct);
+    Task RecoverStaleAsync(CancellationToken ct);
+    Task<MedicationReminderTask?> TryTakeAsync(CancellationToken ct);
+    Task CompleteAsync(Guid taskId, CancellationToken ct);
+    Task RetryAsync(Guid taskId, string error, CancellationToken ct);
+}
+
+public interface IMedicationReminderDispatcher
+{
+    Task DispatchAsync(MedicationReminderTask task, CancellationToken ct);
+}

backend/src/Health.Application/Medications/MedicationReminderScanner.cs

@@ -0,0 +1,64 @@
+using Health.Domain.Entities;
+using Health.Domain.Enums;
+
+namespace Health.Application.Medications;
+
+public sealed class MedicationReminderScanner(IMedicationRepository medications) : IMedicationReminderScanner
+{
+    private readonly IMedicationRepository _medications = medications;
+
+    public async Task<IReadOnlyList<MedicationReminderTask>> ScanAsync(DateTime utcNow, CancellationToken ct)
+    {
+        var beijingNow = utcNow.AddHours(8);
+        var date = DateOnly.FromDateTime(beijingNow);
+        var time = TimeOnly.FromDateTime(beijingNow);
+        var windowStart = time.AddMinutes(-5);
+        var todayStartUtc = beijingNow.Date.AddHours(-8);
+        var todayEndUtc = todayStartUtc.AddDays(1);
+        var active = await _medications.ListActiveForReminderScanAsync(ct);
+        var tasks = new List<MedicationReminderTask>();
+
+        foreach (var medication in active)
+        {
+            if (!IsActiveOn(medication, date) || !GetDosesForToday(medication, date)) continue;
+            if (await _medications.HasTakenInWindowAsync(medication.UserId, medication.Id, todayStartUtc, todayEndUtc, ct)) continue;
+
+            foreach (var scheduledTime in medication.TimeOfDay.Where(t => IsInWindow(t, windowStart, time)))
+            {
+                tasks.Add(new MedicationReminderTask(
+                    Guid.NewGuid(),
+                    medication.UserId,
+                    medication.Id,
+                    medication.Name,
+                    medication.Dosage,
+                    date,
+                    scheduledTime));
+            }
+        }
+
+        return tasks;
+    }
+
+    private static bool IsActiveOn(Medication medication, DateOnly date) =>
+        (medication.StartDate == null || medication.StartDate <= date)
+        && (medication.EndDate == null || medication.EndDate >= date);
+
+    private static bool IsInWindow(TimeOnly value, TimeOnly start, TimeOnly end) =>
+        end >= start ? value >= start && value <= end : value >= start || value <= end;
+
+    private static bool GetDosesForToday(Medication medication, DateOnly today)
+    {
+        if (medication.Frequency is MedicationFrequency.Daily
+            or MedicationFrequency.TwiceDaily
+            or MedicationFrequency.ThreeTimesDaily
+            or MedicationFrequency.AsNeeded)
+            return true;
+
+        var startDate = medication.StartDate ?? today;
+        if (medication.Frequency == MedicationFrequency.EveryOtherDay)
+            return (today.DayNumber - startDate.DayNumber) % 2 == 0;
+        if (medication.Frequency == MedicationFrequency.Weekly)
+            return today.DayOfWeek == startDate.DayOfWeek;
+        return true;
+    }
+}

backend/src/Health.Application/Medications/MedicationService.cs

@@ -0,0 +1,217 @@
+using Health.Domain.Entities;
+using Health.Domain.Enums;
+
+namespace Health.Application.Medications;
+
+public sealed class MedicationService(IMedicationRepository medications) : IMedicationService
+{
+    private readonly IMedicationRepository _medications = medications;
+
+    public async Task<IReadOnlyList<MedicationDto>> ListAsync(Guid userId, string? filter, CancellationToken ct)
+    {
+        var (todayStartUtc, todayEndUtc) = GetBeijingTodayUtcWindow();
+        var meds = await _medications.ListAsync(userId, filter, ct);
+        return meds.Select(m => ToDto(m, HasTakenToday(m, todayStartUtc, todayEndUtc))).ToList();
+    }
+
+    public async Task<Guid> CreateAsync(Guid userId, MedicationUpsertRequest request, CancellationToken ct)
+    {
+        var med = new Medication
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            Name = request.Name,
+            Dosage = request.Dosage,
+            Frequency = request.Frequency,
+            TimeOfDay = request.TimeOfDay.Count > 0 ? request.TimeOfDay.ToList() : [new TimeOnly(8, 0)],
+            StartDate = request.StartDate,
+            EndDate = request.EndDate,
+            Source = request.Source,
+            Notes = request.Notes,
+            IsActive = true,
+            CreatedAt = DateTime.UtcNow,
+            UpdatedAt = DateTime.UtcNow,
+        };
+
+        await _medications.AddMedicationAsync(med, ct);
+        await _medications.SaveChangesAsync(ct);
+        return med.Id;
+    }
+
+    public async Task<bool> UpdateAsync(Guid userId, Guid medicationId, MedicationPatchRequest request, CancellationToken ct)
+    {
+        var med = await _medications.GetOwnedAsync(userId, medicationId, ct);
+        if (med == null) return false;
+
+        if (!string.IsNullOrWhiteSpace(request.Name)) med.Name = request.Name;
+        if (request.Dosage != null) med.Dosage = request.Dosage;
+        if (request.Frequency.HasValue) med.Frequency = request.Frequency.Value;
+        if (request.TimeOfDay != null) med.TimeOfDay = request.TimeOfDay.ToList();
+        if (request.StartDate.HasValue) med.StartDate = request.StartDate.Value;
+        if (request.EndDate.HasValue) med.EndDate = request.EndDate.Value;
+        if (request.Notes != null) med.Notes = request.Notes;
+        med.UpdatedAt = DateTime.UtcNow;
+
+        await _medications.SaveChangesAsync(ct);
+        return true;
+    }
+
+    public async Task<bool> DeleteAsync(Guid userId, Guid medicationId, CancellationToken ct)
+    {
+        var med = await _medications.GetOwnedAsync(userId, medicationId, ct);
+        if (med == null) return false;
+
+        _medications.DeleteMedication(med);
+        await _medications.SaveChangesAsync(ct);
+        return true;
+    }
+
+    public async Task<bool?> ToggleTodayTakenAsync(Guid userId, Guid medicationId, CancellationToken ct)
+    {
+        if (!await _medications.ExistsOwnedAsync(userId, medicationId, ct)) return null;
+
+        var (todayStartUtc, todayEndUtc) = GetBeijingTodayUtcWindow();
+        var existing = await _medications.GetTodayTakenLogAsync(userId, medicationId, todayStartUtc, todayEndUtc, ct);
+        if (existing != null)
+        {
+            _medications.DeleteLog(existing);
+            await _medications.SaveChangesAsync(ct);
+            return false;
+        }
+
+        await AddLogAsync(userId, medicationId, MedicationLogStatus.Taken, TimeOnly.FromDateTime(DateTime.UtcNow.AddHours(8)), ct);
+        return true;
+    }
+
+    public async Task<IReadOnlyList<MedicationReminderDto>> GetRemindersAsync(Guid userId, CancellationToken ct)
+    {
+        var beijingNow = DateTime.UtcNow.AddHours(8);
+        var now = TimeOnly.FromDateTime(beijingNow);
+        var today = DateOnly.FromDateTime(beijingNow);
+        var (todayStartUtc, todayEndUtc) = GetBeijingTodayUtcWindow();
+
+        var meds = await _medications.ListActiveForRemindersAsync(userId, today, ct);
+        var logs = await _medications.ListLogsInWindowAsync(userId, todayStartUtc, todayEndUtc, ct);
+
+        var reminders = new List<MedicationReminderDto>();
+        foreach (var med in meds)
+        {
+            if (!GetDosesForToday(med, today)) continue;
+
+            foreach (var scheduledTime in med.TimeOfDay)
+            {
+                var log = logs.FirstOrDefault(l => l.MedicationId == med.Id && l.ScheduledTime == scheduledTime);
+                string status;
+                if (log != null)
+                    status = log.Status == MedicationLogStatus.Taken ? "taken" : "skipped";
+                else if (scheduledTime <= now.AddMinutes(-30))
+                    status = "overdue";
+                else if (scheduledTime <= now.AddHours(3))
+                    status = "upcoming";
+                else
+                    continue;
+
+                reminders.Add(new MedicationReminderDto(med.Id, med.Name, med.Dosage, scheduledTime.ToString("HH:mm"), status));
+            }
+        }
+
+        return reminders
+            .OrderBy(r => r.Status == "overdue" ? 0 : r.Status == "upcoming" ? 1 : 2)
+            .ToList();
+    }
+
+    public async Task<bool?> ConfirmDoseAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, MedicationLogStatus status, CancellationToken ct)
+    {
+        if (!await _medications.ExistsOwnedAsync(userId, medicationId, ct)) return null;
+
+        var (todayStartUtc, todayEndUtc) = GetBeijingTodayUtcWindow();
+        var existing = await _medications.DoseLogExistsAsync(userId, medicationId, scheduledTime, todayStartUtc, todayEndUtc, ct);
+        if (existing) return false;
+
+        await AddLogAsync(userId, medicationId, status, scheduledTime, ct);
+        return true;
+    }
+
+    public async Task<bool> CancelDoseAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, CancellationToken ct)
+    {
+        var (todayStartUtc, todayEndUtc) = GetBeijingTodayUtcWindow();
+        var log = await _medications.GetDoseLogAsync(userId, medicationId, scheduledTime, todayStartUtc, todayEndUtc, ct);
+        if (log == null) return false;
+
+        _medications.DeleteLog(log);
+        await _medications.SaveChangesAsync(ct);
+        return true;
+    }
+
+    public Task<IReadOnlyList<MedicationDto>> ListActiveAsync(Guid userId, CancellationToken ct) =>
+        ListAsync(userId, "active", ct);
+
+    public async Task<bool> ConfirmNowAsync(Guid userId, Guid medicationId, CancellationToken ct)
+    {
+        var result = await ConfirmDoseAsync(
+            userId,
+            medicationId,
+            TimeOnly.FromDateTime(DateTime.UtcNow.AddHours(8)),
+            MedicationLogStatus.Taken,
+            ct);
+        return result == true;
+    }
+
+    private async Task AddLogAsync(Guid userId, Guid medicationId, MedicationLogStatus status, TimeOnly scheduledTime, CancellationToken ct)
+    {
+        await _medications.AddLogAsync(new MedicationLog
+        {
+            Id = Guid.NewGuid(),
+            MedicationId = medicationId,
+            UserId = userId,
+            Status = status,
+            ScheduledTime = scheduledTime,
+            ConfirmedAt = DateTime.UtcNow,
+            CreatedAt = DateTime.UtcNow,
+        }, ct);
+        await _medications.SaveChangesAsync(ct);
+    }
+
+    private static MedicationDto ToDto(Medication med, bool todayTaken) => new(
+        med.Id,
+        med.Name,
+        med.Dosage,
+        med.Frequency.ToString(),
+        med.TimeOfDay,
+        med.StartDate,
+        med.EndDate,
+        med.IsActive,
+        med.Notes,
+        med.Source.ToString(),
+        med.CreatedAt,
+        med.UpdatedAt,
+        todayTaken);
+
+    private static bool HasTakenToday(Medication med, DateTime todayStartUtc, DateTime todayEndUtc) =>
+        med.Logs.Any(l => l.CreatedAt >= todayStartUtc && l.CreatedAt < todayEndUtc && l.Status == MedicationLogStatus.Taken);
+
+    private static (DateTime StartUtc, DateTime EndUtc) GetBeijingTodayUtcWindow()
+    {
+        var beijingToday = DateTime.UtcNow.AddHours(8).Date;
+        var todayStartUtc = beijingToday.AddHours(-8);
+        return (todayStartUtc, todayStartUtc.AddDays(1));
+    }
+
+    private static bool GetDosesForToday(Medication med, DateOnly today)
+    {
+        if (med.Frequency is MedicationFrequency.Daily
+            or MedicationFrequency.TwiceDaily
+            or MedicationFrequency.ThreeTimesDaily
+            or MedicationFrequency.AsNeeded)
+            return true;
+
+        var startDate = med.StartDate ?? today;
+        if (med.Frequency == MedicationFrequency.EveryOtherDay)
+            return (today.DayNumber - startDate.DayNumber) % 2 == 0;
+
+        if (med.Frequency == MedicationFrequency.Weekly)
+            return today.DayOfWeek == startDate.DayOfWeek;
+
+        return true;
+    }
+}

backend/src/Health.Application/Notifications/InAppNotificationContracts.cs

@@ -0,0 +1,26 @@
+namespace Health.Application.Notifications;
+
+public sealed record InAppNotificationDto(
+    Guid Id,
+    string Type,
+    string Title,
+    string Message,
+    DateTime CreatedAt);
+
+public interface IInAppNotificationService
+{
+    Task<IReadOnlyList<InAppNotificationDto>> GetPendingAsync(Guid userId, CancellationToken ct);
+    Task<bool> AcknowledgeAsync(Guid userId, Guid notificationId, CancellationToken ct);
+}
+
+public interface IInAppNotificationRepository
+{
+    Task<IReadOnlyList<InAppNotificationRecord>> GetPendingAsync(Guid userId, CancellationToken ct);
+    Task<bool> AcknowledgeAsync(Guid userId, Guid notificationId, CancellationToken ct);
+}
+
+public sealed record InAppNotificationRecord(
+    Guid Id,
+    string Type,
+    string Payload,
+    DateTime CreatedAt);

backend/src/Health.Application/Notifications/InAppNotificationService.cs

@@ -0,0 +1,47 @@
+using System.Text.Json;
+
+namespace Health.Application.Notifications;
+
+public sealed class InAppNotificationService(IInAppNotificationRepository notifications) : IInAppNotificationService
+{
+    private readonly IInAppNotificationRepository _notifications = notifications;
+
+    public async Task<IReadOnlyList<InAppNotificationDto>> GetPendingAsync(Guid userId, CancellationToken ct)
+    {
+        var records = await _notifications.GetPendingAsync(userId, ct);
+        return records.Select(ToDto).ToList();
+    }
+
+    public Task<bool> AcknowledgeAsync(Guid userId, Guid notificationId, CancellationToken ct) =>
+        _notifications.AcknowledgeAsync(userId, notificationId, ct);
+
+    private static InAppNotificationDto ToDto(InAppNotificationRecord record)
+    {
+        if (record.Type == "MedicationReminder")
+        {
+            using var json = JsonDocument.Parse(record.Payload);
+            var root = json.RootElement;
+            var name = root.TryGetProperty("Name", out var nameValue) ? nameValue.GetString() : null;
+            var dosage = root.TryGetProperty("Dosage", out var dosageValue) ? dosageValue.GetString() : null;
+            var time = root.TryGetProperty("ScheduledTime", out var timeValue) ? timeValue.GetString() : null;
+            var details = string.Join(" · ", new[] { dosage, time }.Where(x => !string.IsNullOrWhiteSpace(x)));
+            return new InAppNotificationDto(
+                record.Id,
+                record.Type,
+                "用药提醒",
+                $"该服用{name ?? "药物"}{(details.Length > 0 ? $"（{details}）" : "")}了",
+                record.CreatedAt);
+        }
+
+        if (record.Type == "ExerciseReminder")
+        {
+            using var json = JsonDocument.Parse(record.Payload);
+            var root = json.RootElement;
+            var type = root.TryGetProperty("ExerciseType", out var typeValue) ? typeValue.GetString() : "运动";
+            var minutes = root.TryGetProperty("DurationMinutes", out var minutesValue) ? minutesValue.GetInt32() : 30;
+            return new InAppNotificationDto(record.Id, record.Type, "运动提醒", $"今天的{type}计划还未完成，目标 {minutes} 分钟", record.CreatedAt);
+        }
+
+        return new InAppNotificationDto(record.Id, record.Type, "健康提醒", "您有一条新的健康提醒", record.CreatedAt);
+    }
+}

backend/src/Health.Application/Reports/ReportContracts.cs

@@ -0,0 +1,83 @@
+using Health.Domain.Entities;
+using Health.Domain.Enums;
+
+namespace Health.Application.Reports;
+
+public sealed record ReportUploadFile(
+    string FileName,
+    long Length,
+    Stream Content);
+
+public sealed record ReportDto(
+    Guid Id,
+    Guid UserId,
+    string FileUrl,
+    string FileType,
+    string Category,
+    string Status,
+    string AiStatus,
+    string ReviewStatus,
+    string? Severity,
+    string? AiSummary,
+    string? AiIndicators,
+    string? DoctorComment,
+    string? DoctorRecommendation,
+    string? DoctorName,
+    DateTime? ReviewedAt,
+    DateTime CreatedAt);
+
+public sealed record ReportUploadResult(
+    bool Success,
+    int Code,
+    string? Message,
+    ReportDto? Report);
+
+public sealed record ReportAnalysisJob(
+    Guid TaskId,
+    Guid ReportId,
+    string FilePath);
+
+public sealed record StoredReportFile(
+    string FileUrl,
+    string FilePath);
+
+public interface IReportService
+{
+    Task<IReadOnlyList<ReportDto>> GetReportsAsync(Guid userId, CancellationToken ct);
+    Task<ReportDto?> GetReportAsync(Guid userId, Guid reportId, CancellationToken ct);
+    Task<ReportUploadResult> UploadReportAsync(Guid userId, ReportUploadFile file, CancellationToken ct);
+    Task<bool> DeleteReportAsync(Guid userId, Guid reportId, CancellationToken ct);
+    Task<bool> ReanalyzeReportAsync(Guid userId, Guid reportId, CancellationToken ct);
+}
+
+public interface IReportAnalysisQueue
+{
+    Task EnqueueAsync(ReportAnalysisJob job, CancellationToken ct = default);
+    Task RecoverStaleAsync(CancellationToken ct);
+    Task<ReportAnalysisJob?> TryTakeAsync(CancellationToken ct);
+    Task CompleteAsync(Guid taskId, CancellationToken ct);
+    Task RetryAsync(Guid taskId, string error, CancellationToken ct);
+}
+
+public interface IReportAnalysisService
+{
+    Task AnalyzeAsync(ReportAnalysisJob job, CancellationToken ct);
+}
+
+public interface IReportRepository
+{
+    Task<IReadOnlyList<Report>> ListAsync(Guid userId, CancellationToken ct);
+    Task<Report?> GetOwnedAsync(Guid userId, Guid reportId, CancellationToken ct);
+    Task<Report?> GetByIdAsync(Guid reportId, CancellationToken ct);
+    Task AddAsync(Report report, CancellationToken ct);
+    void Delete(Report report);
+    Task SaveChangesAsync(CancellationToken ct);
+}
+
+public interface IReportFileStorage
+{
+    Task<StoredReportFile> SaveAsync(ReportUploadFile file, string extension, CancellationToken ct);
+    string GetLocalFilePath(string fileUrl);
+    bool Exists(string filePath);
+    void Delete(string filePath);
+}

backend/src/Health.Application/Reports/ReportService.cs

@@ -0,0 +1,122 @@
+using Health.Domain.Entities;
+using Health.Domain.Enums;
+
+namespace Health.Application.Reports;
+
+public sealed class ReportService(
+    IReportRepository reports,
+    IReportFileStorage fileStorage,
+    IReportAnalysisQueue queue) : IReportService
+{
+    private const long MaxReportImageBytes = 10 * 1024 * 1024;
+    private static readonly HashSet<string> AllowedExtensions = new(StringComparer.OrdinalIgnoreCase)
+    {
+        ".jpg", ".jpeg", ".png", ".webp"
+    };
+
+    private readonly IReportRepository _reports = reports;
+    private readonly IReportFileStorage _fileStorage = fileStorage;
+    private readonly IReportAnalysisQueue _queue = queue;
+
+    public async Task<IReadOnlyList<ReportDto>> GetReportsAsync(Guid userId, CancellationToken ct)
+    {
+        var result = await _reports.ListAsync(userId, ct);
+        return result.Select(ToDto).ToList();
+    }
+
+    public async Task<ReportDto?> GetReportAsync(Guid userId, Guid reportId, CancellationToken ct)
+    {
+        var report = await _reports.GetOwnedAsync(userId, reportId, ct);
+        return report == null ? null : ToDto(report);
+    }
+
+    public async Task<ReportUploadResult> UploadReportAsync(Guid userId, ReportUploadFile file, CancellationToken ct)
+    {
+        if (file.Length <= 0)
+            return Fail(400, "未上传文件");
+
+        if (file.Length > MaxReportImageBytes)
+            return Fail(400, "报告图片不能超过 10MB，请压缩后重新上传");
+
+        var ext = Path.GetExtension(file.FileName).ToLowerInvariant();
+        if (!AllowedExtensions.Contains(ext))
+            return Fail(400, "目前仅支持上传 JPG、PNG、WEBP 格式的报告图片");
+
+        var storedFile = await _fileStorage.SaveAsync(file, ext, ct);
+        var report = new Report
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            FileUrl = storedFile.FileUrl,
+            FileType = ReportFileType.Image,
+            Category = ReportCategory.Other,
+            Status = ReportStatus.Analyzing,
+            AiSummary = null,
+            AiIndicators = null,
+            CreatedAt = DateTime.UtcNow,
+        };
+
+        await _reports.AddAsync(report, ct);
+        await _queue.EnqueueAsync(new ReportAnalysisJob(Guid.NewGuid(), report.Id, storedFile.FilePath), ct);
+
+        return new ReportUploadResult(true, 0, "报告已上传，AI 正在分析中", ToDto(report));
+    }
+
+    public async Task<bool> DeleteReportAsync(Guid userId, Guid reportId, CancellationToken ct)
+    {
+        var report = await _reports.GetOwnedAsync(userId, reportId, ct);
+        if (report == null) return false;
+
+        var filePath = _fileStorage.GetLocalFilePath(report.FileUrl);
+        if (_fileStorage.Exists(filePath))
+            _fileStorage.Delete(filePath);
+
+        _reports.Delete(report);
+        await _reports.SaveChangesAsync(ct);
+        return true;
+    }
+
+    public async Task<bool> ReanalyzeReportAsync(Guid userId, Guid reportId, CancellationToken ct)
+    {
+        var report = await _reports.GetOwnedAsync(userId, reportId, ct);
+        if (report == null) return false;
+
+        var filePath = _fileStorage.GetLocalFilePath(report.FileUrl);
+        if (!_fileStorage.Exists(filePath)) return false;
+
+        report.Status = ReportStatus.Analyzing;
+        report.AiSummary = null;
+        report.AiIndicators = null;
+        await _queue.EnqueueAsync(new ReportAnalysisJob(Guid.NewGuid(), report.Id, filePath), ct);
+        return true;
+    }
+
+    public static ReportDto ToDto(Report report) => new(
+        report.Id,
+        report.UserId,
+        report.FileUrl,
+        report.FileType.ToString(),
+        report.Category.ToString(),
+        report.Status.ToString(),
+        ToAiStatus(report),
+        report.Status == ReportStatus.DoctorReviewed ? "Reviewed" : "Pending",
+        report.Severity,
+        report.AiSummary,
+        report.AiIndicators,
+        report.DoctorComment,
+        report.DoctorRecommendation,
+        report.DoctorName,
+        report.ReviewedAt,
+        report.CreatedAt);
+
+    private static string ToAiStatus(Report report) => report.Status switch
+    {
+        ReportStatus.Analyzing => "Analyzing",
+        ReportStatus.AnalysisFailed => "Failed",
+        _ when string.IsNullOrWhiteSpace(report.AiSummary) => "Analyzing",
+        _ => "Succeeded"
+    };
+
+    private static ReportUploadResult Fail(int code, string message) =>
+        new(false, code, message, null);
+}

backend/src/Health.Application/Users/UserContracts.cs

@@ -0,0 +1,31 @@
+using Health.Domain.Entities;
+
+namespace Health.Application.Users;
+
+public sealed record UserProfileDto(
+    Guid Id,
+    string Phone,
+    string Role,
+    string? Name,
+    string? Gender,
+    string? BirthDate,
+    string? AvatarUrl);
+
+public sealed record UserProfileUpdateRequest(
+    string? Name,
+    string? Gender,
+    DateOnly? BirthDate);
+
+public interface IUserService
+{
+    Task<UserProfileDto?> GetProfileAsync(Guid userId, CancellationToken ct);
+    Task<bool> UpdateProfileAsync(Guid userId, UserProfileUpdateRequest request, CancellationToken ct);
+    Task DeleteAccountAsync(Guid userId, CancellationToken ct);
+}
+
+public interface IUserRepository
+{
+    Task<User?> GetAsync(Guid userId, CancellationToken ct);
+    Task SaveChangesAsync(CancellationToken ct);
+    Task DeleteAccountDataAsync(Guid userId, CancellationToken ct);
+}

backend/src/Health.Application/Users/UserService.cs

@@ -0,0 +1,35 @@
+namespace Health.Application.Users;
+
+public sealed class UserService(IUserRepository users) : IUserService
+{
+    private readonly IUserRepository _users = users;
+
+    public async Task<UserProfileDto?> GetProfileAsync(Guid userId, CancellationToken ct)
+    {
+        var user = await _users.GetAsync(userId, ct);
+        return user == null ? null : new UserProfileDto(
+            user.Id,
+            user.Phone,
+            user.Role,
+            user.Name,
+            user.Gender,
+            user.BirthDate?.ToString("yyyy-MM-dd"),
+            user.AvatarUrl);
+    }
+
+    public async Task<bool> UpdateProfileAsync(Guid userId, UserProfileUpdateRequest request, CancellationToken ct)
+    {
+        var user = await _users.GetAsync(userId, ct);
+        if (user == null) return false;
+
+        if (request.Name != null) user.Name = request.Name;
+        if (request.Gender != null) user.Gender = request.Gender;
+        if (request.BirthDate.HasValue) user.BirthDate = request.BirthDate.Value;
+        user.UpdatedAt = DateTime.UtcNow;
+        await _users.SaveChangesAsync(ct);
+        return true;
+    }
+
+    public Task DeleteAccountAsync(Guid userId, CancellationToken ct) =>
+        _users.DeleteAccountDataAsync(userId, ct);
+}

backend/src/Health.Domain/Entities/exercise_plan.cs

@@ -7,7 +7,9 @@ public sealed class ExercisePlan
 {
     public Guid Id { get; set; }
     public Guid UserId { get; set; }
-    public DateOnly WeekStartDate { get; set; } // 起始日期
+    public DateOnly StartDate { get; set; }
+    public DateOnly EndDate { get; set; }
+    public TimeOnly ReminderTime { get; set; } = new(19, 0);
     public DateTime CreatedAt { get; set; } = DateTime.UtcNow;
     public DateTime UpdatedAt { get; set; } = DateTime.UtcNow;
 
@@ -22,7 +24,7 @@ public sealed class ExercisePlanItem
 {
     public Guid Id { get; set; }
     public Guid PlanId { get; set; }
-    public int DayOfWeek { get; set; }    // C# DayOfWeek: 0=周日, 6=周六
+    public DateOnly ScheduledDate { get; set; }
     public string ExerciseType { get; set; } = string.Empty; // 散步/慢跑/游泳
     public int DurationMinutes { get; set; }
     public bool IsCompleted { get; set; }

backend/src/Health.Domain/Enums/health_enums.cs

@@ -71,6 +71,8 @@ public enum MedicationFrequency
 /// </summary>
 public enum ReportStatus
 {
+    Analyzing,      // AI 分析中
+    AnalysisFailed, // AI 分析失败
     PendingDoctor,  // 待医生确认
     DoctorReviewed  // 医生已确认
 }

backend/src/Health.Infrastructure/AI/AgentHandlers/common_agent_handler.cs

@@ -1,3 +1,6 @@
+using Health.Application.HealthArchives;
+using Health.Application.HealthRecords;
+
 namespace Health.Infrastructure.AI.AgentHandlers;
 
 /// <summary>
@@ -21,38 +24,33 @@ public static class CommonAgentHandler
 
     public static List<ToolDefinition> Tools => [QueryHealthRecordsTool, CheckArchiveTool];
 
-    public static async Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId)
+    public static async Task<object> Execute(
+        string toolName,
+        JsonElement args,
+        Guid userId,
+        IHealthRecordService healthRecords,
+        IHealthArchiveService archives,
+        CancellationToken ct = default)
     {
         return toolName switch
         {
-            "query_health_records" => await ExecuteQueryHealthRecords(db, userId, args),
-            "check_archive" => await ExecuteCheckArchive(db, userId),
+            "query_health_records" => await ExecuteQueryHealthRecords(healthRecords, userId, args, ct),
+            "check_archive" => await ExecuteCheckArchive(archives, userId, ct),
             _ => new { success = false, message = $"未知工具: {toolName}" }
         };
     }
 
-    private static async Task<object> ExecuteQueryHealthRecords(AppDbContext db, Guid userId, JsonElement args)
+    private static async Task<object> ExecuteQueryHealthRecords(IHealthRecordService healthRecords, Guid userId, JsonElement args, CancellationToken ct)
     {
         var type = args.TryGetProperty("type", out var t) ? t.GetString() : null;
         var days = args.TryGetProperty("days", out var d) ? d.GetInt32() : 7;
-
-        var query = db.HealthRecords.Where(r => r.UserId == userId);
-        if (!string.IsNullOrEmpty(type) && Enum.TryParse<HealthMetricType>(type, ignoreCase: true, out var mt))
-            query = query.Where(r => r.MetricType == mt);
-
-        query = query.Where(r => r.RecordedAt >= DateTime.UtcNow.AddDays(-days));
-
-        var records = await query.OrderByDescending(r => r.RecordedAt).Take(30).Select(r => new
-        {
-            r.Id, Type = r.MetricType.ToString(), r.Systolic, r.Diastolic, r.Value, r.Unit, r.IsAbnormal, r.RecordedAt,
-        }).ToListAsync();
-
+        var records = await healthRecords.GetRecordsAsync(userId, type, days, ct);
         return new { count = records.Count, records };
     }
 
-    private static async Task<object> ExecuteCheckArchive(AppDbContext db, Guid userId)
+    private static async Task<object> ExecuteCheckArchive(IHealthArchiveService archives, Guid userId, CancellationToken ct)
     {
-        var archive = await db.HealthArchives.FirstOrDefaultAsync(a => a.UserId == userId);
+        var archive = await archives.GetAsync(userId, ct);
         if (archive == null) return new { found = false };
         return new
         {
@@ -85,49 +83,26 @@ public static class CommonAgentHandler
         }
     };
 
-    public static async Task<object> ExecuteManageArchive(AppDbContext db, Guid userId, JsonElement args)
+    public static Task<object> ExecuteManageArchive(
+        IHealthArchiveService archives,
+        Guid userId,
+        JsonElement args,
+        CancellationToken ct = default)
     {
         var action = args.TryGetProperty("action", out var a) ? a.GetString()! : "query";
-        var archive = await db.HealthArchives.FirstOrDefaultAsync(x => x.UserId == userId);
-        if (archive == null)
-        {
-            archive = new HealthArchive { Id = Guid.NewGuid(), UserId = userId };
-            db.HealthArchives.Add(archive);
-        }
-
-        switch (action)
-        {
-            case "update_diagnosis":
-                archive.Diagnosis = args.TryGetProperty("diagnosis", out var d) ? d.GetString() : archive.Diagnosis;
-                break;
-            case "update_surgery":
-                archive.SurgeryType = args.TryGetProperty("surgery_type", out var st) ? st.GetString() : archive.SurgeryType;
-                if (args.TryGetProperty("surgery_date", out var sd))
-                    archive.SurgeryDate = DateOnly.TryParse(sd.GetString(), out var date) ? date : archive.SurgeryDate;
-                break;
-            case "update_allergies":
-                if (args.TryGetProperty("allergies", out var al) && al.ValueKind == JsonValueKind.Array)
-                    archive.Allergies = [.. al.EnumerateArray().Select(x => x.GetString()!)];
-                break;
-            case "update_chronic_diseases":
-                if (args.TryGetProperty("chronic_diseases", out var cd) && cd.ValueKind == JsonValueKind.Array)
-                    archive.ChronicDiseases = [.. cd.EnumerateArray().Select(x => x.GetString()!)];
-                break;
-            case "update_diet_restrictions":
-                if (args.TryGetProperty("diet_restrictions", out var dr) && dr.ValueKind == JsonValueKind.Array)
-                    archive.DietRestrictions = [.. dr.EnumerateArray().Select(x => x.GetString()!)];
-                break;
-            default: // query
-                return new
-                {
-                    found = true, archive.Diagnosis, archive.SurgeryType,
-                    SurgeryDate = archive.SurgeryDate?.ToString("yyyy-MM-dd"),
-                    archive.Allergies, archive.DietRestrictions, archive.ChronicDiseases, archive.FamilyHistory,
-                };
-        }
-
-        archive.UpdatedAt = DateTime.UtcNow;
-        await db.SaveChangesAsync();
-        return new { success = true };
+        var request = new HealthArchiveUpdateRequest(
+            args.TryGetProperty("diagnosis", out var diagnosis) ? diagnosis.GetString() : null,
+            args.TryGetProperty("surgery_type", out var surgeryType) ? surgeryType.GetString() : null,
+            args.TryGetProperty("surgery_date", out var surgeryDate) && DateOnly.TryParse(surgeryDate.GetString(), out var date) ? date : null,
+            ReadStringArray(args, "allergies"),
+            ReadStringArray(args, "diet_restrictions"),
+            ReadStringArray(args, "chronic_diseases"),
+            args.TryGetProperty("family_history", out var familyHistory) ? familyHistory.GetString() : null);
+        return archives.ExecuteAiActionAsync(userId, action, request, ct);
     }
+
+    private static IReadOnlyList<string>? ReadStringArray(JsonElement args, string propertyName) =>
+        args.TryGetProperty(propertyName, out var value) && value.ValueKind == JsonValueKind.Array
+            ? value.EnumerateArray().Select(x => x.GetString()).Where(x => !string.IsNullOrWhiteSpace(x)).Cast<string>().ToList()
+            : null;
 }

backend/src/Health.Infrastructure/AI/AgentHandlers/consultation_agent_handler.cs

@@ -7,12 +7,4 @@ public static class ConsultationAgentHandler
 {
     public static List<ToolDefinition> Tools => [CommonAgentHandler.QueryHealthRecordsTool, CommonAgentHandler.CheckArchiveTool];
 
-    public static Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId)
-    {
-        return toolName switch
-        {
-            "query_health_records" or "check_archive" => CommonAgentHandler.Execute(toolName, args, db, userId),
-            _ => Task.FromResult<object>(new { success = false, message = $"未知工具: {toolName}" })
-        };
-    }
 }

backend/src/Health.Infrastructure/AI/AgentHandlers/diet_agent_handler.cs

@@ -7,12 +7,4 @@ public static class DietAgentHandler
 {
     public static List<ToolDefinition> Tools => [CommonAgentHandler.CheckArchiveTool];
 
-    public static Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId)
-    {
-        return toolName switch
-        {
-            "check_archive" => CommonAgentHandler.Execute(toolName, args, db, userId),
-            _ => Task.FromResult<object>(new { success = false, message = $"未知工具: {toolName}" })
-        };
-    }
 }

backend/src/Health.Infrastructure/AI/AgentHandlers/exercise_agent_handler.cs

@@ -1,85 +1,83 @@
+using Health.Application.Exercises;
+
 namespace Health.Infrastructure.AI.AgentHandlers;
 
-/// <summary>
-/// 运动计划 Agent 工具处理器
-/// </summary>
 public static class ExerciseAgentHandler
 {
     public static readonly ToolDefinition ManageExerciseTool = new()
     {
         Function = new()
         {
-            Name = "manage_exercise", Description = "运动计划管理（创建/查询/打卡）",
-            Parameters = new { type = "object", properties = new {
-                action = new { type = "string", description = "create/query/checkin" },
-                week_start_date = new { type = "string", description = "开始日期 yyyy-MM-dd" },
-                items = new { type = "array", description = "每天的运动项目", items = new { type = "object", properties = new {
-                    day_of_week = new { type = "integer", description = "0=周日 1=周一...6=周六" },
-                    exercise_type = new { type = "string", description = "运动类型，如散步/慢跑/游泳/太极" },
-                    duration_minutes = new { type = "integer", description = "时长（分钟）" },
-                    is_rest_day = new { type = "boolean", description = "是否休息日" }
-                }}}
-            }, required = new[] { "action" } }
-        }
+            Name = "manage_exercise",
+            Description = "运动计划管理（创建/查询/打卡）",
+            Parameters = new
+            {
+                type = "object",
+                properties = new
+                {
+                    action = new { type = "string", description = "create/query/checkin" },
+                    start_date = new { type = "string", description = "开始日期 yyyy-MM-dd，默认今天" },
+                    duration_days = new { type = "integer", description = "连续运动天数，如一周为7天" },
+                    exercise_type = new { type = "string", description = "运动类型，如散步、慢跑、游泳" },
+                    duration_minutes = new { type = "integer", description = "每天运动时长，单位分钟" },
+                    reminder_time = new { type = "string", description = "每天提醒时间 HH:mm，默认19:00" },
+                    item_id = new { type = "string", description = "打卡条目 ID" },
+                },
+                required = new[] { "action" },
+            },
+        },
     };
 
     public static List<ToolDefinition> Tools => [ManageExerciseTool];
 
-    public static async Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId)
+    public static async Task<object> Execute(
+        string toolName,
+        JsonElement args,
+        AppDbContext db,
+        Guid userId,
+        IExerciseService? exercises = null,
+        CancellationToken ct = default)
     {
-        return toolName switch
+        if (toolName != "manage_exercise" || exercises == null)
+            return new { success = false, message = $"未知工具: {toolName}" };
+
+        var action = args.TryGetProperty("action", out var actionValue) ? actionValue.GetString() : "query";
+        if (action == "create")
         {
-            "manage_exercise" => await ExecuteManageExercise(db, userId, args),
-            _ => new { success = false, message = $"未知工具: {toolName}" }
-        };
-    }
-
-    private static async Task<object> ExecuteManageExercise(AppDbContext db, Guid userId, JsonElement args)
-    {
-        var action = args.TryGetProperty("action", out var a) ? a.GetString()! : "query";
-        switch (action)
-        {
-            case "create":
-                var weekStart = args.TryGetProperty("week_start_date", out var wsd) ? DateOnly.Parse(wsd.GetString()!) : DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8));
-                var plan = new ExercisePlan { Id = Guid.NewGuid(), UserId = userId, WeekStartDate = weekStart };
-                if (args.TryGetProperty("items", out var items))
-                {
-                    foreach (var item in items.EnumerateArray())
-                    {
-                        plan.Items.Add(new ExercisePlanItem
-                        {
-                            Id = Guid.NewGuid(), DayOfWeek = item.GetProperty("day_of_week").GetInt32(),
-                            ExerciseType = item.GetProperty("exercise_type").GetString() ?? "散步",
-                            DurationMinutes = item.GetProperty("duration_minutes").GetInt32(),
-                            IsRestDay = item.TryGetProperty("is_rest_day", out var rd) && rd.GetBoolean(),
-                        });
-                    }
-                }
-                db.ExercisePlans.Add(plan);
-                await db.SaveChangesAsync();
-                var firstItem = plan.Items.FirstOrDefault();
-                return new {
-                    success = true, plan_id = plan.Id,
-                    exercise_type = firstItem?.ExerciseType ?? "运动",
-                    duration_minutes = firstItem?.DurationMinutes ?? 30,
-                    day_count = plan.Items.Count,
-                };
-
-            case "checkin":
-                var itemId = args.TryGetProperty("item_id", out var iid) ? iid.GetGuid() : Guid.Empty;
-                var exerciseItem = await db.ExercisePlanItems.FindAsync([itemId]);
-                if (exerciseItem == null) return new { success = false, message = "条目不存在" };
-                exerciseItem.IsCompleted = true;
-                exerciseItem.CompletedAt = DateTime.UtcNow;
-                await db.SaveChangesAsync();
-                return new { success = true };
-
-            default:
-                var existingPlan = await db.ExercisePlans.Where(p => p.UserId == userId)
-                    .OrderByDescending(p => p.WeekStartDate).FirstOrDefaultAsync();
-                if (existingPlan == null) return new { found = false };
-                var exerciseItems = await db.ExercisePlanItems.Where(i => i.PlanId == existingPlan.Id).OrderBy(i => i.DayOfWeek).ToListAsync();
-                return new { found = true, plan_id = existingPlan.Id, items = exerciseItems.Select(i => new { i.Id, i.DayOfWeek, i.ExerciseType, i.DurationMinutes, i.IsCompleted }) };
+            var startDate = args.TryGetProperty("start_date", out var startValue) && DateOnly.TryParse(startValue.GetString(), out var parsedStart)
+                ? parsedStart
+                : DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8));
+            var days = args.TryGetProperty("duration_days", out var daysValue) && daysValue.TryGetInt32(out var parsedDays)
+                ? Math.Clamp(parsedDays, 1, 366)
+                : 7;
+            var exerciseType = args.TryGetProperty("exercise_type", out var typeValue) ? typeValue.GetString() : "散步";
+            var minutes = args.TryGetProperty("duration_minutes", out var minutesValue) && minutesValue.TryGetInt32(out var parsedMinutes) ? parsedMinutes : 30;
+            var reminder = args.TryGetProperty("reminder_time", out var reminderValue) && TimeOnly.TryParse(reminderValue.GetString(), out var parsedReminder)
+                ? parsedReminder
+                : new TimeOnly(19, 0);
+            var planId = await exercises.CreateAsync(userId, new ExercisePlanCreateRequest(
+                startDate, startDate.AddDays(days - 1), exerciseType, minutes, reminder), ct);
+            return new { success = true, plan_id = planId, exercise_type = exerciseType, duration_minutes = minutes, day_count = days, start_date = startDate, end_date = startDate.AddDays(days - 1), reminder_time = reminder };
         }
+
+        if (action == "checkin")
+        {
+            var itemId = args.TryGetProperty("item_id", out var itemValue) && itemValue.TryGetGuid(out var parsedId) ? parsedId : Guid.Empty;
+            var success = await exercises.CheckInAsync(userId, itemId, ct);
+            return success ? new { success = true } : new { success = false, message = "条目不存在" };
+        }
+
+        var plan = await exercises.GetLatestAsync(userId, ct);
+        return plan == null
+            ? new { found = false }
+            : new
+            {
+                found = true,
+                plan_id = plan.Id,
+                plan.StartDate,
+                plan.EndDate,
+                plan.ReminderTime,
+                items = plan.Items.Select(i => new { i.Id, i.ScheduledDate, i.ExerciseType, i.DurationMinutes, i.IsCompleted }),
+            };
     }
 }

backend/src/Health.Infrastructure/AI/AgentHandlers/health_data_agent_handler.cs

@@ -1,3 +1,5 @@
+using Health.Application.HealthRecords;
+
 namespace Health.Infrastructure.AI.AgentHandlers;
 
 /// <summary>
@@ -16,16 +18,50 @@ public static class HealthDataAgentHandler
 
     public static List<ToolDefinition> Tools => [RecordHealthDataTool, CommonAgentHandler.QueryHealthRecordsTool];
 
-    public static async Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId)
+    public static async Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId, IHealthRecordService? healthRecords = null)
     {
         return toolName switch
         {
-            "record_health_data" => await ExecuteRecordHealthData(db, userId, args),
-            "query_health_records" => await CommonAgentHandler.Execute(toolName, args, db, userId),
+            "record_health_data" => healthRecords == null
+                ? await ExecuteRecordHealthData(db, userId, args)
+                : await ExecuteRecordHealthData(healthRecords, userId, args),
             _ => new { success = false, message = $"未知工具: {toolName}" }
         };
     }
 
+    private static async Task<object> ExecuteRecordHealthData(IHealthRecordService healthRecords, Guid userId, JsonElement args)
+    {
+        var type = args.TryGetProperty("type", out var t) ? t.GetString()! : "";
+        var (metricType, value, unit, systolic, diastolic) = ParseMetric(type, args);
+        if (metricType == null)
+            return new { success = false, message = $"未知指标类型: {type}" };
+
+        var recordedAt = args.TryGetProperty("recorded_at", out var ra) && ra.TryGetDateTime(out var dt)
+            ? dt
+            : DateTime.UtcNow;
+
+        var request = new HealthRecordUpsertRequest(
+            metricType.Value,
+            systolic,
+            diastolic,
+            value,
+            unit,
+            HealthRecordSource.AiEntry,
+            recordedAt);
+
+        var id = await healthRecords.CreateAsync(userId, request, CancellationToken.None);
+        var valStr = metricType == HealthMetricType.BloodPressure ? $"{systolic}/{diastolic}" : value?.ToString() ?? "";
+        return new
+        {
+            success = true,
+            record_id = id,
+            type = metricType.Value.ToString(),
+            value = valStr,
+            unit,
+            isAbnormal = HealthRecordRules.CheckAbnormal(request)
+        };
+    }
+
     private static async Task<object> ExecuteRecordHealthData(AppDbContext db, Guid userId, JsonElement args)
     {
         var type = args.TryGetProperty("type", out var t) ? t.GetString()! : "";
@@ -82,4 +118,42 @@ public static class HealthDataAgentHandler
         };
         return new { success = true, record_id = record.Id, type = record.MetricType.ToString(), value = valStr, unit = record.Unit, isAbnormal = record.IsAbnormal };
     }
+
+    private static (HealthMetricType? Type, decimal? Value, string Unit, int? Systolic, int? Diastolic) ParseMetric(string type, JsonElement args)
+    {
+        return type switch
+        {
+            "blood_pressure" => (
+                HealthMetricType.BloodPressure,
+                null,
+                "mmHg",
+                args.TryGetProperty("systolic", out var s) ? s.GetInt32() : null,
+                args.TryGetProperty("diastolic", out var d) ? d.GetInt32() : null),
+            "heart_rate" => (
+                HealthMetricType.HeartRate,
+                args.TryGetProperty("heart_rate", out var hr) ? hr.GetDecimal() : null,
+                "次/分",
+                null,
+                null),
+            "glucose" => (
+                HealthMetricType.Glucose,
+                args.TryGetProperty("glucose", out var g) ? g.GetDecimal() : null,
+                "mmol/L",
+                null,
+                null),
+            "spo2" => (
+                HealthMetricType.SpO2,
+                args.TryGetProperty("spo2", out var o) ? o.GetDecimal() : null,
+                "%",
+                null,
+                null),
+            "weight" => (
+                HealthMetricType.Weight,
+                args.TryGetProperty("weight", out var w) ? w.GetDecimal() : null,
+                "kg",
+                null,
+                null),
+            _ => (null, null, "", null, null)
+        };
+    }
 }

backend/src/Health.Infrastructure/AI/AgentHandlers/medication_agent_handler.cs

@@ -1,7 +1,9 @@
+using Health.Application.Medications;
+
 namespace Health.Infrastructure.AI.AgentHandlers;
 
 /// <summary>
-/// 药管家 Agent 工具处理器——用药管理
+/// 药管家 Agent 工具处理器。
 /// </summary>
 public static class MedicationAgentHandler
 {
@@ -9,31 +11,105 @@ public static class MedicationAgentHandler
     {
         Function = new()
         {
-            Name = "manage_medication", Description = "用药管理（创建/查询/确认服药）",
-            Parameters = new { type = "object", properties = new {
-                action = new { type = "string", description = "create/query/confirm" },
-                name = new { type = "string", description = "药品名称" },
-                dosage = new { type = "string", description = "剂量，如 100mg" },
-                frequency = new { type = "string", description = "频率，如 Daily/EveryOtherDay/Weekly" },
-                time_of_day = new { type = "array", items = new { type = "string" }, description = "服药时间，如 [\"08:00\",\"20:00\"]" },
-                duration_days = new { type = "integer", description = "服用天数" },
-                start_date = new { type = "string", description = "开始日期 yyyy-MM-dd" },
-            }, required = new[] { "action" } }
+            Name = "manage_medication",
+            Description = "用药管理（创建/查询/确认服药）",
+            Parameters = new
+            {
+                type = "object",
+                properties = new
+                {
+                    action = new { type = "string", description = "create/query/confirm" },
+                    medication_id = new { type = "string", description = "药品 ID，确认服药时使用" },
+                    name = new { type = "string", description = "药品名称" },
+                    dosage = new { type = "string", description = "剂量，如 100mg" },
+                    frequency = new { type = "string", description = "频率，如 Daily/EveryOtherDay/Weekly" },
+                    time_of_day = new { type = "array", items = new { type = "string" }, description = "服药时间，如 [\"08:00\",\"20:00\"]" },
+                    duration_days = new { type = "integer", description = "服用天数" },
+                    start_date = new { type = "string", description = "开始日期 yyyy-MM-dd" },
+                },
+                required = new[] { "action" }
+            }
         }
     };
 
     public static List<ToolDefinition> Tools => [ManageMedicationTool, CommonAgentHandler.CheckArchiveTool];
 
-    public static async Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId)
+    public static async Task<object> Execute(
+        string toolName,
+        JsonElement args,
+        AppDbContext db,
+        Guid userId,
+        IMedicationService? medications = null,
+        CancellationToken ct = default)
     {
         return toolName switch
         {
-            "manage_medication" => await ExecuteManageMedication(db, userId, args),
-            "check_archive" => await CommonAgentHandler.Execute(toolName, args, db, userId),
+            "manage_medication" => medications != null
+                ? await ExecuteManageMedication(medications, userId, args, ct)
+                : await ExecuteManageMedication(db, userId, args),
             _ => new { success = false, message = $"未知工具: {toolName}" }
         };
     }
 
+    private static async Task<object> ExecuteManageMedication(IMedicationService medications, Guid userId, JsonElement args, CancellationToken ct)
+    {
+        var action = args.TryGetProperty("action", out var a) ? a.GetString()! : "query";
+        return action switch
+        {
+            "create" => await CreateMedication(medications, userId, args, ct),
+            "query" => await QueryMedications(medications, userId, ct),
+            "confirm" => await ConfirmMedication(medications, userId, args, ct),
+            _ => new { success = false, message = $"未知操作: {action}" }
+        };
+    }
+
+    private static async Task<object> CreateMedication(IMedicationService medications, Guid userId, JsonElement args, CancellationToken ct)
+    {
+        var name = args.TryGetProperty("name", out var n) ? n.GetString()! : "";
+        var dosage = args.TryGetProperty("dosage", out var dg) ? dg.GetString() : null;
+        var frequency = ReadFrequency(args);
+        var times = ReadTimes(args);
+        var durationDays = args.TryGetProperty("duration_days", out var dd) ? dd.GetInt32() : 0;
+        var startDate = ReadStartDate(args);
+        var endDate = durationDays > 0 ? startDate.AddDays(durationDays) : (DateOnly?)null;
+
+        var medicationId = await medications.CreateAsync(userId, new MedicationUpsertRequest(
+            name,
+            dosage,
+            frequency,
+            times.Count > 0 ? times : [new TimeOnly(8, 0)],
+            startDate,
+            endDate,
+            MedicationSource.AiEntry,
+            null), ct);
+
+        var timeLabels = times.Count > 0 ? string.Join(", ", times.Select(t => t.ToString("HH:mm"))) : "08:00";
+        return new
+        {
+            success = true,
+            medication_id = medicationId,
+            name,
+            dosage,
+            frequency = frequency.ToString(),
+            time = timeLabels,
+            start_date = startDate.ToString("yyyy-MM-dd"),
+            duration_days = durationDays,
+        };
+    }
+
+    private static async Task<object> QueryMedications(IMedicationService medications, Guid userId, CancellationToken ct)
+    {
+        var meds = await medications.ListActiveAsync(userId, ct);
+        return new { count = meds.Count, medications = meds.Select(m => new { m.Id, m.Name, m.Dosage, m.TimeOfDay }) };
+    }
+
+    private static async Task<object> ConfirmMedication(IMedicationService medications, Guid userId, JsonElement args, CancellationToken ct)
+    {
+        var medId = args.TryGetProperty("medication_id", out var mid) ? mid.GetGuid() : Guid.Empty;
+        var success = await medications.ConfirmNowAsync(userId, medId, ct);
+        return success ? new { success = true } : new { success = false, message = "药品不存在或今天已经打卡" };
+    }
+
     private static async Task<object> ExecuteManageMedication(AppDbContext db, Guid userId, JsonElement args)
     {
         var action = args.TryGetProperty("action", out var a) ? a.GetString()! : "query";
@@ -50,38 +126,36 @@ public static class MedicationAgentHandler
     {
         var name = args.TryGetProperty("name", out var n) ? n.GetString()! : "";
         var dosage = args.TryGetProperty("dosage", out var dg) ? dg.GetString() : null;
-        var frequencyStr = args.TryGetProperty("frequency", out var f) ? f.GetString() : "Daily";
-        var frequency = Enum.TryParse<MedicationFrequency>(frequencyStr, out var fr) ? fr : MedicationFrequency.Daily;
-
-        List<TimeOnly> times = [];
-        if (args.TryGetProperty("time_of_day", out var tod) && tod.ValueKind == JsonValueKind.Array)
-        {
-            foreach (var t in tod.EnumerateArray())
-            {
-                if (TimeOnly.TryParse(t.GetString(), out var parsed)) times.Add(parsed);
-            }
-        }
-
+        var frequency = ReadFrequency(args);
+        var times = ReadTimes(args);
         var durationDays = args.TryGetProperty("duration_days", out var dd) ? dd.GetInt32() : 0;
-        var startDateStr = args.TryGetProperty("start_date", out var sd) && sd.GetString() is string sds ? sds : null;
+        var startDate = ReadStartDate(args);
 
         var med = new Medication
         {
-            Id = Guid.NewGuid(), UserId = userId,
-            Name = name, Dosage = dosage, Frequency = frequency,
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            Name = name,
+            Dosage = dosage,
+            Frequency = frequency,
             TimeOfDay = times.Count > 0 ? times : [new TimeOnly(8, 0)],
-            Source = MedicationSource.AiEntry, IsActive = true,
-            StartDate = DateOnly.TryParse(startDateStr, out var parsedDate) ? parsedDate : DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8)),
-            EndDate = durationDays > 0 ? DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8)).AddDays(durationDays) : null,
+            Source = MedicationSource.AiEntry,
+            IsActive = true,
+            StartDate = startDate,
+            EndDate = durationDays > 0 ? startDate.AddDays(durationDays) : null,
         };
         db.Medications.Add(med);
         await db.SaveChangesAsync();
 
         var timeLabels = times.Count > 0 ? string.Join(", ", times.Select(t => t.ToString("HH:mm"))) : "08:00";
-        return new {
-            success = true, medication_id = med.Id,
-            name = med.Name, dosage = med.Dosage,
-            frequency = med.Frequency.ToString(), time = timeLabels,
+        return new
+        {
+            success = true,
+            medication_id = med.Id,
+            name = med.Name,
+            dosage = med.Dosage,
+            frequency = med.Frequency.ToString(),
+            time = timeLabels,
             start_date = med.StartDate?.ToString("yyyy-MM-dd"),
             duration_days = durationDays,
         };
@@ -97,12 +171,47 @@ public static class MedicationAgentHandler
     private static async Task<object> ConfirmMedication(AppDbContext db, Guid userId, JsonElement args)
     {
         var medId = args.TryGetProperty("medication_id", out var mid) ? mid.GetGuid() : Guid.Empty;
+        var med = await db.Medications.FirstOrDefaultAsync(m => m.Id == medId && m.UserId == userId);
+        if (med == null) return new { success = false, message = "药品不存在" };
+
         db.MedicationLogs.Add(new MedicationLog
         {
-            Id = Guid.NewGuid(), MedicationId = medId, UserId = userId,
-            Status = MedicationLogStatus.Taken, ScheduledTime = TimeOnly.FromDateTime(DateTime.UtcNow.AddHours(8)), ConfirmedAt = DateTime.UtcNow,
+            Id = Guid.NewGuid(),
+            MedicationId = medId,
+            UserId = userId,
+            Status = MedicationLogStatus.Taken,
+            ScheduledTime = TimeOnly.FromDateTime(DateTime.UtcNow.AddHours(8)),
+            ConfirmedAt = DateTime.UtcNow,
         });
         await db.SaveChangesAsync();
         return new { success = true };
     }
+
+    private static MedicationFrequency ReadFrequency(JsonElement args)
+    {
+        var frequencyStr = args.TryGetProperty("frequency", out var f) ? f.GetString() : "Daily";
+        return Enum.TryParse<MedicationFrequency>(frequencyStr, out var frequency) ? frequency : MedicationFrequency.Daily;
+    }
+
+    private static DateOnly ReadStartDate(JsonElement args)
+    {
+        var startDateStr = args.TryGetProperty("start_date", out var sd) && sd.GetString() is string sds ? sds : null;
+        return DateOnly.TryParse(startDateStr, out var parsedDate)
+            ? parsedDate
+            : DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8));
+    }
+
+    private static List<TimeOnly> ReadTimes(JsonElement args)
+    {
+        List<TimeOnly> times = [];
+        if (!args.TryGetProperty("time_of_day", out var tod) || tod.ValueKind != JsonValueKind.Array)
+            return times;
+
+        foreach (var t in tod.EnumerateArray())
+        {
+            if (TimeOnly.TryParse(t.GetString(), out var parsed)) times.Add(parsed);
+        }
+
+        return times;
+    }
 }

backend/src/Health.Infrastructure/AI/AgentHandlers/report_agent_handler.cs

@@ -12,15 +12,6 @@ public static class ReportAgentHandler
 
     public static List<ToolDefinition> Tools => [AnalyzeReportTool, CommonAgentHandler.QueryHealthRecordsTool];
 
-    public static Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId)
-    {
-        return toolName switch
-        {
-            "query_health_records" => CommonAgentHandler.Execute(toolName, args, db, userId),
-            _ => Task.FromResult<object>(new { success = false, message = $"未知工具: {toolName}" })
-        };
-    }
-
     public static async Task<object> AnalyzeReport(AppDbContext db, Guid userId, JsonElement args, VisionClient visionClient)
     {
         var imageUrl = args.TryGetProperty("image_url", out var u) ? u.GetString()! : "";
@@ -28,13 +19,13 @@ public static class ReportAgentHandler
             return new { success = false, message = "缺少报告图片" };
 
         var prompt = """
-            你是一个医学报告解读专家。请分析以下检查报告图片，以JSON格式返回：
+            你是患者端医学报告预解读助手。请分析以下检查报告图片，以JSON格式返回：
             {
               "reportType": "报告类型（血常规/生化全项/心电图/彩超/出院小结/其他）",
               "indicators": [
                 {"name":"指标名","value":"数值","unit":"单位","range":"参考范围","status":"normal/high/low"}
               ],
-              "summary": "初步分析摘要",
+              "summary": "面向患者的初步预解读，说明异常指标的可能方向，不作确定诊断，不给出处方、停药、换药或调药建议；必要时建议咨询医生",
               "needsDoctorReview": true/false
             }
             只返回JSON，不要其他内容。

backend/src/Health.Infrastructure/AI/AiToolExecutionService.cs

@@ -0,0 +1,78 @@
+using System.Text.Json;
+using Health.Application.AI;
+using Health.Application.Exercises;
+using Health.Application.HealthArchives;
+using Health.Application.HealthRecords;
+using Health.Application.Medications;
+using Health.Infrastructure.AI.AgentHandlers;
+
+namespace Health.Infrastructure.AI;
+
+public sealed class AiToolExecutionService(
+    AppDbContext db,
+    VisionClient visionClient,
+    IHealthArchiveService healthArchives,
+    IHealthRecordService healthRecords,
+    IExerciseService exercises,
+    IMedicationService medications,
+    IAiWriteConfirmationStore confirmations) : IAiToolExecutionService
+{
+    private readonly AppDbContext _db = db;
+    private readonly VisionClient _visionClient = visionClient;
+    private readonly IHealthArchiveService _healthArchives = healthArchives;
+    private readonly IHealthRecordService _healthRecords = healthRecords;
+    private readonly IExerciseService _exercises = exercises;
+    private readonly IMedicationService _medications = medications;
+    private readonly IAiWriteConfirmationStore _confirmations = confirmations;
+
+    public async Task<object> ExecuteAsync(string toolName, string arguments, Guid userId, CancellationToken ct)
+    {
+        using var json = JsonDocument.Parse(arguments);
+        var root = json.RootElement;
+        return await (toolName switch
+        {
+            "record_health_data" => HealthDataAgentHandler.Execute(toolName, root, _db, userId, _healthRecords),
+            "query_health_records" => CommonAgentHandler.Execute(toolName, root, userId, _healthRecords, _healthArchives, ct),
+            "check_archive" => CommonAgentHandler.Execute(toolName, root, userId, _healthRecords, _healthArchives, ct),
+            "manage_medication" => MedicationAgentHandler.Execute(toolName, root, _db, userId, _medications, ct),
+            "analyze_report" => ReportAgentHandler.AnalyzeReport(_db, userId, root, _visionClient),
+            "manage_exercise" => ExerciseAgentHandler.Execute(toolName, root, _db, userId, _exercises, ct),
+            "manage_archive" => CommonAgentHandler.ExecuteManageArchive(_healthArchives, userId, root, ct),
+            _ => Task.FromResult<object>(new { success = false, message = $"未知工具: {toolName}" }),
+        });
+    }
+
+    public async Task<AiConfirmedWriteResult> ConfirmAsync(Guid commandId, Guid userId, CancellationToken ct)
+    {
+        await using var transaction = await _db.Database.BeginTransactionAsync(ct);
+        var command = await _confirmations.TakeAsync(commandId, userId, ct);
+        if (command == null)
+            return new AiConfirmedWriteResult(40004, null, "确认请求不存在、已执行或已过期");
+
+        try
+        {
+            var result = await ExecuteAsync(command.ToolName, command.Arguments, userId, ct);
+            if (!Succeeded(result, out var error))
+            {
+                await transaction.RollbackAsync(ct);
+                return new AiConfirmedWriteResult(40001, result, error ?? "写入失败，请检查内容后重试");
+            }
+            await _confirmations.CompleteAsync(command, ct);
+            await transaction.CommitAsync(ct);
+            return new AiConfirmedWriteResult(0, result, null);
+        }
+        catch (Exception ex)
+        {
+            await transaction.RollbackAsync(ct);
+            return new AiConfirmedWriteResult(50001, null, $"写入失败: {ex.Message}");
+        }
+    }
+
+    private static bool Succeeded(object result, out string? error)
+    {
+        using var json = JsonDocument.Parse(JsonSerializer.Serialize(result));
+        var root = json.RootElement;
+        error = root.TryGetProperty("message", out var message) ? message.GetString() : null;
+        return !root.TryGetProperty("success", out var success) || success.ValueKind != JsonValueKind.False;
+    }
+}

backend/src/Health.Infrastructure/AI/EfAiConversationRepository.cs

@@ -0,0 +1,45 @@
+using Health.Application.AI;
+
+namespace Health.Infrastructure.AI;
+
+public sealed class EfAiConversationRepository(AppDbContext db) : IAiConversationRepository
+{
+    private readonly AppDbContext _db = db;
+
+    public Task<Conversation?> GetOwnedAsync(Guid userId, Guid conversationId, CancellationToken ct) =>
+        _db.Conversations.FirstOrDefaultAsync(c => c.Id == conversationId && c.UserId == userId, ct);
+
+    public Task<Conversation?> GetAsync(Guid conversationId, CancellationToken ct) =>
+        _db.Conversations.FirstOrDefaultAsync(c => c.Id == conversationId, ct);
+
+    public async Task<IReadOnlyList<Conversation>> ListAsync(Guid userId, CancellationToken ct) =>
+        await _db.Conversations
+            .Where(c => c.UserId == userId)
+            .OrderByDescending(c => c.UpdatedAt)
+            .ToListAsync(ct);
+
+    public async Task<IReadOnlyList<ConversationMessage>> GetMessagesAsync(Guid conversationId, CancellationToken ct) =>
+        await _db.ConversationMessages
+            .Where(m => m.ConversationId == conversationId)
+            .OrderBy(m => m.CreatedAt)
+            .ToListAsync(ct);
+
+    public async Task<IReadOnlyList<ConversationMessage>> GetRecentMessagesAsync(Guid conversationId, int limit, CancellationToken ct) =>
+        await _db.ConversationMessages
+            .Where(m => m.ConversationId == conversationId)
+            .OrderByDescending(m => m.CreatedAt)
+            .Take(limit)
+            .ToListAsync(ct);
+
+    public async Task AddConversationAsync(Conversation conversation, CancellationToken ct) =>
+        await _db.Conversations.AddAsync(conversation, ct);
+
+    public async Task AddMessageAsync(ConversationMessage message, CancellationToken ct) =>
+        await _db.ConversationMessages.AddAsync(message, ct);
+
+    public void Delete(Conversation conversation) =>
+        _db.Conversations.Remove(conversation);
+
+    public Task SaveChangesAsync(CancellationToken ct) =>
+        _db.SaveChangesAsync(ct);
+}

backend/src/Health.Infrastructure/AI/EfAiWriteConfirmationStore.cs

@@ -0,0 +1,98 @@
+using Health.Application.AI;
+using Health.Infrastructure.Data.Records;
+
+namespace Health.Infrastructure.AI;
+
+public sealed class EfAiWriteConfirmationStore(AppDbContext db) : IAiWriteConfirmationStore
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<PendingAiWriteCommand> CreateAsync(
+        Guid userId,
+        string toolName,
+        string arguments,
+        TimeSpan lifetime,
+        CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        if (IsInMemory())
+        {
+            var expired = await _db.AiWriteCommands.Where(x => x.Status == "Pending" && x.ExpiresAt <= now).ToListAsync(ct);
+            foreach (var item in expired) { item.Status = "Expired"; item.UpdatedAt = now; }
+        }
+        else
+        {
+            await _db.AiWriteCommands
+                .Where(x => x.Status == "Pending" && x.ExpiresAt <= now)
+                .ExecuteUpdateAsync(setters => setters
+                    .SetProperty(x => x.Status, "Expired")
+                    .SetProperty(x => x.UpdatedAt, now), ct);
+        }
+
+        var command = new AiWriteCommandRecord
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            ToolName = toolName,
+            Arguments = arguments,
+            Status = "Pending",
+            ExpiresAt = now.Add(lifetime),
+            CreatedAt = now,
+            UpdatedAt = now,
+        };
+        await _db.AiWriteCommands.AddAsync(command, ct);
+        await _db.SaveChangesAsync(ct);
+        return ToCommand(command);
+    }
+
+    public async Task<PendingAiWriteCommand?> TakeAsync(Guid commandId, Guid userId, CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        if (IsInMemory())
+        {
+            var tracked = await _db.AiWriteCommands.FirstOrDefaultAsync(
+                x => x.Id == commandId && x.UserId == userId && x.Status == "Pending" && x.ExpiresAt > now, ct);
+            if (tracked == null) return null;
+            tracked.Status = "Processing";
+            tracked.UpdatedAt = now;
+            await _db.SaveChangesAsync(ct);
+        }
+        else
+        {
+            var updated = await _db.AiWriteCommands
+                .Where(x => x.Id == commandId && x.UserId == userId && x.Status == "Pending" && x.ExpiresAt > now)
+                .ExecuteUpdateAsync(setters => setters
+                    .SetProperty(x => x.Status, "Processing")
+                    .SetProperty(x => x.UpdatedAt, now), ct);
+            if (updated == 0) return null;
+        }
+
+        var record = await _db.AiWriteCommands.AsNoTracking().FirstAsync(x => x.Id == commandId, ct);
+        return ToCommand(record);
+    }
+
+    public async Task CompleteAsync(PendingAiWriteCommand command, CancellationToken ct)
+    {
+        if (IsInMemory())
+        {
+            var tracked = await _db.AiWriteCommands.FirstOrDefaultAsync(
+                x => x.Id == command.Id && x.UserId == command.UserId && x.Status == "Processing", ct);
+            if (tracked != null) { tracked.Status = "Completed"; tracked.UpdatedAt = DateTime.UtcNow; await _db.SaveChangesAsync(ct); }
+            return;
+        }
+        await _db.AiWriteCommands
+            .Where(x => x.Id == command.Id && x.UserId == command.UserId && x.Status == "Processing")
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Completed")
+                .SetProperty(x => x.UpdatedAt, DateTime.UtcNow), ct);
+    }
+
+    private bool IsInMemory() => _db.Database.ProviderName == "Microsoft.EntityFrameworkCore.InMemory";
+
+    private static PendingAiWriteCommand ToCommand(AiWriteCommandRecord record) => new(
+        record.Id,
+        record.UserId,
+        record.ToolName,
+        record.Arguments,
+        record.ExpiresAt);
+}

backend/src/Health.Infrastructure/AI/prompt_manager.cs

@@ -8,18 +8,33 @@ public sealed class PromptManager
     /// <summary>
     /// 获取指定 Agent 的 System Prompt
     /// </summary>
-    public string GetSystemPrompt(AgentType agentType) => agentType switch
+    public string GetSystemPrompt(AgentType agentType)
     {
-        AgentType.Default => DefaultPrompt,
-        AgentType.Consultation => ConsultationPrompt,
-        AgentType.Health => HealthDataPrompt,
-        AgentType.Diet => DietPrompt,
-        AgentType.Medication => MedicationPrompt,
-        AgentType.Report => ReportPrompt,
-        AgentType.Exercise => ExercisePrompt,
-        AgentType.Unified => UnifiedPrompt,
-        _ => DefaultPrompt
-    };
+        var prompt = agentType switch
+        {
+            AgentType.Default => DefaultPrompt,
+            AgentType.Consultation => ConsultationPrompt,
+            AgentType.Health => HealthDataPrompt,
+            AgentType.Diet => DietPrompt,
+            AgentType.Medication => MedicationPrompt,
+            AgentType.Report => ReportPrompt,
+            AgentType.Exercise => ExercisePrompt,
+            AgentType.Unified => UnifiedPrompt,
+            _ => DefaultPrompt
+        };
+
+        return $"{prompt}\n\n{MedicalBoundaryRules}";
+    }
+
+    private const string MedicalBoundaryRules = """
+        医疗边界（必须遵守）：
+        - 你的定位是患者端 AI 健康解释与预问诊助手，不是医生，不能替代医生诊断、处方或治疗决策。
+        - 可以解释健康数据、报告指标和症状可能方向，但不要给出确定诊断，不要说“你就是/一定是/已经确诊”。
+        - 不要要求用户自行新增、停用、更换药物或调整剂量；涉及用药变化时，必须建议咨询医生或药师。
+        - 对胸痛、胸闷憋气、呼吸困难、意识异常、晕厥、说话不清、一侧肢体无力、血氧明显偏低、血压或血糖严重异常等情况，优先建议及时就医或急诊评估。
+        - 回答用语使用“可能、建议、需要结合医生判断”等表达，避免绝对化结论。
+        - 医疗相关分析末尾用一句自然的话提醒：以上为 AI 预分析，不能替代医生诊断和治疗建议。
+        """;
 
     private const string DefaultPrompt = """
         你是一位专业的AI健康管家，专注于为心脏术后康复患者提供贴心的健康管理服务。
@@ -38,15 +53,15 @@ public sealed class PromptManager
         """;
 
     private const string ConsultationPrompt = """
-        你是一个心血管内科医生助手，负责对心脏术后患者进行多轮问诊。
+        你是一个患者端 AI 预问诊助手，负责帮助心脏术后患者梳理症状和就医前信息。
 
         规则：
         1. 每次只问一个问题，不要一次问多个
         2. 给出 2-3 个快捷选项让患者点击
         3. 问诊步骤：先问感受 → 持续时间 → 伴随症状 → 近期用药 → 给出初步分析
         4. 遇到以下情况建议立即就医：剧烈胸痛、呼吸困难、心悸
-        5. 遇到以下情况建议转医生：血压持续>160/100、心率>120或<50
-        6. 所有分析末尾标注"以上为AI分析，具体请咨询医生"
+        5. 遇到以下情况建议咨询医生：血压持续>160/100、心率>120或<50
+        6. 只给出初步分析和下一步建议，不作诊断结论
         7. 问诊结束给出结构化小结
         """;
 
@@ -55,13 +70,13 @@ public sealed class PromptManager
 
         规则：
         1. 解析用户消息中的指标和数值（血压/心率/血糖/血氧/体重）
-        2. 指标明确+数值明确→直接调用 record_health_data 录入
+        2. 指标明确+数值明确→调用 record_health_data 生成待确认写入命令，不要直接声称已经录入
         3. 用户可以一次性说多个指标（如"血压120/80，血糖6.2，血氧97"）→多次调用 record_health_data
-        4. 用户可以分时段说（如"早上血压120，下午血压130"）→分别录入，recorded_at 参数用不同时间
+        4. 用户可以分时段说（如"早上血压120，下午血压130"）→分别生成待确认命令，recorded_at 参数用不同时间
         5. 数值明确但指标模糊（如只说"120"）→追问是"收缩压还是血糖？"
         6. 时间模糊→取当前时间
         7. 数值超出正常范围→附带异常提醒
-        8. 每次调用 record_health_data 后，继续调用下一个，全部录入完成后生成确认卡片格式的回复
+        8. 每次调用 record_health_data 后继续处理下一个；工具返回仅表示等待确认，必须提示用户点击确认卡片，不能说“录入成功”
 
         正常值参考范围：
         - 收缩压 90-139 mmHg，舒张压 60-89 mmHg
@@ -86,24 +101,24 @@ public sealed class PromptManager
         """;
 
     private const string MedicationPrompt = """
-        你是一个用药管理专家。
+        你是一个用药记录与提醒助手。
 
         规则：
         1. 用户询问当前用药时，必须先调用 manage_medication(action="query") 查询已有用药记录
         2. 解析用户口中的药品信息（药名/剂量/频次/时间）
         3. "早饭后"等模糊时间→追问具体几点
-        4. 解析完成后展示确认卡片
+        4. 解析完成后调用 manage_medication(action="create") 生成待确认命令并展示确认卡片；用户点击确认前不得声称已保存
         5. 处方拍照→提取药品信息→生成用药计划→让用户确认
-        6. 回答用药相关疑问
+        6. 可以解释常见用药注意事项，但不要建议用户自行新增、停用、更换药物或调整剂量
         """;
 
     private const string ReportPrompt = """
-        你是一个医学报告解读专家。
+        你是一个患者端医学报告预解读助手。
 
         规则：
         1. 收到报告图片后，提取所有指标及其数值
         2. 标注异常指标（偏高/偏低/正常）
-        3. 给出初步分析
+        3. 给出初步分析和可能方向，不作诊断结论
         4. 所有内容标注"AI预解读，待医生确认"
         5. 图像类报告（彩超/CT）注明"需医生人工审阅"
         """;
@@ -120,7 +135,7 @@ public sealed class PromptManager
         """;
 
     private const string UnifiedPrompt = """
-        你是一个全能的AI健康管家，为心脏术后康复患者提供全方位服务。
+        你是一个患者端 AI 健康管家，为心脏术后康复患者提供健康解释、记录和预问诊辅助服务。
 
         核心规则：首先理解用户意图属于哪个领域，然后调用对应的工具。
 
@@ -133,20 +148,21 @@ public sealed class PromptManager
         6. 历史数据查询 → 调用 query_health_records
 
         运动计划参数格式（manage_exercise）：
-        - action="create", week_start_date="今天日期(YYYY-MM-DD)"
-        - items: [{"day_of_week":0-6(周日=0),"exercise_type":"散步","duration_minutes":30,"is_rest_day":false}, ...]
+        - action="create", start_date="开始日期(YYYY-MM-DD，默认今天)"
+        - duration_days=连续天数，exercise_type="散步"，duration_minutes=30，reminder_time="19:00"
         - 时长必须识别中文数字：半小时=30 一小时=60 三十分钟=30 一个半小时=90 一小时二十分钟=80，中文数字必须转为阿拉伯数字
         - 天数："一个月"=30天 "一周"=7天 "10天"=10天，必须识别中文，默认7天
         - 用户说"坚持X天/月/周"则创建对应天数
-        - items 数量必须等于持续天数
+        - 结束日期由 start_date + duration_days - 1 自动计算，不要按星期几生成条目
 
         用药管理参数格式（manage_medication）：
         - action="create", name="药名", dosage="剂量", frequency="Daily", time_of_day=["08:00","20:00"], duration_days=7
 
         规则：
         - 用户可能一句话涉及多个领域，全部处理
-        - 数值明确+指标明确→直接录入，不要追问
-        - 录入完成后生成确认卡片
+        - 数值明确+指标明确→直接生成待确认命令，不要追问
+        - 所有写入工具调用只生成待确认命令；用户点击卡片确认后才真正写入数据库
+        - 工具返回 pendingConfirmation=true 时，不得回复“已录入”或“保存成功”，应提示用户核对并点击确认
         - 遇到紧急症状（剧烈胸痛、呼吸困难）立即建议就医
         - 回复语气温暖、专业
         """;

backend/src/Health.Infrastructure/Admin/AdminService.cs

@@ -0,0 +1,90 @@
+using Health.Application.Admin;
+
+namespace Health.Infrastructure.Admin;
+
+public sealed class AdminService(AppDbContext db) : IAdminService
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<AdminResult> ListDoctorsAsync(CancellationToken ct)
+    {
+        var doctors = await _db.Doctors.AsNoTracking().OrderBy(x => x.CreatedAt)
+            .Select(x => new { x.Id, x.Name, x.Title, x.Department, x.Phone, x.ProfessionalDirection, x.IsActive, x.AvatarUrl, x.Introduction, x.CreatedAt })
+            .ToListAsync(ct);
+        return Ok(doctors);
+    }
+
+    public async Task<AdminResult> AddDoctorAsync(AddDoctorCommand command, CancellationToken ct)
+    {
+        if (string.IsNullOrWhiteSpace(command.Phone)) return Error(40001, "手机号不能为空");
+        if (string.IsNullOrWhiteSpace(command.Name)) return Error(40002, "姓名不能为空");
+        var doctor = new Doctor
+        {
+            Id = Guid.NewGuid(), Name = command.Name, Title = command.Title, Department = command.Department,
+            Phone = command.Phone, ProfessionalDirection = command.ProfessionalDirection, IsActive = true, CreatedAt = DateTime.UtcNow,
+        };
+        _db.Doctors.Add(doctor);
+        if (!await _db.Users.AnyAsync(x => x.Phone == command.Phone, ct))
+        {
+            var user = new User { Id = Guid.NewGuid(), Phone = command.Phone, Role = "Doctor", Name = command.Name, CreatedAt = DateTime.UtcNow, UpdatedAt = DateTime.UtcNow };
+            _db.Users.Add(user);
+            _db.DoctorProfiles.Add(new DoctorProfile
+            {
+                Id = Guid.NewGuid(), UserId = user.Id, DoctorId = doctor.Id, Name = command.Name,
+                Title = command.Title, Department = command.Department, IsActive = true,
+                CreatedAt = DateTime.UtcNow, UpdatedAt = DateTime.UtcNow,
+            });
+        }
+        await _db.SaveChangesAsync(ct);
+        return Ok(new { doctor.Id, doctor.Name });
+    }
+
+    public async Task<AdminResult> UpdateDoctorAsync(Guid id, UpdateDoctorCommand command, CancellationToken ct)
+    {
+        var doctor = await _db.Doctors.FindAsync([id], ct);
+        if (doctor == null) return Error(404, "医生不存在");
+        if (command.Name != null) doctor.Name = command.Name;
+        if (command.Title != null) doctor.Title = command.Title;
+        if (command.Department != null) doctor.Department = command.Department;
+        if (command.Phone != null) doctor.Phone = command.Phone;
+        if (command.ProfessionalDirection != null) doctor.ProfessionalDirection = command.ProfessionalDirection;
+        await _db.SaveChangesAsync(ct);
+        return Ok(new { doctor.Id });
+    }
+
+    public async Task<AdminResult> ToggleDoctorAsync(Guid id, CancellationToken ct)
+    {
+        var doctor = await _db.Doctors.FindAsync([id], ct);
+        if (doctor == null) return Error(404, "医生不存在");
+        doctor.IsActive = !doctor.IsActive;
+        await _db.SaveChangesAsync(ct);
+        return Ok(new { doctor.Id, doctor.IsActive });
+    }
+
+    public async Task<AdminResult> DeleteDoctorAsync(Guid id, CancellationToken ct)
+    {
+        var doctor = await _db.Doctors.FindAsync([id], ct);
+        if (doctor == null) return Error(404, "医生不存在");
+        await _db.Users.Where(x => x.DoctorId == id).ExecuteUpdateAsync(s => s.SetProperty(x => x.DoctorId, (Guid?)null), ct);
+        _db.Doctors.Remove(doctor);
+        await _db.SaveChangesAsync(ct);
+        return Ok(new { success = true });
+    }
+
+    public async Task<AdminResult> ListPatientsAsync(string? search, int page, int pageSize, CancellationToken ct)
+    {
+        page = Math.Max(page, 1);
+        pageSize = Math.Clamp(pageSize, 1, 100);
+        var query = _db.Users.AsNoTracking().Where(x => x.Role == "User");
+        if (!string.IsNullOrWhiteSpace(search))
+            query = query.Where(x => (x.Name != null && x.Name.Contains(search)) || x.Phone.Contains(search));
+        var total = await query.CountAsync(ct);
+        var patients = await query.OrderByDescending(x => x.CreatedAt).Skip((page - 1) * pageSize).Take(pageSize)
+            .Select(x => new { x.Id, x.Name, x.Phone, x.Gender, x.BirthDate, x.CreatedAt, DoctorName = x.Doctor != null ? x.Doctor.Name : null, DoctorDepartment = x.Doctor != null ? x.Doctor.Department : null })
+            .ToListAsync(ct);
+        return Ok(new { patients, total, page, pageSize });
+    }
+
+    private static AdminResult Ok(object data) => new(0, data);
+    private static AdminResult Error(int code, string message) => new(code, null, message);
+}

backend/src/Health.Infrastructure/Auth/AuthService.cs

@@ -0,0 +1,115 @@
+using Health.Application.Auth;
+using Health.Infrastructure.Services;
+
+namespace Health.Infrastructure.Auth;
+
+public sealed class AuthService(AppDbContext db, JwtProvider jwt, SmsService sms) : IAuthService
+{
+    private const string AdminPhone = "12345678910";
+    private const string AdminSmsCode = "000000";
+    private static readonly Guid AdminId = Guid.Parse("00000000-0000-0000-0000-000000000001");
+    private readonly AppDbContext _db = db;
+    private readonly JwtProvider _jwt = jwt;
+    private readonly SmsService _sms = sms;
+
+    public async Task<AuthResult> SendCodeAsync(string phone, bool revealDevelopmentCode, CancellationToken ct)
+    {
+        var code = phone == AdminPhone ? AdminSmsCode : _sms.GenerateCode();
+        await _db.VerificationCodes.AddAsync(new VerificationCode
+        {
+            Id = Guid.NewGuid(), Phone = phone, Code = code,
+            ExpiresAt = DateTime.UtcNow.AddMinutes(5),
+        }, ct);
+        await _db.SaveChangesAsync(ct);
+        if (phone != AdminPhone) await _sms.SendCodeAsync(phone, code);
+        return new AuthResult(0, new { success = true, devCode = revealDevelopmentCode ? code : null });
+    }
+
+    public async Task<AuthResult> RegisterAsync(RegisterCommand command, CancellationToken ct)
+    {
+        var code = await TakeCodeAsync(command.Phone, command.SmsCode, ct);
+        if (code == null) return Error(40001, "验证码错误或已过期");
+        if (await _db.Users.AnyAsync(x => x.Phone == command.Phone, ct)) return Error(40002, "该手机号已注册，请直接登录");
+        if (string.IsNullOrWhiteSpace(command.Name)) return Error(40003, "请输入姓名");
+        if (!await _db.Doctors.AnyAsync(x => x.Id == command.DoctorId && x.IsActive, ct)) return Error(40004, "所选医生不存在或已停诊");
+
+        code.IsUsed = true;
+        var user = new User
+        {
+            Id = Guid.NewGuid(), Phone = command.Phone, Role = "User", Name = command.Name,
+            DoctorId = command.DoctorId, CreatedAt = DateTime.UtcNow, UpdatedAt = DateTime.UtcNow,
+        };
+        _db.Users.Add(user);
+        _db.NotificationPreferences.Add(new NotificationPreference { Id = Guid.NewGuid(), UserId = user.Id });
+        _db.HealthArchives.Add(new HealthArchive { Id = Guid.NewGuid(), UserId = user.Id });
+        var tokens = AddTokens(user.Id, user.Phone, user.Role);
+        await _db.SaveChangesAsync(ct);
+        return new AuthResult(0, new { tokens.accessToken, tokens.refreshToken, user = new { user.Id, user.Phone, user.Role, isNew = true } });
+    }
+
+    public async Task<AuthResult> LoginAsync(string phone, string smsCode, CancellationToken ct)
+    {
+        var code = await TakeCodeAsync(phone, smsCode, ct);
+        if (code == null) return Error(40001, "验证码错误或已过期");
+        code.IsUsed = true;
+
+        if (phone == AdminPhone)
+        {
+            var tokens = AddTokens(AdminId, AdminPhone, "Admin");
+            await _db.SaveChangesAsync(ct);
+            return new AuthResult(0, new { tokens.accessToken, tokens.refreshToken, user = new { id = AdminId, phone = AdminPhone, role = "Admin", name = "管理员", isNew = false } });
+        }
+
+        var user = await _db.Users.FirstOrDefaultAsync(x => x.Phone == phone, ct);
+        if (user == null) return Error(40004, "该手机号未注册，请先注册");
+        user.UpdatedAt = DateTime.UtcNow;
+        var userTokens = AddTokens(user.Id, user.Phone, user.Role);
+        await _db.SaveChangesAsync(ct);
+        return new AuthResult(0, new
+        {
+            userTokens.accessToken, userTokens.refreshToken,
+            user = new { user.Id, user.Phone, user.Role, user.Name, user.Gender, user.AvatarUrl, BirthDate = user.BirthDate?.ToString("yyyy-MM-dd"), isNew = false }
+        });
+    }
+
+    public async Task<AuthResult> RefreshAsync(string refreshToken, CancellationToken ct)
+    {
+        var oldToken = await _db.RefreshTokens.FirstOrDefaultAsync(x => x.Token == refreshToken && !x.IsRevoked, ct);
+        if (oldToken == null || oldToken.ExpiresAt < DateTime.UtcNow) return Error(40002, "登录已过期，请重新登录");
+        oldToken.IsRevoked = true;
+
+        if (oldToken.UserId == AdminId)
+        {
+            var tokens = AddTokens(AdminId, AdminPhone, "Admin");
+            await _db.SaveChangesAsync(ct);
+            return new AuthResult(0, new { tokens.accessToken, tokens.refreshToken, user = new { role = "Admin" } });
+        }
+
+        var user = await _db.Users.FindAsync([oldToken.UserId], ct);
+        if (user == null) return Error(40002, "用户不存在");
+        var userTokens = AddTokens(user.Id, user.Phone, user.Role);
+        await _db.SaveChangesAsync(ct);
+        return new AuthResult(0, new { userTokens.accessToken, userTokens.refreshToken, user = new { user.Role } });
+    }
+
+    public async Task LogoutAsync(string refreshToken, CancellationToken ct)
+    {
+        var token = await _db.RefreshTokens.FirstOrDefaultAsync(x => x.Token == refreshToken, ct);
+        if (token != null) token.IsRevoked = true;
+        await _db.SaveChangesAsync(ct);
+    }
+
+    private Task<VerificationCode?> TakeCodeAsync(string phone, string code, CancellationToken ct) =>
+        _db.VerificationCodes.Where(x => x.Phone == phone && x.Code == code && x.ExpiresAt > DateTime.UtcNow && !x.IsUsed)
+            .OrderByDescending(x => x.CreatedAt).FirstOrDefaultAsync(ct);
+
+    private (string accessToken, string refreshToken) AddTokens(Guid userId, string phone, string role)
+    {
+        var access = _jwt.GenerateAccessToken(userId, phone, role);
+        var refresh = _jwt.GenerateRefreshToken();
+        _db.RefreshTokens.Add(new RefreshToken { Id = Guid.NewGuid(), UserId = userId, Token = refresh, ExpiresAt = DateTime.UtcNow.AddDays(30) });
+        return (access, refresh);
+    }
+
+    private static AuthResult Error(int code, string message) => new(code, null, message);
+}

backend/src/Health.Infrastructure/Calendars/EfCalendarRepository.cs

@@ -0,0 +1,27 @@
+using Health.Application.Calendars;
+
+namespace Health.Infrastructure.Calendars;
+
+public sealed class EfCalendarRepository(AppDbContext db) : ICalendarRepository
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<CalendarDataSnapshot> GetSnapshotAsync(Guid userId, DateOnly start, DateOnly end, CancellationToken ct)
+    {
+        var startUtc = start.ToDateTime(TimeOnly.MinValue, DateTimeKind.Utc);
+        var endUtc = end.ToDateTime(TimeOnly.MinValue, DateTimeKind.Utc);
+
+        var medications = await _db.Medications
+            .Where(m => m.UserId == userId && m.IsActive)
+            .ToListAsync(ct);
+        var exercisePlans = await _db.ExercisePlans
+            .Include(p => p.Items)
+            .Where(p => p.UserId == userId && p.StartDate < end && p.EndDate >= start)
+            .ToListAsync(ct);
+        var followUps = await _db.FollowUps
+            .Where(f => f.UserId == userId && f.ScheduledAt >= startUtc && f.ScheduledAt < endUtc)
+            .ToListAsync(ct);
+
+        return new CalendarDataSnapshot(medications, exercisePlans, followUps);
+    }
+}

backend/src/Health.Infrastructure/Data/DatabaseSchemaMigrator.cs

@@ -0,0 +1,166 @@
+using Microsoft.Extensions.Logging;
+
+namespace Health.Infrastructure.Data;
+
+public sealed class DatabaseSchemaMigrator(AppDbContext db, ILogger<DatabaseSchemaMigrator> logger)
+{
+    private readonly AppDbContext _db = db;
+    private readonly ILogger<DatabaseSchemaMigrator> _logger = logger;
+
+    public async Task ApplyAsync(CancellationToken ct = default)
+    {
+        await using var transaction = await _db.Database.BeginTransactionAsync(ct);
+        await _db.Database.ExecuteSqlRawAsync("""
+            CREATE TABLE IF NOT EXISTS "__AppSchemaMigrations" (
+                "Id" varchar(128) PRIMARY KEY,
+                "AppliedAt" timestamptz NOT NULL
+            );
+
+            CREATE TABLE IF NOT EXISTS "AiWriteCommands" (
+                "Id" uuid PRIMARY KEY,
+                "UserId" uuid NOT NULL,
+                "ToolName" varchar(64) NOT NULL,
+                "Arguments" jsonb NOT NULL,
+                "Status" varchar(32) NOT NULL,
+                "ExpiresAt" timestamptz NOT NULL,
+                "CreatedAt" timestamptz NOT NULL,
+                "UpdatedAt" timestamptz NOT NULL
+            );
+            CREATE INDEX IF NOT EXISTS "IX_AiWriteCommands_UserId_Status_ExpiresAt"
+                ON "AiWriteCommands" ("UserId", "Status", "ExpiresAt");
+
+            CREATE TABLE IF NOT EXISTS "ReportAnalysisTasks" (
+                "Id" uuid PRIMARY KEY,
+                "ReportId" uuid NOT NULL,
+                "FilePath" text NOT NULL,
+                "Status" varchar(32) NOT NULL,
+                "Attempts" integer NOT NULL,
+                "AvailableAt" timestamptz NOT NULL,
+                "LastError" text NULL,
+                "CreatedAt" timestamptz NOT NULL,
+                "UpdatedAt" timestamptz NOT NULL
+            );
+            CREATE INDEX IF NOT EXISTS "IX_ReportAnalysisTasks_Status_AvailableAt"
+                ON "ReportAnalysisTasks" ("Status", "AvailableAt");
+            CREATE INDEX IF NOT EXISTS "IX_ReportAnalysisTasks_ReportId"
+                ON "ReportAnalysisTasks" ("ReportId");
+
+            CREATE TABLE IF NOT EXISTS "DietImageAnalysisTasks" (
+                "Id" uuid PRIMARY KEY,
+                "FilePaths" jsonb NOT NULL,
+                "Status" varchar(32) NOT NULL,
+                "Attempts" integer NOT NULL,
+                "AvailableAt" timestamptz NOT NULL,
+                "ResultCode" integer NULL,
+                "ResultData" text NULL,
+                "ResultMessage" text NULL,
+                "LastError" text NULL,
+                "CreatedAt" timestamptz NOT NULL,
+                "UpdatedAt" timestamptz NOT NULL
+            );
+            CREATE INDEX IF NOT EXISTS "IX_DietImageAnalysisTasks_Status_AvailableAt"
+                ON "DietImageAnalysisTasks" ("Status", "AvailableAt");
+
+            CREATE TABLE IF NOT EXISTS "MedicationReminderTasks" (
+                "Id" uuid PRIMARY KEY,
+                "UserId" uuid NOT NULL,
+                "MedicationId" uuid NOT NULL,
+                "Name" text NOT NULL,
+                "Dosage" text NULL,
+                "ScheduledDate" date NOT NULL,
+                "ScheduledTime" time without time zone NOT NULL,
+                "Status" varchar(32) NOT NULL,
+                "Attempts" integer NOT NULL,
+                "AvailableAt" timestamptz NOT NULL,
+                "LastError" text NULL,
+                "CreatedAt" timestamptz NOT NULL,
+                "UpdatedAt" timestamptz NOT NULL
+            );
+            CREATE INDEX IF NOT EXISTS "IX_MedicationReminderTasks_Status_AvailableAt"
+                ON "MedicationReminderTasks" ("Status", "AvailableAt");
+            CREATE UNIQUE INDEX IF NOT EXISTS "IX_MedicationReminderTasks_MedicationId_ScheduledDate_ScheduledTime"
+                ON "MedicationReminderTasks" ("MedicationId", "ScheduledDate", "ScheduledTime");
+
+            CREATE TABLE IF NOT EXISTS "NotificationOutbox" (
+                "Id" uuid PRIMARY KEY,
+                "UserId" uuid NOT NULL,
+                "SourceTaskId" uuid NOT NULL,
+                "Type" varchar(64) NOT NULL,
+                "Payload" jsonb NOT NULL,
+                "Status" varchar(32) NOT NULL,
+                "Attempts" integer NOT NULL,
+                "AvailableAt" timestamptz NOT NULL,
+                "LastError" text NULL,
+                "CreatedAt" timestamptz NOT NULL,
+                "UpdatedAt" timestamptz NOT NULL
+            );
+            CREATE UNIQUE INDEX IF NOT EXISTS "IX_NotificationOutbox_SourceTaskId"
+                ON "NotificationOutbox" ("SourceTaskId");
+            CREATE INDEX IF NOT EXISTS "IX_NotificationOutbox_Status_AvailableAt"
+                ON "NotificationOutbox" ("Status", "AvailableAt");
+
+            ALTER TABLE IF EXISTS "ExercisePlans"
+                ADD COLUMN IF NOT EXISTS "StartDate" date NULL,
+                ADD COLUMN IF NOT EXISTS "EndDate" date NULL,
+                ADD COLUMN IF NOT EXISTS "ReminderTime" time without time zone NOT NULL DEFAULT TIME '19:00';
+            ALTER TABLE IF EXISTS "ExercisePlanItems"
+                ADD COLUMN IF NOT EXISTS "ScheduledDate" date NULL;
+
+            DO $exercise_migration$
+            BEGIN
+                IF EXISTS (
+                    SELECT 1 FROM information_schema.columns
+                    WHERE table_schema = 'public' AND table_name = 'ExercisePlans' AND column_name = 'WeekStartDate'
+                ) THEN
+                    UPDATE "ExercisePlans"
+                    SET "StartDate" = COALESCE("StartDate", "WeekStartDate")
+                    WHERE "StartDate" IS NULL;
+
+                    WITH ranked AS (
+                        SELECT i."Id", p."StartDate",
+                               ROW_NUMBER() OVER (PARTITION BY i."PlanId" ORDER BY i."Id") - 1 AS day_offset
+                        FROM "ExercisePlanItems" i
+                        JOIN "ExercisePlans" p ON p."Id" = i."PlanId"
+                        WHERE i."ScheduledDate" IS NULL
+                    )
+                    UPDATE "ExercisePlanItems" i
+                    SET "ScheduledDate" = ranked."StartDate" + ranked.day_offset::integer
+                    FROM ranked
+                    WHERE i."Id" = ranked."Id";
+
+                    UPDATE "ExercisePlans" p
+                    SET "EndDate" = COALESCE(
+                        p."EndDate",
+                        (SELECT MAX(i."ScheduledDate") FROM "ExercisePlanItems" i WHERE i."PlanId" = p."Id"),
+                        p."StartDate"
+                    )
+                    WHERE p."EndDate" IS NULL;
+                END IF;
+            END $exercise_migration$;
+
+            ALTER TABLE IF EXISTS "ExercisePlans"
+                ALTER COLUMN "StartDate" SET NOT NULL,
+                ALTER COLUMN "EndDate" SET NOT NULL;
+            ALTER TABLE IF EXISTS "ExercisePlanItems"
+                ALTER COLUMN "ScheduledDate" SET NOT NULL;
+            CREATE INDEX IF NOT EXISTS "IX_ExercisePlans_UserId_StartDate_EndDate"
+                ON "ExercisePlans" ("UserId", "StartDate", "EndDate");
+            CREATE UNIQUE INDEX IF NOT EXISTS "IX_ExercisePlanItems_PlanId_ScheduledDate"
+                ON "ExercisePlanItems" ("PlanId", "ScheduledDate");
+
+            INSERT INTO "__AppSchemaMigrations" ("Id", "AppliedAt")
+            VALUES ('20260619_01_persistent_ai_commands_and_report_tasks', now())
+            ON CONFLICT ("Id") DO NOTHING;
+
+            INSERT INTO "__AppSchemaMigrations" ("Id", "AppliedAt")
+            VALUES ('20260619_02_persistent_diet_and_medication_tasks', now())
+            ON CONFLICT ("Id") DO NOTHING;
+
+            INSERT INTO "__AppSchemaMigrations" ("Id", "AppliedAt")
+            VALUES ('20260620_03_date_based_exercise_plans', now())
+            ON CONFLICT ("Id") DO NOTHING;
+            """, ct);
+        await transaction.CommitAsync(ct);
+        _logger.LogInformation("数据库结构迁移已检查: 20260620_03");
+    }
+}

backend/src/Health.Infrastructure/Data/Records/AiWriteCommandRecord.cs

@@ -0,0 +1,13 @@
+namespace Health.Infrastructure.Data.Records;
+
+public sealed class AiWriteCommandRecord
+{
+    public Guid Id { get; set; }
+    public Guid UserId { get; set; }
+    public string ToolName { get; set; } = string.Empty;
+    public string Arguments { get; set; } = string.Empty;
+    public string Status { get; set; } = "Pending";
+    public DateTime ExpiresAt { get; set; }
+    public DateTime CreatedAt { get; set; } = DateTime.UtcNow;
+    public DateTime UpdatedAt { get; set; } = DateTime.UtcNow;
+}

backend/src/Health.Infrastructure/Data/Records/DietImageAnalysisTaskRecord.cs

@@ -0,0 +1,16 @@
+namespace Health.Infrastructure.Data.Records;
+
+public sealed class DietImageAnalysisTaskRecord
+{
+    public Guid Id { get; set; }
+    public string FilePaths { get; set; } = "[]";
+    public string Status { get; set; } = "Pending";
+    public int Attempts { get; set; }
+    public DateTime AvailableAt { get; set; } = DateTime.UtcNow;
+    public int? ResultCode { get; set; }
+    public string? ResultData { get; set; }
+    public string? ResultMessage { get; set; }
+    public string? LastError { get; set; }
+    public DateTime CreatedAt { get; set; } = DateTime.UtcNow;
+    public DateTime UpdatedAt { get; set; } = DateTime.UtcNow;
+}

backend/src/Health.Infrastructure/Data/Records/MedicationReminderTaskRecord.cs

@@ -0,0 +1,18 @@
+namespace Health.Infrastructure.Data.Records;
+
+public sealed class MedicationReminderTaskRecord
+{
+    public Guid Id { get; set; }
+    public Guid UserId { get; set; }
+    public Guid MedicationId { get; set; }
+    public string Name { get; set; } = string.Empty;
+    public string? Dosage { get; set; }
+    public DateOnly ScheduledDate { get; set; }
+    public TimeOnly ScheduledTime { get; set; }
+    public string Status { get; set; } = "Pending";
+    public int Attempts { get; set; }
+    public DateTime AvailableAt { get; set; } = DateTime.UtcNow;
+    public string? LastError { get; set; }
+    public DateTime CreatedAt { get; set; } = DateTime.UtcNow;
+    public DateTime UpdatedAt { get; set; } = DateTime.UtcNow;
+}

backend/src/Health.Infrastructure/Data/Records/NotificationOutboxRecord.cs

@@ -0,0 +1,16 @@
+namespace Health.Infrastructure.Data.Records;
+
+public sealed class NotificationOutboxRecord
+{
+    public Guid Id { get; set; }
+    public Guid UserId { get; set; }
+    public Guid SourceTaskId { get; set; }
+    public string Type { get; set; } = string.Empty;
+    public string Payload { get; set; } = "{}";
+    public string Status { get; set; } = "AwaitingProvider";
+    public int Attempts { get; set; }
+    public DateTime AvailableAt { get; set; } = DateTime.UtcNow;
+    public string? LastError { get; set; }
+    public DateTime CreatedAt { get; set; } = DateTime.UtcNow;
+    public DateTime UpdatedAt { get; set; } = DateTime.UtcNow;
+}

backend/src/Health.Infrastructure/Data/Records/ReportAnalysisTaskRecord.cs

@@ -0,0 +1,14 @@
+namespace Health.Infrastructure.Data.Records;
+
+public sealed class ReportAnalysisTaskRecord
+{
+    public Guid Id { get; set; }
+    public Guid ReportId { get; set; }
+    public string FilePath { get; set; } = string.Empty;
+    public string Status { get; set; } = "Pending";
+    public int Attempts { get; set; }
+    public DateTime AvailableAt { get; set; } = DateTime.UtcNow;
+    public string? LastError { get; set; }
+    public DateTime CreatedAt { get; set; } = DateTime.UtcNow;
+    public DateTime UpdatedAt { get; set; } = DateTime.UtcNow;
+}

backend/src/Health.Infrastructure/Data/app_db_context.cs

@@ -1,5 +1,6 @@
 using Microsoft.EntityFrameworkCore;
 using Microsoft.EntityFrameworkCore.Storage.ValueConversion;
+using Health.Infrastructure.Data.Records;
 
 namespace Health.Infrastructure.Data;
 
@@ -33,6 +34,11 @@ public sealed class AppDbContext(DbContextOptions<AppDbContext> options) : DbCon
     public DbSet<VerificationCode> VerificationCodes => Set<VerificationCode>();
     public DbSet<NotificationPreference> NotificationPreferences => Set<NotificationPreference>();
     public DbSet<DeviceToken> DeviceTokens => Set<DeviceToken>();
+    public DbSet<AiWriteCommandRecord> AiWriteCommands => Set<AiWriteCommandRecord>();
+    public DbSet<ReportAnalysisTaskRecord> ReportAnalysisTasks => Set<ReportAnalysisTaskRecord>();
+    public DbSet<DietImageAnalysisTaskRecord> DietImageAnalysisTasks => Set<DietImageAnalysisTaskRecord>();
+    public DbSet<MedicationReminderTaskRecord> MedicationReminderTasks => Set<MedicationReminderTaskRecord>();
+    public DbSet<NotificationOutboxRecord> NotificationOutbox => Set<NotificationOutboxRecord>();
 
     protected override void OnModelCreating(ModelBuilder builder)
     {
@@ -95,7 +101,12 @@ public sealed class AppDbContext(DbContextOptions<AppDbContext> options) : DbCon
         // ---- ExercisePlan ----
         builder.Entity<ExercisePlan>(e =>
         {
-            e.HasIndex(p => new { p.UserId, p.WeekStartDate }).IsDescending(false, true);
+            e.HasIndex(p => new { p.UserId, p.StartDate, p.EndDate });
+        });
+
+        builder.Entity<ExercisePlanItem>(e =>
+        {
+            e.HasIndex(i => new { i.PlanId, i.ScheduledDate }).IsUnique();
         });
 
         // ---- Report ----
@@ -148,5 +159,48 @@ public sealed class AppDbContext(DbContextOptions<AppDbContext> options) : DbCon
         {
             e.HasIndex(a => a.UserId).IsUnique();
         });
+
+        builder.Entity<AiWriteCommandRecord>(e =>
+        {
+            e.ToTable("AiWriteCommands");
+            e.HasIndex(x => new { x.UserId, x.Status, x.ExpiresAt });
+            e.Property(x => x.ToolName).HasMaxLength(64);
+            e.Property(x => x.Status).HasMaxLength(32);
+            e.Property(x => x.Arguments).HasColumnType("jsonb");
+        });
+
+        builder.Entity<ReportAnalysisTaskRecord>(e =>
+        {
+            e.ToTable("ReportAnalysisTasks");
+            e.HasIndex(x => new { x.Status, x.AvailableAt });
+            e.HasIndex(x => x.ReportId);
+            e.Property(x => x.Status).HasMaxLength(32);
+        });
+
+        builder.Entity<DietImageAnalysisTaskRecord>(e =>
+        {
+            e.ToTable("DietImageAnalysisTasks");
+            e.HasIndex(x => new { x.Status, x.AvailableAt });
+            e.Property(x => x.FilePaths).HasColumnType("jsonb");
+            e.Property(x => x.Status).HasMaxLength(32);
+        });
+
+        builder.Entity<MedicationReminderTaskRecord>(e =>
+        {
+            e.ToTable("MedicationReminderTasks");
+            e.HasIndex(x => new { x.Status, x.AvailableAt });
+            e.HasIndex(x => new { x.MedicationId, x.ScheduledDate, x.ScheduledTime }).IsUnique();
+            e.Property(x => x.Status).HasMaxLength(32);
+        });
+
+        builder.Entity<NotificationOutboxRecord>(e =>
+        {
+            e.ToTable("NotificationOutbox");
+            e.HasIndex(x => x.SourceTaskId).IsUnique();
+            e.HasIndex(x => new { x.Status, x.AvailableAt });
+            e.Property(x => x.Type).HasMaxLength(64);
+            e.Property(x => x.Status).HasMaxLength(32);
+            e.Property(x => x.Payload).HasColumnType("jsonb");
+        });
     }
 }

backend/src/Health.Infrastructure/Data/dev_data_seeder.cs

@@ -137,14 +137,14 @@ public static class DevDataSeeder
 
         // ---- 运动计划 ----
         var monday = DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8).AddDays(-(int)DateTime.UtcNow.AddHours(8).DayOfWeek + 1));
-        var plan = new ExercisePlan { Id = Guid.NewGuid(), UserId = user.Id, WeekStartDate = monday };
-        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), DayOfWeek = 0, ExerciseType = "散步", DurationMinutes = 30, IsCompleted = true, CompletedAt = DateTime.UtcNow.AddDays(-1) });
-        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), DayOfWeek = 1, ExerciseType = "慢跑", DurationMinutes = 20 });
-        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), DayOfWeek = 2, ExerciseType = "散步", DurationMinutes = 30 });
-        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), DayOfWeek = 3, IsRestDay = true });
-        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), DayOfWeek = 4, ExerciseType = "太极", DurationMinutes = 40 });
-        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), DayOfWeek = 5, IsRestDay = true });
-        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), DayOfWeek = 6, ExerciseType = "散步", DurationMinutes = 30 });
+        var plan = new ExercisePlan { Id = Guid.NewGuid(), UserId = user.Id, StartDate = monday, EndDate = monday.AddDays(6), ReminderTime = new TimeOnly(19, 0) };
+        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = monday, ExerciseType = "散步", DurationMinutes = 30, IsCompleted = true, CompletedAt = DateTime.UtcNow.AddDays(-1) });
+        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = monday.AddDays(1), ExerciseType = "慢跑", DurationMinutes = 20 });
+        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = monday.AddDays(2), ExerciseType = "散步", DurationMinutes = 30 });
+        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = monday.AddDays(3), IsRestDay = true });
+        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = monday.AddDays(4), ExerciseType = "太极", DurationMinutes = 40 });
+        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = monday.AddDays(5), IsRestDay = true });
+        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = monday.AddDays(6), ExerciseType = "散步", DurationMinutes = 30 });
         db.ExercisePlans.Add(plan);
 
         // ---- 饮食记录 ----

backend/src/Health.Infrastructure/Diets/DietImageAnalysisCoordinator.cs

@@ -0,0 +1,59 @@
+using Health.Application.Diets;
+
+namespace Health.Infrastructure.Diets;
+
+public sealed class DietImageAnalysisCoordinator(IDietImageAnalysisQueue queue) : IDietImageAnalysisCoordinator
+{
+    private const long MaxImageBytes = 20 * 1024 * 1024;
+    private static readonly HashSet<string> AllowedExtensions = new(StringComparer.OrdinalIgnoreCase)
+    {
+        ".jpg", ".jpeg", ".png", ".heic"
+    };
+
+    private readonly IDietImageAnalysisQueue _queue = queue;
+
+    public async Task<DietImageAnalysisResult> AnalyzeAsync(IReadOnlyList<DietImageUploadFile> files, CancellationToken ct)
+    {
+        if (files.Count == 0)
+            return new DietImageAnalysisResult(false, 40001, null, "请上传至少一张图片");
+
+        var uploadsDir = Path.Combine(Directory.GetCurrentDirectory(), "uploads", "diet-analysis");
+        Directory.CreateDirectory(uploadsDir);
+        var paths = new List<string>();
+        var handedOff = false;
+
+        try
+        {
+            foreach (var file in files)
+            {
+                if (file.Length <= 0 || file.Length > MaxImageBytes)
+                    return new DietImageAnalysisResult(false, 40001, null, "文件大小超过 20MB 限制");
+
+                var extension = Path.GetExtension(file.FileName).ToLowerInvariant();
+                if (!AllowedExtensions.Contains(extension))
+                    return new DietImageAnalysisResult(false, 40001, null, "不支持的图片格式，仅支持 JPG/PNG/HEIC");
+
+                var filePath = Path.Combine(uploadsDir, $"{Guid.NewGuid()}{extension}");
+                await using var stream = new FileStream(filePath, FileMode.CreateNew);
+                await file.Content.CopyToAsync(stream, ct);
+                paths.Add(filePath);
+            }
+
+            var jobId = await _queue.EnqueueAsync(paths, ct);
+            handedOff = true;
+            return await _queue.WaitForResultAsync(jobId, ct);
+        }
+        catch
+        {
+            if (!handedOff)
+            {
+                foreach (var path in paths)
+                {
+                    try { if (File.Exists(path)) File.Delete(path); }
+                    catch { }
+                }
+            }
+            throw;
+        }
+    }
+}

backend/src/Health.Infrastructure/Diets/DietImageAnalysisQueue.cs

@@ -0,0 +1,113 @@
+using System.Text.Json;
+using Health.Application.Diets;
+using Health.Infrastructure.Data.Records;
+
+namespace Health.Infrastructure.Diets;
+
+public sealed class DietImageAnalysisQueue(AppDbContext db) : IDietImageAnalysisQueue
+{
+    private const int MaxAttempts = 3;
+    private readonly AppDbContext _db = db;
+
+    public async Task<Guid> EnqueueAsync(IReadOnlyList<string> filePaths, CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        var task = new DietImageAnalysisTaskRecord
+        {
+            Id = Guid.NewGuid(),
+            FilePaths = JsonSerializer.Serialize(filePaths),
+            AvailableAt = now,
+            CreatedAt = now,
+            UpdatedAt = now,
+        };
+        await _db.DietImageAnalysisTasks.AddAsync(task, ct);
+        await _db.SaveChangesAsync(ct);
+        return task.Id;
+    }
+
+    public Task RecoverStaleAsync(CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        return _db.DietImageAnalysisTasks
+            .Where(x => x.Status == "Processing" && x.UpdatedAt < now.AddMinutes(-5) && x.Attempts < MaxAttempts)
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Pending")
+                .SetProperty(x => x.AvailableAt, now)
+                .SetProperty(x => x.UpdatedAt, now), ct);
+    }
+
+    public async Task<DietImageAnalysisJob?> TryTakeAsync(CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        var candidate = await _db.DietImageAnalysisTasks.AsNoTracking()
+            .Where(x => x.Status == "Pending" && x.AvailableAt <= now && x.Attempts < MaxAttempts)
+            .OrderBy(x => x.CreatedAt)
+            .FirstOrDefaultAsync(ct);
+        if (candidate == null) return null;
+
+        var claimed = await _db.DietImageAnalysisTasks
+            .Where(x => x.Id == candidate.Id && x.Status == "Pending")
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Processing")
+                .SetProperty(x => x.Attempts, x => x.Attempts + 1)
+                .SetProperty(x => x.UpdatedAt, now), ct);
+        if (claimed == 0) return null;
+
+        var paths = JsonSerializer.Deserialize<List<string>>(candidate.FilePaths) ?? [];
+        return new DietImageAnalysisJob(candidate.Id, paths);
+    }
+
+    public async Task<DietImageAnalysisResult> WaitForResultAsync(Guid jobId, CancellationToken ct)
+    {
+        while (!ct.IsCancellationRequested)
+        {
+            var task = await _db.DietImageAnalysisTasks.AsNoTracking()
+                .FirstOrDefaultAsync(x => x.Id == jobId, ct);
+            if (task == null)
+                return new DietImageAnalysisResult(false, 40004, null, "饮食识别任务不存在");
+            if (task.Status is "Completed" or "Failed")
+                return new DietImageAnalysisResult(
+                    task.Status == "Completed",
+                    task.ResultCode ?? 50001,
+                    task.ResultData,
+                    task.ResultMessage);
+            await Task.Delay(TimeSpan.FromMilliseconds(500), ct);
+        }
+
+        throw new OperationCanceledException(ct);
+    }
+
+    public Task CompleteAsync(Guid jobId, DietImageAnalysisResult result, CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        return _db.DietImageAnalysisTasks.Where(x => x.Id == jobId)
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, result.Success ? "Completed" : "Failed")
+                .SetProperty(x => x.ResultCode, result.Code)
+                .SetProperty(x => x.ResultData, result.Data)
+                .SetProperty(x => x.ResultMessage, result.Message)
+                .SetProperty(x => x.UpdatedAt, now), ct);
+    }
+
+    public async Task<bool> RetryAsync(Guid jobId, string error, CancellationToken ct)
+    {
+        var task = await _db.DietImageAnalysisTasks.FirstOrDefaultAsync(x => x.Id == jobId, ct);
+        if (task == null) return true;
+
+        task.LastError = error.Length > 2000 ? error[..2000] : error;
+        task.UpdatedAt = DateTime.UtcNow;
+        if (task.Attempts >= MaxAttempts)
+        {
+            task.Status = "Failed";
+            task.ResultCode = 50001;
+            task.ResultMessage = $"食物识别失败: {error}";
+        }
+        else
+        {
+            task.Status = "Pending";
+            task.AvailableAt = DateTime.UtcNow.AddSeconds(Math.Pow(2, task.Attempts) * 5);
+        }
+        await _db.SaveChangesAsync(ct);
+        return task.Status == "Failed";
+    }
+}

backend/src/Health.Infrastructure/Diets/DietImageAnalyzer.cs

@@ -0,0 +1,42 @@
+using Health.Application.Diets;
+using Health.Infrastructure.AI;
+
+namespace Health.Infrastructure.Diets;
+
+public sealed class DietImageAnalyzer(VisionClient vision) : IDietImageAnalyzer
+{
+    private readonly VisionClient _vision = vision;
+
+    public async Task<DietImageAnalysisResult> AnalyzeAsync(DietImageAnalysisJob job, CancellationToken ct)
+    {
+        var imageUrls = new List<string>();
+        foreach (var filePath in job.FilePaths)
+        {
+            if (!File.Exists(filePath))
+                return new DietImageAnalysisResult(false, 40004, null, "待识别图片不存在");
+
+            var bytes = await File.ReadAllBytesAsync(filePath, ct);
+            var base64 = Convert.ToBase64String(bytes);
+            if (base64.Length > 7 * 1024 * 1024)
+                return new DietImageAnalysisResult(false, 40001, null, "图片过大，请压缩后重新上传");
+
+            var extension = Path.GetExtension(filePath).ToLowerInvariant();
+            var mime = extension switch
+            {
+                ".png" => "image/png",
+                ".heic" => "image/heic",
+                _ => "image/jpeg"
+            };
+            imageUrls.Add($"data:{mime};base64,{base64}");
+        }
+
+        var prompt = """
+            识别图片中的食物和饮品，返回JSON数组：
+            [{"name":"名称","portion":"份量","calories":热量}]
+            只返回JSON，不要其他内容。
+            """;
+        var response = await _vision.VisionAsync(prompt, imageUrls, userText: null, maxTokens: 8192, ct: ct);
+        var result = response.Choices?.FirstOrDefault()?.Message?.Content ?? "[]";
+        return new DietImageAnalysisResult(true, 0, result, null);
+    }
+}

backend/src/Health.Infrastructure/Diets/EfDietRepository.cs

@@ -0,0 +1,33 @@
+using Health.Application.Diets;
+
+namespace Health.Infrastructure.Diets;
+
+public sealed class EfDietRepository(AppDbContext db) : IDietRepository
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<IReadOnlyList<DietRecord>> ListAsync(Guid userId, DateOnly? recordedAt, MealType? mealType, CancellationToken ct)
+    {
+        var query = _db.DietRecords.Include(d => d.FoodItems).Where(d => d.UserId == userId);
+
+        if (recordedAt.HasValue)
+            query = query.Where(r => r.RecordedAt == recordedAt.Value);
+
+        if (mealType.HasValue)
+            query = query.Where(r => r.MealType == mealType.Value);
+
+        return await query.OrderByDescending(r => r.RecordedAt).ToListAsync(ct);
+    }
+
+    public Task<DietRecord?> GetOwnedAsync(Guid userId, Guid recordId, CancellationToken ct) =>
+        _db.DietRecords.FirstOrDefaultAsync(r => r.Id == recordId && r.UserId == userId, ct);
+
+    public async Task AddAsync(DietRecord record, CancellationToken ct) =>
+        await _db.DietRecords.AddAsync(record, ct);
+
+    public void Delete(DietRecord record) =>
+        _db.DietRecords.Remove(record);
+
+    public Task SaveChangesAsync(CancellationToken ct) =>
+        _db.SaveChangesAsync(ct);
+}

backend/src/Health.Infrastructure/Exercises/EfExerciseRepository.cs

@@ -0,0 +1,44 @@
+using Health.Application.Exercises;
+
+namespace Health.Infrastructure.Exercises;
+
+public sealed class EfExerciseRepository(AppDbContext db) : IExerciseRepository
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<IReadOnlyList<ExercisePlan>> ListActiveOnAsync(Guid userId, DateOnly date, CancellationToken ct) =>
+        await _db.ExercisePlans.Include(p => p.Items)
+            .Where(p => p.UserId == userId && p.StartDate <= date && p.EndDate >= date)
+            .OrderByDescending(p => p.StartDate)
+            .ToListAsync(ct);
+
+    public async Task<IReadOnlyList<ExercisePlan>> ListAsync(Guid userId, int limit, CancellationToken ct) =>
+        await _db.ExercisePlans.Include(p => p.Items)
+            .Where(p => p.UserId == userId)
+            .OrderByDescending(p => p.StartDate)
+            .Take(limit)
+            .ToListAsync(ct);
+
+    public Task<ExercisePlan?> GetOwnedPlanAsync(Guid userId, Guid planId, CancellationToken ct) =>
+        _db.ExercisePlans.Include(p => p.Items)
+            .FirstOrDefaultAsync(p => p.Id == planId && p.UserId == userId, ct);
+
+    public Task<ExercisePlan?> GetLatestAsync(Guid userId, CancellationToken ct) =>
+        _db.ExercisePlans.Include(p => p.Items)
+            .Where(p => p.UserId == userId)
+            .OrderByDescending(p => p.StartDate)
+            .FirstOrDefaultAsync(ct);
+
+    public Task<ExercisePlanItem?> GetOwnedItemAsync(Guid userId, Guid itemId, CancellationToken ct) =>
+        _db.ExercisePlanItems.Include(i => i.Plan)
+            .FirstOrDefaultAsync(i => i.Id == itemId && i.Plan != null && i.Plan.UserId == userId, ct);
+
+    public async Task AddAsync(ExercisePlan plan, CancellationToken ct) =>
+        await _db.ExercisePlans.AddAsync(plan, ct);
+
+    public void Delete(ExercisePlan plan) =>
+        _db.ExercisePlans.Remove(plan);
+
+    public Task SaveChangesAsync(CancellationToken ct) =>
+        _db.SaveChangesAsync(ct);
+}

backend/src/Health.Infrastructure/Exercises/ExerciseReminderProducer.cs

@@ -0,0 +1,44 @@
+using System.Text.Json;
+using Health.Application.Exercises;
+using Health.Infrastructure.Data.Records;
+
+namespace Health.Infrastructure.Exercises;
+
+public sealed class ExerciseReminderProducer(AppDbContext db) : IExerciseReminderProducer
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<int> ProduceDueAsync(DateTime utcNow, CancellationToken ct)
+    {
+        var beijingNow = utcNow.AddHours(8);
+        var today = DateOnly.FromDateTime(beijingNow);
+        var currentTime = TimeOnly.FromDateTime(beijingNow);
+        var dueItems = await _db.ExercisePlanItems.AsNoTracking()
+            .Include(x => x.Plan)
+            .Where(x => x.ScheduledDate == today && !x.IsCompleted && !x.IsRestDay && x.Plan.ReminderTime <= currentTime)
+            .ToListAsync(ct);
+        var sourceIds = dueItems.Select(x => x.Id).ToList();
+        var existing = await _db.NotificationOutbox.AsNoTracking()
+            .Where(x => sourceIds.Contains(x.SourceTaskId))
+            .Select(x => x.SourceTaskId)
+            .ToListAsync(ct);
+        var existingSet = existing.ToHashSet();
+        var now = DateTime.UtcNow;
+        foreach (var item in dueItems.Where(x => !existingSet.Contains(x.Id)))
+        {
+            await _db.NotificationOutbox.AddAsync(new NotificationOutboxRecord
+            {
+                Id = Guid.NewGuid(), UserId = item.Plan.UserId, SourceTaskId = item.Id,
+                Type = "ExerciseReminder",
+                Payload = JsonSerializer.Serialize(new
+                {
+                    item.ExerciseType, item.DurationMinutes, item.ScheduledDate,
+                    ReminderTime = item.Plan.ReminderTime,
+                }),
+                Status = "AwaitingProvider", AvailableAt = now, CreatedAt = now, UpdatedAt = now,
+            }, ct);
+        }
+        if (_db.ChangeTracker.HasChanges()) await _db.SaveChangesAsync(ct);
+        return dueItems.Count - existingSet.Count;
+    }
+}

backend/src/Health.Infrastructure/Health.Infrastructure.csproj

@@ -1,12 +1,14 @@
 <Project Sdk="Microsoft.NET.Sdk">
 
   <ItemGroup>
+    <ProjectReference Include="..\Health.Application\Health.Application.csproj" />
     <ProjectReference Include="..\Health.Domain\Health.Domain.csproj" />
   </ItemGroup>
 
   <ItemGroup>
     <PackageReference Include="Microsoft.EntityFrameworkCore" Version="10.0.8" />
     <PackageReference Include="Microsoft.Extensions.Configuration.Abstractions" Version="10.0.8" />
+    <PackageReference Include="Microsoft.Extensions.Logging.Abstractions" Version="10.0.8" />
     <PackageReference Include="Microsoft.IdentityModel.Tokens" Version="8.18.0" />
     <PackageReference Include="Minio" Version="7.0.0" />
     <PackageReference Include="Npgsql.EntityFrameworkCore.PostgreSQL" Version="10.0.2" />

backend/src/Health.Infrastructure/HealthArchives/EfHealthArchiveRepository.cs

@@ -0,0 +1,17 @@
+using Health.Application.HealthArchives;
+
+namespace Health.Infrastructure.HealthArchives;
+
+public sealed class EfHealthArchiveRepository(AppDbContext db) : IHealthArchiveRepository
+{
+    private readonly AppDbContext _db = db;
+
+    public Task<HealthArchive?> GetByUserIdAsync(Guid userId, CancellationToken ct) =>
+        _db.HealthArchives.FirstOrDefaultAsync(a => a.UserId == userId, ct);
+
+    public async Task AddAsync(HealthArchive archive, CancellationToken ct) =>
+        await _db.HealthArchives.AddAsync(archive, ct);
+
+    public Task SaveChangesAsync(CancellationToken ct) =>
+        _db.SaveChangesAsync(ct);
+}

backend/src/Health.Infrastructure/HealthRecords/EfHealthRecordRepository.cs

@@ -0,0 +1,45 @@
+using Health.Application.HealthRecords;
+
+namespace Health.Infrastructure.HealthRecords;
+
+public sealed class EfHealthRecordRepository(AppDbContext db) : IHealthRecordRepository
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<IReadOnlyList<HealthRecord>> ListAsync(Guid userId, HealthMetricType? type, DateTime? recordedAfter, int limit, CancellationToken ct)
+    {
+        var query = _db.HealthRecords.Where(r => r.UserId == userId);
+
+        if (type.HasValue)
+            query = query.Where(r => r.MetricType == type.Value);
+
+        if (recordedAfter.HasValue)
+            query = query.Where(r => r.RecordedAt >= recordedAfter.Value);
+
+        return await query.OrderByDescending(r => r.RecordedAt).Take(limit).ToListAsync(ct);
+    }
+
+    public Task<HealthRecord?> GetOwnedAsync(Guid userId, Guid id, CancellationToken ct) =>
+        _db.HealthRecords.FirstOrDefaultAsync(r => r.Id == id && r.UserId == userId, ct);
+
+    public Task<HealthRecord?> GetLatestByTypeAsync(Guid userId, HealthMetricType type, CancellationToken ct) =>
+        _db.HealthRecords
+            .Where(r => r.UserId == userId && r.MetricType == type)
+            .OrderByDescending(r => r.RecordedAt)
+            .FirstOrDefaultAsync(ct);
+
+    public async Task<IReadOnlyList<HealthRecord>> GetTrendAsync(Guid userId, HealthMetricType type, DateTime recordedAfter, CancellationToken ct) =>
+        await _db.HealthRecords
+            .Where(r => r.UserId == userId && r.MetricType == type && r.RecordedAt >= recordedAfter)
+            .OrderBy(r => r.RecordedAt)
+            .ToListAsync(ct);
+
+    public async Task AddAsync(HealthRecord record, CancellationToken ct) =>
+        await _db.HealthRecords.AddAsync(record, ct);
+
+    public void Delete(HealthRecord record) =>
+        _db.HealthRecords.Remove(record);
+
+    public Task SaveChangesAsync(CancellationToken ct) =>
+        _db.SaveChangesAsync(ct);
+}

backend/src/Health.Infrastructure/Maintenance/EfMaintenanceRepository.cs

@@ -0,0 +1,52 @@
+using Health.Application.Maintenance;
+
+namespace Health.Infrastructure.Maintenance;
+
+public sealed class EfMaintenanceRepository(AppDbContext db) : IMaintenanceRepository
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<MaintenanceCleanupResult> CleanupAsync(
+        DateTime conversationCutoff,
+        DateTime taskCutoff,
+        DateTime utcNow,
+        CancellationToken ct)
+    {
+        var oldConversationIds = await _db.Conversations.AsNoTracking()
+            .Where(x => x.UpdatedAt < conversationCutoff)
+            .Select(x => x.Id)
+            .ToListAsync(ct);
+        if (oldConversationIds.Count > 0)
+        {
+            await _db.ConversationMessages
+                .Where(x => oldConversationIds.Contains(x.ConversationId))
+                .ExecuteDeleteAsync(ct);
+            await _db.Conversations
+                .Where(x => oldConversationIds.Contains(x.Id))
+                .ExecuteDeleteAsync(ct);
+        }
+
+        var verificationCodes = await _db.VerificationCodes
+            .Where(x => x.ExpiresAt < utcNow)
+            .ExecuteDeleteAsync(ct);
+
+        var backgroundTasks = 0;
+        backgroundTasks += await _db.ReportAnalysisTasks
+            .Where(x => x.UpdatedAt < taskCutoff && (x.Status == "Completed" || x.Status == "Failed"))
+            .ExecuteDeleteAsync(ct);
+        backgroundTasks += await _db.DietImageAnalysisTasks
+            .Where(x => x.UpdatedAt < taskCutoff && (x.Status == "Completed" || x.Status == "Failed"))
+            .ExecuteDeleteAsync(ct);
+        backgroundTasks += await _db.MedicationReminderTasks
+            .Where(x => x.UpdatedAt < taskCutoff && (x.Status == "Completed" || x.Status == "Failed"))
+            .ExecuteDeleteAsync(ct);
+        backgroundTasks += await _db.NotificationOutbox
+            .Where(x => x.UpdatedAt < taskCutoff)
+            .ExecuteDeleteAsync(ct);
+        backgroundTasks += await _db.AiWriteCommands
+            .Where(x => x.UpdatedAt < taskCutoff)
+            .ExecuteDeleteAsync(ct);
+
+        return new MaintenanceCleanupResult(oldConversationIds.Count, verificationCodes, backgroundTasks);
+    }
+}

backend/src/Health.Infrastructure/Medications/EfMedicationRepository.cs

@@ -0,0 +1,79 @@
+using Health.Application.Medications;
+
+namespace Health.Infrastructure.Medications;
+
+public sealed class EfMedicationRepository(AppDbContext db) : IMedicationRepository
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<IReadOnlyList<Medication>> ListAsync(Guid userId, string? filter, CancellationToken ct)
+    {
+        var query = _db.Medications.Include(m => m.Logs).Where(m => m.UserId == userId);
+        if (filter == "active") query = query.Where(m => m.IsActive);
+        else if (filter == "inactive") query = query.Where(m => !m.IsActive);
+
+        return await query.OrderByDescending(m => m.CreatedAt).ToListAsync(ct);
+    }
+
+    public async Task<IReadOnlyList<Medication>> ListActiveForRemindersAsync(Guid userId, DateOnly today, CancellationToken ct) =>
+        await _db.Medications
+            .Where(m => m.UserId == userId && m.IsActive && m.TimeOfDay.Count > 0
+                && (m.StartDate == null || m.StartDate <= today)
+                && (m.EndDate == null || m.EndDate >= today))
+            .ToListAsync(ct);
+
+    public async Task<IReadOnlyList<MedicationLog>> ListLogsInWindowAsync(Guid userId, DateTime startUtc, DateTime endUtc, CancellationToken ct) =>
+        await _db.MedicationLogs
+            .Where(l => l.UserId == userId && l.ConfirmedAt >= startUtc && l.ConfirmedAt < endUtc)
+            .ToListAsync(ct);
+
+    public Task<Medication?> GetOwnedAsync(Guid userId, Guid medicationId, CancellationToken ct) =>
+        _db.Medications.FirstOrDefaultAsync(m => m.Id == medicationId && m.UserId == userId, ct);
+
+    public Task<bool> ExistsOwnedAsync(Guid userId, Guid medicationId, CancellationToken ct) =>
+        _db.Medications.AnyAsync(m => m.Id == medicationId && m.UserId == userId, ct);
+
+    public Task<MedicationLog?> GetTodayTakenLogAsync(Guid userId, Guid medicationId, DateTime startUtc, DateTime endUtc, CancellationToken ct) =>
+        _db.MedicationLogs.FirstOrDefaultAsync(l =>
+            l.MedicationId == medicationId && l.UserId == userId
+            && l.CreatedAt >= startUtc && l.CreatedAt < endUtc
+            && l.Status == MedicationLogStatus.Taken, ct);
+
+    public Task<bool> DoseLogExistsAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, DateTime startUtc, DateTime endUtc, CancellationToken ct) =>
+        _db.MedicationLogs.AnyAsync(l =>
+            l.MedicationId == medicationId && l.UserId == userId
+            && l.ScheduledTime == scheduledTime
+            && l.ConfirmedAt >= startUtc && l.ConfirmedAt < endUtc, ct);
+
+    public Task<MedicationLog?> GetDoseLogAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, DateTime startUtc, DateTime endUtc, CancellationToken ct) =>
+        _db.MedicationLogs.FirstOrDefaultAsync(l =>
+            l.MedicationId == medicationId && l.UserId == userId
+            && l.ScheduledTime == scheduledTime
+            && l.ConfirmedAt >= startUtc && l.ConfirmedAt < endUtc, ct);
+
+    public async Task<IReadOnlyList<Medication>> ListActiveForReminderScanAsync(CancellationToken ct) =>
+        await _db.Medications
+            .Where(m => m.IsActive && m.TimeOfDay.Count > 0)
+            .ToListAsync(ct);
+
+    public Task<bool> HasTakenInWindowAsync(Guid userId, Guid medicationId, DateTime startUtc, DateTime endUtc, CancellationToken ct) =>
+        _db.MedicationLogs.AnyAsync(l =>
+            l.UserId == userId && l.MedicationId == medicationId
+            && l.CreatedAt >= startUtc && l.CreatedAt < endUtc
+            && l.Status == MedicationLogStatus.Taken, ct);
+
+    public async Task AddMedicationAsync(Medication medication, CancellationToken ct) =>
+        await _db.Medications.AddAsync(medication, ct);
+
+    public async Task AddLogAsync(MedicationLog log, CancellationToken ct) =>
+        await _db.MedicationLogs.AddAsync(log, ct);
+
+    public void DeleteMedication(Medication medication) =>
+        _db.Medications.Remove(medication);
+
+    public void DeleteLog(MedicationLog log) =>
+        _db.MedicationLogs.Remove(log);
+
+    public Task SaveChangesAsync(CancellationToken ct) =>
+        _db.SaveChangesAsync(ct);
+}

backend/src/Health.Infrastructure/Medications/MedicationReminderQueue.cs

@@ -0,0 +1,110 @@
+using Health.Application.Medications;
+using Health.Infrastructure.Data.Records;
+using Npgsql;
+
+namespace Health.Infrastructure.Medications;
+
+public sealed class MedicationReminderQueue(AppDbContext db) : IMedicationReminderQueue
+{
+    private const int MaxAttempts = 5;
+    private readonly AppDbContext _db = db;
+
+    public async Task<bool> EnqueueAsync(MedicationReminderTask task, CancellationToken ct)
+    {
+        var exists = await _db.MedicationReminderTasks.AsNoTracking().AnyAsync(x =>
+            x.MedicationId == task.MedicationId &&
+            x.ScheduledDate == task.ScheduledDate &&
+            x.ScheduledTime == task.ScheduledTime, ct);
+        if (exists) return false;
+
+        var now = DateTime.UtcNow;
+        await _db.MedicationReminderTasks.AddAsync(new MedicationReminderTaskRecord
+        {
+            Id = task.TaskId,
+            UserId = task.UserId,
+            MedicationId = task.MedicationId,
+            Name = task.Name,
+            Dosage = task.Dosage,
+            ScheduledDate = task.ScheduledDate,
+            ScheduledTime = task.ScheduledTime,
+            AvailableAt = now,
+            CreatedAt = now,
+            UpdatedAt = now,
+        }, ct);
+
+        try
+        {
+            await _db.SaveChangesAsync(ct);
+            return true;
+        }
+        catch (DbUpdateException ex) when (
+            ex.InnerException is PostgresException { SqlState: PostgresErrorCodes.UniqueViolation })
+        {
+            _db.ChangeTracker.Clear();
+            return false;
+        }
+    }
+
+    public Task RecoverStaleAsync(CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        return _db.MedicationReminderTasks
+            .Where(x => x.Status == "Processing" && x.UpdatedAt < now.AddMinutes(-5) && x.Attempts < MaxAttempts)
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Pending")
+                .SetProperty(x => x.AvailableAt, now)
+                .SetProperty(x => x.UpdatedAt, now), ct);
+    }
+
+    public async Task<MedicationReminderTask?> TryTakeAsync(CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        var candidate = await _db.MedicationReminderTasks.AsNoTracking()
+            .Where(x => x.Status == "Pending" && x.AvailableAt <= now && x.Attempts < MaxAttempts)
+            .OrderBy(x => x.CreatedAt)
+            .FirstOrDefaultAsync(ct);
+        if (candidate == null) return null;
+
+        var claimed = await _db.MedicationReminderTasks
+            .Where(x => x.Id == candidate.Id && x.Status == "Pending")
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Processing")
+                .SetProperty(x => x.Attempts, x => x.Attempts + 1)
+                .SetProperty(x => x.UpdatedAt, now), ct);
+        if (claimed == 0) return null;
+
+        return new MedicationReminderTask(
+            candidate.Id,
+            candidate.UserId,
+            candidate.MedicationId,
+            candidate.Name,
+            candidate.Dosage,
+            candidate.ScheduledDate,
+            candidate.ScheduledTime);
+    }
+
+    public Task CompleteAsync(Guid taskId, CancellationToken ct) =>
+        _db.MedicationReminderTasks.Where(x => x.Id == taskId)
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Completed")
+                .SetProperty(x => x.UpdatedAt, DateTime.UtcNow), ct);
+
+    public async Task RetryAsync(Guid taskId, string error, CancellationToken ct)
+    {
+        var task = await _db.MedicationReminderTasks.FirstOrDefaultAsync(x => x.Id == taskId, ct);
+        if (task == null) return;
+
+        task.LastError = error.Length > 2000 ? error[..2000] : error;
+        task.UpdatedAt = DateTime.UtcNow;
+        if (task.Attempts >= MaxAttempts)
+        {
+            task.Status = "Failed";
+        }
+        else
+        {
+            task.Status = "Pending";
+            task.AvailableAt = DateTime.UtcNow.AddSeconds(Math.Pow(2, task.Attempts) * 5);
+        }
+        await _db.SaveChangesAsync(ct);
+    }
+}

backend/src/Health.Infrastructure/Medications/OutboxMedicationReminderDispatcher.cs

@@ -0,0 +1,47 @@
+using System.Text.Json;
+using Health.Application.Medications;
+using Health.Infrastructure.Data.Records;
+using Microsoft.Extensions.Logging;
+
+namespace Health.Infrastructure.Medications;
+
+public sealed class OutboxMedicationReminderDispatcher(
+    AppDbContext db,
+    ILogger<OutboxMedicationReminderDispatcher> logger) : IMedicationReminderDispatcher
+{
+    private readonly AppDbContext _db = db;
+    private readonly ILogger<OutboxMedicationReminderDispatcher> _logger = logger;
+
+    public async Task DispatchAsync(MedicationReminderTask task, CancellationToken ct)
+    {
+        if (await _db.NotificationOutbox.AsNoTracking().AnyAsync(x => x.SourceTaskId == task.TaskId, ct))
+            return;
+
+        var now = DateTime.UtcNow;
+        await _db.NotificationOutbox.AddAsync(new NotificationOutboxRecord
+        {
+            Id = Guid.NewGuid(),
+            UserId = task.UserId,
+            SourceTaskId = task.TaskId,
+            Type = "MedicationReminder",
+            Payload = JsonSerializer.Serialize(new
+            {
+                task.MedicationId,
+                task.Name,
+                task.Dosage,
+                task.ScheduledDate,
+                task.ScheduledTime,
+            }),
+            Status = "AwaitingProvider",
+            AvailableAt = now,
+            CreatedAt = now,
+            UpdatedAt = now,
+        }, ct);
+        await _db.SaveChangesAsync(ct);
+
+        _logger.LogInformation(
+            "用药提醒已写入通知 Outbox，等待推送服务: {TaskId} {UserId}",
+            task.TaskId,
+            task.UserId);
+    }
+}

backend/src/Health.Infrastructure/Notifications/EfInAppNotificationRepository.cs

@@ -0,0 +1,26 @@
+using Health.Application.Notifications;
+
+namespace Health.Infrastructure.Notifications;
+
+public sealed class EfInAppNotificationRepository(AppDbContext db) : IInAppNotificationRepository
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<IReadOnlyList<InAppNotificationRecord>> GetPendingAsync(Guid userId, CancellationToken ct) =>
+        await _db.NotificationOutbox.AsNoTracking()
+            .Where(x => x.UserId == userId && x.Status == "AwaitingProvider")
+            .OrderBy(x => x.CreatedAt)
+            .Take(10)
+            .Select(x => new InAppNotificationRecord(x.Id, x.Type, x.Payload, x.CreatedAt))
+            .ToListAsync(ct);
+
+    public async Task<bool> AcknowledgeAsync(Guid userId, Guid notificationId, CancellationToken ct)
+    {
+        var updated = await _db.NotificationOutbox
+            .Where(x => x.Id == notificationId && x.UserId == userId && x.Status == "AwaitingProvider")
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "InAppDelivered")
+                .SetProperty(x => x.UpdatedAt, DateTime.UtcNow), ct);
+        return updated > 0;
+    }
+}

backend/src/Health.Infrastructure/Reports/EfReportAnalysisQueue.cs

@@ -0,0 +1,86 @@
+using Health.Application.Reports;
+using Health.Infrastructure.Data.Records;
+
+namespace Health.Infrastructure.Reports;
+
+public sealed class EfReportAnalysisQueue(AppDbContext db) : IReportAnalysisQueue
+{
+    private const int MaxAttempts = 3;
+    private readonly AppDbContext _db = db;
+
+    public async Task EnqueueAsync(ReportAnalysisJob job, CancellationToken ct = default)
+    {
+        var now = DateTime.UtcNow;
+        await _db.ReportAnalysisTasks.AddAsync(new ReportAnalysisTaskRecord
+        {
+            Id = job.TaskId,
+            ReportId = job.ReportId,
+            FilePath = job.FilePath,
+            Status = "Pending",
+            Attempts = 0,
+            AvailableAt = now,
+            CreatedAt = now,
+            UpdatedAt = now,
+        }, ct);
+        await _db.SaveChangesAsync(ct);
+    }
+
+    public Task RecoverStaleAsync(CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        return _db.ReportAnalysisTasks
+            .Where(x => x.Status == "Processing" && x.UpdatedAt < now.AddMinutes(-5) && x.Attempts < MaxAttempts)
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Pending")
+                .SetProperty(x => x.AvailableAt, now)
+                .SetProperty(x => x.UpdatedAt, now), ct);
+    }
+
+    public async Task<ReportAnalysisJob?> TryTakeAsync(CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        var candidate = await _db.ReportAnalysisTasks.AsNoTracking()
+            .Where(x => x.Status == "Pending" && x.AvailableAt <= now && x.Attempts < MaxAttempts)
+            .OrderBy(x => x.CreatedAt)
+            .FirstOrDefaultAsync(ct);
+        if (candidate == null) return null;
+
+        var claimed = await _db.ReportAnalysisTasks
+            .Where(x => x.Id == candidate.Id && x.Status == "Pending")
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Processing")
+                .SetProperty(x => x.Attempts, x => x.Attempts + 1)
+                .SetProperty(x => x.UpdatedAt, now), ct);
+        return claimed == 0
+            ? null
+            : new ReportAnalysisJob(candidate.Id, candidate.ReportId, candidate.FilePath);
+    }
+
+    public async Task CompleteAsync(Guid taskId, CancellationToken ct)
+    {
+        await _db.ReportAnalysisTasks
+            .Where(x => x.Id == taskId && x.Status == "Processing")
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Completed")
+                .SetProperty(x => x.UpdatedAt, DateTime.UtcNow), ct);
+    }
+
+    public async Task RetryAsync(Guid taskId, string error, CancellationToken ct)
+    {
+        var task = await _db.ReportAnalysisTasks.FirstOrDefaultAsync(x => x.Id == taskId, ct);
+        if (task == null) return;
+
+        task.LastError = error.Length > 2000 ? error[..2000] : error;
+        task.UpdatedAt = DateTime.UtcNow;
+        if (task.Attempts >= MaxAttempts)
+        {
+            task.Status = "Failed";
+        }
+        else
+        {
+            task.Status = "Pending";
+            task.AvailableAt = DateTime.UtcNow.AddSeconds(Math.Pow(2, task.Attempts) * 5);
+        }
+        await _db.SaveChangesAsync(ct);
+    }
+}

backend/src/Health.Infrastructure/Reports/EfReportRepository.cs

@@ -0,0 +1,29 @@
+using Health.Application.Reports;
+
+namespace Health.Infrastructure.Reports;
+
+public sealed class EfReportRepository(AppDbContext db) : IReportRepository
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<IReadOnlyList<Report>> ListAsync(Guid userId, CancellationToken ct) =>
+        await _db.Reports
+            .Where(r => r.UserId == userId)
+            .OrderByDescending(r => r.CreatedAt)
+            .ToListAsync(ct);
+
+    public Task<Report?> GetOwnedAsync(Guid userId, Guid reportId, CancellationToken ct) =>
+        _db.Reports.FirstOrDefaultAsync(r => r.Id == reportId && r.UserId == userId, ct);
+
+    public Task<Report?> GetByIdAsync(Guid reportId, CancellationToken ct) =>
+        _db.Reports.FirstOrDefaultAsync(r => r.Id == reportId, ct);
+
+    public async Task AddAsync(Report report, CancellationToken ct) =>
+        await _db.Reports.AddAsync(report, ct);
+
+    public void Delete(Report report) =>
+        _db.Reports.Remove(report);
+
+    public Task SaveChangesAsync(CancellationToken ct) =>
+        _db.SaveChangesAsync(ct);
+}

backend/src/Health.Infrastructure/Reports/LocalReportFileStorage.cs

@@ -0,0 +1,30 @@
+using Health.Application.Reports;
+
+namespace Health.Infrastructure.Reports;
+
+public sealed class LocalReportFileStorage : IReportFileStorage
+{
+    public async Task<StoredReportFile> SaveAsync(ReportUploadFile file, string extension, CancellationToken ct)
+    {
+        var uploadsDir = Path.Combine(Directory.GetCurrentDirectory(), "uploads", "reports");
+        Directory.CreateDirectory(uploadsDir);
+
+        var fileName = $"{Guid.NewGuid()}{extension}";
+        var filePath = Path.Combine(uploadsDir, fileName);
+        await using (var stream = new FileStream(filePath, FileMode.CreateNew))
+        {
+            await file.Content.CopyToAsync(stream, ct);
+        }
+
+        return new StoredReportFile($"/uploads/reports/{fileName}", filePath);
+    }
+
+    public string GetLocalFilePath(string fileUrl) =>
+        Path.Combine(Directory.GetCurrentDirectory(), fileUrl.TrimStart('/'));
+
+    public bool Exists(string filePath) =>
+        File.Exists(filePath);
+
+    public void Delete(string filePath) =>
+        File.Delete(filePath);
+}

backend/src/Health.Infrastructure/Reports/ReportAnalysisService.cs

@@ -0,0 +1,165 @@
+using Health.Application.Reports;
+using Health.Infrastructure.AI;
+using Microsoft.Extensions.Logging;
+
+namespace Health.Infrastructure.Reports;
+
+public sealed class ReportAnalysisService(
+    IReportRepository reports,
+    VisionClient vision,
+    DeepSeekClient llm,
+    ILogger<ReportAnalysisService> logger) : IReportAnalysisService
+{
+    private readonly IReportRepository _reports = reports;
+    private readonly VisionClient _vision = vision;
+    private readonly DeepSeekClient _llm = llm;
+    private readonly ILogger<ReportAnalysisService> _logger = logger;
+
+    public async Task AnalyzeAsync(ReportAnalysisJob job, CancellationToken ct)
+    {
+        var report = await _reports.GetByIdAsync(job.ReportId, ct);
+        if (report == null) return;
+
+        try
+        {
+            var vlmJson = await ExtractIndicatorsAsync(job.FilePath, ct);
+
+            var isReport = vlmJson.TryGetProperty("isReport", out var ir) && ir.GetBoolean();
+            var reason = vlmJson.TryGetProperty("reason", out var rsn) ? rsn.GetString() : null;
+            if (!isReport)
+            {
+                report.AiSummary = $"AI 暂时无法完成解读：{reason ?? "这可能不是一份医学报告"}。请重新上传清晰的报告图片。";
+                report.AiIndicators = "[]";
+                report.Status = ReportStatus.AnalysisFailed;
+                await _reports.SaveChangesAsync(ct);
+                return;
+            }
+
+            var reportType = vlmJson.TryGetProperty("reportType", out var rt) ? rt.GetString() ?? "Other" : "Other";
+            var indicatorsJson = vlmJson.TryGetProperty("indicators", out var inds) ? inds.GetRawText() : "[]";
+
+            report.Category = Enum.TryParse<ReportCategory>(reportType, out var cat) ? cat : ReportCategory.Other;
+            report.AiIndicators = indicatorsJson;
+            report.AiSummary = await GenerateSummaryAsync(indicatorsJson, ct);
+            report.Status = ReportStatus.PendingDoctor;
+
+            await _reports.SaveChangesAsync(ct);
+            _logger.LogInformation("报告 AI 分析完成: {ReportId}", job.ReportId);
+        }
+        catch (Exception ex)
+        {
+            _logger.LogError(ex, "报告 AI 分析失败: {ReportId}", job.ReportId);
+            report.Status = ReportStatus.AnalysisFailed;
+            report.AiSummary = "AI 暂时无法完成解读，可能是图片不清晰或服务暂时不可用。请稍后重试，或重新上传更清晰的报告图片。";
+            report.AiIndicators = "[]";
+            await _reports.SaveChangesAsync(ct);
+        }
+    }
+
+    private async Task<JsonElement> ExtractIndicatorsAsync(string filePath, CancellationToken ct)
+    {
+        var imageUrl = await GetLocalImageUrl(filePath, ct);
+        if (imageUrl == null)
+            throw new InvalidOperationException("报告图片文件不存在或无法读取");
+
+        var prompt = """
+            你是一名医学检验报告分析专家。请仔细识别这份医学报告。
+
+            第一步：判断这到底是不是一份医学检验报告。
+            如果不是（比如是自拍、风景照、食物、文件等），直接返回：
+            {"isReport": false, "reason": "这不是医学报告，原因：..."}
+
+            如果是医学报告，提取所有检测指标，返回严格JSON格式（不要markdown包裹）：
+            {
+              "isReport": true,
+              "reportType": "BloodTest/Biochemistry/Ecg/Ultrasound/Discharge/Other",
+              "indicators": [
+                {"name": "指标名称", "value": "数值", "unit": "单位", "referenceRange": "参考范围", "status": "normal/high/low"}
+              ]
+            }
+
+            注意：
+            - status 判断：数值在参考范围内=normal，超出上限=high，低于下限=low
+            - 如果参考范围不明确，根据常见医学标准判断
+            """;
+
+        var response = await _vision.VisionAsync(
+            prompt,
+            [imageUrl],
+            userText: "请分析这份医学报告",
+            maxTokens: 2048,
+            ct: ct);
+
+        var content = response.Choices?.FirstOrDefault()?.Message?.Content ?? "";
+        _logger.LogInformation("报告 VLM 返回: {Content}", content[..Math.Min(content.Length, 200)]);
+
+        var json = TryParseJson(content);
+        return json ?? throw new InvalidOperationException("报告识别结果格式异常");
+    }
+
+    private async Task<string> GenerateSummaryAsync(string indicatorsJson, CancellationToken ct)
+    {
+        var prompt = $"""
+            你是患者端医学报告预解读助手。请根据以下检验指标，用通俗易懂的语言写一份报告解读。
+
+            检测指标：{indicatorsJson}
+
+            要求：
+            1. 总字数200-300字
+            2. 先总结整体情况
+            3. 指出异常指标及其可能原因，但不要给出确定诊断
+            4. 给出生活方式和复查/就医沟通建议，不要给出处方、停药、换药或调药建议
+            5. 如指标明显异常或存在急症风险，优先建议及时就医
+            6. 末尾提醒"以上为AI预解读，不能替代医生诊断和治疗建议"
+
+            只返回解读文本，不要JSON格式。
+            """;
+
+        var messages = new List<ChatMessage>
+        {
+            new() { Role = "system", Content = "你是患者端医学报告预解读助手，不替代医生诊断、处方或治疗决策。" },
+            new() { Role = "user", Content = prompt }
+        };
+
+        var response = await _llm.ChatAsync(messages, maxTokens: 800, temperature: 0.3f, ct: ct);
+        var summary = response.Choices?.FirstOrDefault()?.Message?.Content?.Trim() ?? "";
+        return !string.IsNullOrWhiteSpace(summary)
+            ? summary
+            : throw new InvalidOperationException("AI 未返回有效解读内容");
+    }
+
+    private static async Task<string?> GetLocalImageUrl(string filePath, CancellationToken ct)
+    {
+        if (!File.Exists(filePath)) return null;
+
+        var bytes = await File.ReadAllBytesAsync(filePath, ct);
+        var base64 = Convert.ToBase64String(bytes);
+        var ext = Path.GetExtension(filePath).ToLowerInvariant().TrimStart('.');
+        var mime = ext switch
+        {
+            "png" => "image/png",
+            "jpg" or "jpeg" => "image/jpeg",
+            "webp" => "image/webp",
+            _ => "image/png"
+        };
+        return $"data:{mime};base64,{base64}";
+    }
+
+    private static JsonElement? TryParseJson(string? content)
+    {
+        if (string.IsNullOrWhiteSpace(content)) return null;
+
+        content = content.Trim();
+        if (content.StartsWith("```"))
+        {
+            var end = content.IndexOf('\n');
+            if (end > 0) content = content[(end + 1)..];
+            if (content.EndsWith("```"))
+                content = content[..^3];
+        }
+
+        content = content.Trim();
+        try { return JsonDocument.Parse(content).RootElement; }
+        catch { return null; }
+    }
+}

backend/src/Health.Infrastructure/Users/EfUserRepository.cs

@@ -0,0 +1,51 @@
+using Health.Application.Users;
+
+namespace Health.Infrastructure.Users;
+
+public sealed class EfUserRepository(AppDbContext db) : IUserRepository
+{
+    private readonly AppDbContext _db = db;
+
+    public Task<User?> GetAsync(Guid userId, CancellationToken ct) =>
+        _db.Users.FirstOrDefaultAsync(u => u.Id == userId, ct);
+
+    public Task SaveChangesAsync(CancellationToken ct) =>
+        _db.SaveChangesAsync(ct);
+
+    public async Task DeleteAccountDataAsync(Guid userId, CancellationToken ct)
+    {
+        await using var transaction = await _db.Database.BeginTransactionAsync(ct);
+
+        var profile = await _db.DoctorProfiles.FirstOrDefaultAsync(p => p.UserId == userId, ct);
+        if (profile?.DoctorId != null)
+        {
+            await _db.Users.Where(u => u.DoctorId == profile.DoctorId)
+                .ExecuteUpdateAsync(u => u.SetProperty(x => x.DoctorId, (Guid?)null), ct);
+            await _db.Doctors.Where(d => d.Id == profile.DoctorId).ExecuteDeleteAsync(ct);
+        }
+
+        await _db.HealthRecords.Where(r => r.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.MedicationLogs.Where(l => l.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.Medications.Where(m => m.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.DietFoodItems.Where(i => i.DietRecord!.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.DietRecords.Where(d => d.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.ExercisePlanItems.Where(i => i.Plan!.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.ExercisePlans.Where(p => p.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.ReportAnalysisTasks.Where(t => _db.Reports.Any(r => r.Id == t.ReportId && r.UserId == userId)).ExecuteDeleteAsync(ct);
+        await _db.Reports.Where(r => r.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.ConversationMessages.Where(m => m.Conversation!.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.Conversations.Where(c => c.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.ConsultationMessages.Where(m => m.Consultation!.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.Consultations.Where(c => c.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.FollowUps.Where(f => f.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.RefreshTokens.Where(t => t.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.DeviceTokens.Where(t => t.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.NotificationPreferences.Where(p => p.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.HealthArchives.Where(a => a.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.AiWriteCommands.Where(c => c.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.DoctorProfiles.Where(p => p.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.Users.Where(u => u.Id == userId).ExecuteDeleteAsync(ct);
+
+        await transaction.CommitAsync(ct);
+    }
+}

backend/src/Health.WebApi/BackgroundServices/cleanup_service.cs

@@ -1,8 +1,7 @@
+using Health.Application.Maintenance;
+
 namespace Health.WebApi.BackgroundServices;
 
-/// <summary>
-/// 数据清理后台服务（每小时检查一次）
-/// </summary>
 public sealed class CleanupService(IServiceScopeFactory scopeFactory, ILogger<CleanupService> logger) : BackgroundService
 {
     private readonly IServiceScopeFactory _scopeFactory = scopeFactory;
@@ -15,44 +14,21 @@ public sealed class CleanupService(IServiceScopeFactory scopeFactory, ILogger<Cl
             try
             {
                 using var scope = _scopeFactory.CreateScope();
-                var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
-
-                // 清理 30 天前的对话记录（先删消息再删对话，避免 FK 冲突）
-                var cutoff = DateTime.UtcNow.AddDays(-30);
-                var oldConvIds = await db.Conversations
-                    .Where(c => c.UpdatedAt < cutoff)
-                    .Select(c => c.Id)
-                    .ToListAsync(stoppingToken);
-
-                if (oldConvIds.Count > 0)
+                var maintenance = scope.ServiceProvider.GetRequiredService<IMaintenanceService>();
+                var result = await maintenance.CleanupAsync(DateTime.UtcNow, stoppingToken);
+                if (result.Conversations + result.VerificationCodes + result.BackgroundTasks > 0)
                 {
-                    // 先批量删消息
-                    var oldMessages = await db.ConversationMessages
-                        .Where(m => oldConvIds.Contains(m.ConversationId))
-                        .ToListAsync(stoppingToken);
-                    db.ConversationMessages.RemoveRange(oldMessages);
-
-                    // 再删对话
-                    var oldConversations = await db.Conversations
-                        .Where(c => oldConvIds.Contains(c.Id))
-                        .ToListAsync(stoppingToken);
-                    db.Conversations.RemoveRange(oldConversations);
-
-                    await db.SaveChangesAsync(stoppingToken);
-                    _logger.LogInformation("清理 {Count} 条过期对话", oldConvIds.Count);
-                }
-
-                // 清理过期验证码
-                var expiredCodes = await db.VerificationCodes
-                    .Where(v => v.ExpiresAt < DateTime.UtcNow)
-                    .ToListAsync(stoppingToken);
-
-                if (expiredCodes.Count > 0)
-                {
-                    db.VerificationCodes.RemoveRange(expiredCodes);
-                    await db.SaveChangesAsync(stoppingToken);
+                    _logger.LogInformation(
+                        "自动清理完成: 会话 {Conversations}, 验证码 {Codes}, 后台任务 {Tasks}",
+                        result.Conversations,
+                        result.VerificationCodes,
+                        result.BackgroundTasks);
                 }
             }
+            catch (OperationCanceledException) when (stoppingToken.IsCancellationRequested)
+            {
+                break;
+            }
             catch (Exception ex)
             {
                 _logger.LogError(ex, "数据清理异常");

backend/src/Health.WebApi/BackgroundServices/diet_image_analysis_worker.cs

@@ -0,0 +1,73 @@
+using Health.Application.Diets;
+
+namespace Health.WebApi.BackgroundServices;
+
+public sealed class DietImageAnalysisWorker(
+    IServiceScopeFactory scopeFactory,
+    ILogger<DietImageAnalysisWorker> logger) : BackgroundService
+{
+    private readonly IServiceScopeFactory _scopeFactory = scopeFactory;
+    private readonly ILogger<DietImageAnalysisWorker> _logger = logger;
+
+    protected override async Task ExecuteAsync(CancellationToken stoppingToken)
+    {
+        _logger.LogInformation("饮食图片识别持久化任务消费者已启动");
+        var idleDelay = TimeSpan.FromSeconds(1);
+        var nextRecovery = DateTime.MinValue;
+
+        while (!stoppingToken.IsCancellationRequested)
+        {
+            try
+            {
+                using var scope = _scopeFactory.CreateScope();
+                var queue = scope.ServiceProvider.GetRequiredService<IDietImageAnalysisQueue>();
+                if (DateTime.UtcNow >= nextRecovery)
+                {
+                    await queue.RecoverStaleAsync(stoppingToken);
+                    nextRecovery = DateTime.UtcNow.AddMinutes(1);
+                }
+
+                var job = await queue.TryTakeAsync(stoppingToken);
+                if (job == null)
+                {
+                    await Task.Delay(idleDelay, stoppingToken);
+                    idleDelay = TimeSpan.FromSeconds(Math.Min(idleDelay.TotalSeconds * 2, 5));
+                    continue;
+                }
+
+                idleDelay = TimeSpan.FromSeconds(1);
+                try
+                {
+                    var analyzer = scope.ServiceProvider.GetRequiredService<IDietImageAnalyzer>();
+                    var result = await analyzer.AnalyzeAsync(job, stoppingToken);
+                    await queue.CompleteAsync(job.Id, result, stoppingToken);
+                    DeleteFiles(job.FilePaths);
+                }
+                catch (Exception ex) when (ex is not OperationCanceledException)
+                {
+                    _logger.LogError(ex, "饮食图片识别任务失败: {JobId}", job.Id);
+                    var terminal = await queue.RetryAsync(job.Id, ex.Message, stoppingToken);
+                    if (terminal) DeleteFiles(job.FilePaths);
+                }
+            }
+            catch (OperationCanceledException) when (stoppingToken.IsCancellationRequested)
+            {
+                break;
+            }
+            catch (Exception ex)
+            {
+                _logger.LogError(ex, "饮食图片识别消费者循环异常");
+                await Task.Delay(TimeSpan.FromSeconds(2), stoppingToken);
+            }
+        }
+    }
+
+    private static void DeleteFiles(IEnumerable<string> paths)
+    {
+        foreach (var path in paths)
+        {
+            try { if (File.Exists(path)) File.Delete(path); }
+            catch { }
+        }
+    }
+}

backend/src/Health.WebApi/BackgroundServices/exercise_reminder_service.cs

@@ -0,0 +1,32 @@
+using Health.Application.Exercises;
+
+namespace Health.WebApi.BackgroundServices;
+
+public sealed class ExerciseReminderService(IServiceScopeFactory scopeFactory, ILogger<ExerciseReminderService> logger) : BackgroundService
+{
+    private readonly IServiceScopeFactory _scopeFactory = scopeFactory;
+    private readonly ILogger<ExerciseReminderService> _logger = logger;
+
+    protected override async Task ExecuteAsync(CancellationToken stoppingToken)
+    {
+        while (!stoppingToken.IsCancellationRequested)
+        {
+            try
+            {
+                using var scope = _scopeFactory.CreateScope();
+                var producer = scope.ServiceProvider.GetRequiredService<IExerciseReminderProducer>();
+                var count = await producer.ProduceDueAsync(DateTime.UtcNow, stoppingToken);
+                if (count > 0) _logger.LogInformation("已生成 {Count} 条 App 内运动提醒", count);
+            }
+            catch (OperationCanceledException) when (stoppingToken.IsCancellationRequested)
+            {
+                break;
+            }
+            catch (Exception ex)
+            {
+                _logger.LogError(ex, "生成运动提醒失败");
+            }
+            await Task.Delay(TimeSpan.FromMinutes(1), stoppingToken);
+        }
+    }
+}

backend/src/Health.WebApi/BackgroundServices/medication_reminder_service.cs

@@ -1,22 +1,31 @@
+using Health.Application.Medications;
+
 namespace Health.WebApi.BackgroundServices;
 
-/// <summary>
-/// 用药提醒定时扫描服务（每分钟检查一次）
-/// </summary>
-public sealed class MedicationReminderService(IServiceScopeFactory scopeFactory, ILogger<MedicationReminderService> logger) : BackgroundService
+public sealed class MedicationReminderService(
+    IServiceScopeFactory scopeFactory,
+    ILogger<MedicationReminderService> logger) : BackgroundService
 {
     private readonly IServiceScopeFactory _scopeFactory = scopeFactory;
     private readonly ILogger<MedicationReminderService> _logger = logger;
 
     protected override async Task ExecuteAsync(CancellationToken stoppingToken)
     {
-        _logger.LogInformation("用药提醒服务已启动");
-
+        _logger.LogInformation("用药提醒扫描生产者已启动");
         while (!stoppingToken.IsCancellationRequested)
         {
             try
             {
-                await ProcessReminders(stoppingToken);
+                using var scope = _scopeFactory.CreateScope();
+                var scanner = scope.ServiceProvider.GetRequiredService<IMedicationReminderScanner>();
+                var queue = scope.ServiceProvider.GetRequiredService<IMedicationReminderQueue>();
+                var tasks = await scanner.ScanAsync(DateTime.UtcNow, stoppingToken);
+                foreach (var task in tasks)
+                    await queue.EnqueueAsync(task, stoppingToken);
+            }
+            catch (OperationCanceledException) when (stoppingToken.IsCancellationRequested)
+            {
+                break;
             }
             catch (Exception ex)
             {
@@ -26,37 +35,4 @@ public sealed class MedicationReminderService(IServiceScopeFactory scopeFactory,
             await Task.Delay(TimeSpan.FromMinutes(1), stoppingToken);
         }
     }
-
-    private async Task ProcessReminders(CancellationToken ct)
-    {
-        using var scope = _scopeFactory.CreateScope();
-        var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
-        // 北京时间今天0点 → 转为UTC
-        var beijingToday = DateTime.UtcNow.AddHours(8).Date;
-        var todayStartUtc = beijingToday.AddHours(-8);
-
-        // 查询：启用的用药计划 AND 服药时间在当前时间前后5分钟窗口内
-        var beijingTime = TimeOnly.FromDateTime(DateTime.UtcNow.AddHours(8));
-        var windowStart = beijingTime.AddMinutes(-5);
-        var medications = await db.Medications
-            .Where(m => m.IsActive)
-            .Where(m => m.TimeOfDay.Any(t =>
-                beijingTime > windowStart ? (t >= windowStart && t <= beijingTime) : (t >= windowStart || t <= beijingTime)))
-            .ToListAsync(ct);
-
-        foreach (var med in medications)
-        {
-            // 检查今天是否已打卡（用正确的北京时间区间）
-            var alreadyLogged = await db.MedicationLogs
-                .AnyAsync(l => l.MedicationId == med.Id
-                    && l.CreatedAt >= todayStartUtc
-                    && l.Status == MedicationLogStatus.Taken, ct);
-
-            if (alreadyLogged) continue;
-
-            // TODO: 调用极光推送发送用药提醒
-            _logger.LogInformation("用药提醒: 用户 {UserId} 药品 {Name} {Dosage} 时间 {Time}",
-                med.UserId, med.Name, med.Dosage, beijingTime);
-        }
-    }
 }

backend/src/Health.WebApi/BackgroundServices/medication_reminder_worker.cs

@@ -0,0 +1,62 @@
+using Health.Application.Medications;
+
+namespace Health.WebApi.BackgroundServices;
+
+public sealed class MedicationReminderWorker(
+    IServiceScopeFactory scopeFactory,
+    ILogger<MedicationReminderWorker> logger) : BackgroundService
+{
+    private readonly IServiceScopeFactory _scopeFactory = scopeFactory;
+    private readonly ILogger<MedicationReminderWorker> _logger = logger;
+
+    protected override async Task ExecuteAsync(CancellationToken stoppingToken)
+    {
+        _logger.LogInformation("用药提醒持久化任务消费者已启动");
+        var idleDelay = TimeSpan.FromSeconds(1);
+        var nextRecovery = DateTime.MinValue;
+
+        while (!stoppingToken.IsCancellationRequested)
+        {
+            try
+            {
+                using var scope = _scopeFactory.CreateScope();
+                var queue = scope.ServiceProvider.GetRequiredService<IMedicationReminderQueue>();
+                if (DateTime.UtcNow >= nextRecovery)
+                {
+                    await queue.RecoverStaleAsync(stoppingToken);
+                    nextRecovery = DateTime.UtcNow.AddMinutes(1);
+                }
+
+                var task = await queue.TryTakeAsync(stoppingToken);
+                if (task == null)
+                {
+                    await Task.Delay(idleDelay, stoppingToken);
+                    idleDelay = TimeSpan.FromSeconds(Math.Min(idleDelay.TotalSeconds * 2, 5));
+                    continue;
+                }
+
+                idleDelay = TimeSpan.FromSeconds(1);
+                try
+                {
+                    var dispatcher = scope.ServiceProvider.GetRequiredService<IMedicationReminderDispatcher>();
+                    await dispatcher.DispatchAsync(task, stoppingToken);
+                    await queue.CompleteAsync(task.TaskId, stoppingToken);
+                }
+                catch (Exception ex)
+                {
+                    _logger.LogError(ex, "用药提醒消费失败: {MedicationId}", task.MedicationId);
+                    await queue.RetryAsync(task.TaskId, ex.Message, stoppingToken);
+                }
+            }
+            catch (OperationCanceledException) when (stoppingToken.IsCancellationRequested)
+            {
+                break;
+            }
+            catch (Exception ex)
+            {
+                _logger.LogError(ex, "用药提醒消费者循环异常");
+                await Task.Delay(TimeSpan.FromSeconds(2), stoppingToken);
+            }
+        }
+    }
+}

backend/src/Health.WebApi/BackgroundServices/report_analysis_worker.cs

@@ -0,0 +1,60 @@
+using Health.Application.Reports;
+
+namespace Health.WebApi.BackgroundServices;
+
+public sealed class ReportAnalysisWorker(
+    IServiceScopeFactory scopeFactory,
+    ILogger<ReportAnalysisWorker> logger) : BackgroundService
+{
+    private readonly IServiceScopeFactory _scopeFactory = scopeFactory;
+    private readonly ILogger<ReportAnalysisWorker> _logger = logger;
+
+    protected override async Task ExecuteAsync(CancellationToken stoppingToken)
+    {
+        _logger.LogInformation("报告 AI 持久化任务消费者已启动");
+        var idleDelay = TimeSpan.FromSeconds(1);
+        var nextRecovery = DateTime.MinValue;
+        while (!stoppingToken.IsCancellationRequested)
+        {
+            try
+            {
+                using var scope = _scopeFactory.CreateScope();
+                var queue = scope.ServiceProvider.GetRequiredService<IReportAnalysisQueue>();
+                if (DateTime.UtcNow >= nextRecovery)
+                {
+                    await queue.RecoverStaleAsync(stoppingToken);
+                    nextRecovery = DateTime.UtcNow.AddMinutes(1);
+                }
+                var job = await queue.TryTakeAsync(stoppingToken);
+                if (job == null)
+                {
+                    await Task.Delay(idleDelay, stoppingToken);
+                    idleDelay = TimeSpan.FromSeconds(Math.Min(idleDelay.TotalSeconds * 2, 5));
+                    continue;
+                }
+
+                idleDelay = TimeSpan.FromSeconds(1);
+                try
+                {
+                    var analysisService = scope.ServiceProvider.GetRequiredService<IReportAnalysisService>();
+                    await analysisService.AnalyzeAsync(job, stoppingToken);
+                    await queue.CompleteAsync(job.TaskId, stoppingToken);
+                }
+                catch (Exception ex)
+                {
+                    _logger.LogError(ex, "报告 AI 分析任务执行异常: {ReportId}", job.ReportId);
+                    await queue.RetryAsync(job.TaskId, ex.Message, stoppingToken);
+                }
+            }
+            catch (OperationCanceledException) when (stoppingToken.IsCancellationRequested)
+            {
+                break;
+            }
+            catch (Exception ex)
+            {
+                _logger.LogError(ex, "报告任务消费者循环异常");
+                await Task.Delay(TimeSpan.FromSeconds(2), stoppingToken);
+            }
+        }
+    }
+}

backend/src/Health.WebApi/Endpoints/admin_endpoints.cs

@@ -1,201 +1,33 @@
 using System.Security.Claims;
-using Health.Domain.Entities;
-using Microsoft.EntityFrameworkCore;
+using Health.Application.Admin;
 
 namespace Health.WebApi.Endpoints;
 
-/// <summary>
-/// 管理员 API（需JWT鉴权 + Role=Admin）
-/// </summary>
 public static class AdminEndpoints
 {
-    private static readonly Guid AdminId = Guid.Parse("00000000-0000-0000-0000-000000000001");
-
-    private static Guid GetUserId(HttpContext http) =>
-        Guid.TryParse(http.User.FindFirst(ClaimTypes.NameIdentifier)?.Value, out var id) ? id : Guid.Empty;
-
-    private static string GetUserRole(HttpContext http) =>
-        http.User.FindFirst("Role")?.Value ?? http.User.FindFirst(ClaimTypes.Role)?.Value ?? "User";
-
     public static void MapAdminEndpoints(this WebApplication app)
     {
         var group = app.MapGroup("/api/admin").RequireAuthorization();
-
-        // 管理员身份校验
         group.AddEndpointFilter(async (context, next) =>
-        {
-            var role = GetUserRole(context.HttpContext);
-            if (role != "Admin")
-                return Results.Json(new { code = 403, data = (object?)null, message = "仅管理员可访问" }, statusCode: 403);
-            return await next(context);
-        });
+            GetRole(context.HttpContext) == "Admin"
+                ? await next(context)
+                : Results.Json(new { code = 403, data = (object?)null, message = "仅管理员可访问" }, statusCode: 403));
 
-        // ===== 医生列表 =====
-        group.MapGet("/doctors", async (AppDbContext db) =>
-        {
-            var doctors = await db.Doctors
-                .OrderBy(d => d.CreatedAt)
-                .Select(d => new
-                {
-                    d.Id, d.Name, d.Title, d.Department,
-                    d.Phone, d.ProfessionalDirection,
-                    d.IsActive, d.AvatarUrl, d.Introduction,
-                    d.CreatedAt
-                })
-                .ToListAsync();
-
-            return Results.Ok(new { code = 0, data = doctors, message = (string?)null });
-        });
-
-        // ===== 新增医生 =====
-        group.MapPost("/doctors", async (
-            AddDoctorRequest request,
-            AppDbContext db,
-            CancellationToken ct) =>
-        {
-            if (string.IsNullOrWhiteSpace(request.Phone))
-                return Results.Ok(new { code = 40001, data = (object?)null, message = "手机号不能为空" });
-            if (string.IsNullOrWhiteSpace(request.Name))
-                return Results.Ok(new { code = 40002, data = (object?)null, message = "姓名不能为空" });
-
-            var doctor = new Doctor
-            {
-                Id = Guid.NewGuid(),
-                Name = request.Name,
-                Title = request.Title,
-                Department = request.Department,
-                Phone = request.Phone,
-                ProfessionalDirection = request.ProfessionalDirection,
-                IsActive = true,
-                CreatedAt = DateTime.UtcNow,
-            };
-            db.Doctors.Add(doctor);
-
-            // 同步创建 User + DoctorProfile，医生可用手机号登录
-            var existingUser = await db.Users.FirstOrDefaultAsync(u => u.Phone == request.Phone, ct);
-            if (existingUser == null)
-            {
-                var user = new User
-                {
-                    Id = Guid.NewGuid(),
-                    Phone = request.Phone,
-                    Role = "Doctor",
-                    Name = request.Name,
-                    CreatedAt = DateTime.UtcNow,
-                    UpdatedAt = DateTime.UtcNow,
-                };
-                db.Users.Add(user);
-                db.DoctorProfiles.Add(new DoctorProfile
-                {
-                    Id = Guid.NewGuid(),
-                    UserId = user.Id,
-                    DoctorId = doctor.Id,
-                    Name = request.Name,
-                    Title = request.Title,
-                    Department = request.Department,
-                    IsActive = true,
-                    CreatedAt = DateTime.UtcNow,
-                    UpdatedAt = DateTime.UtcNow,
-                });
-            }
-
-            await db.SaveChangesAsync(ct);
-
-            return Results.Ok(new { code = 0, data = new { doctor.Id, doctor.Name }, message = (string?)null });
-        });
-
-        // ===== 编辑医生 =====
-        group.MapPut("/doctors/{id:guid}", async (
-            Guid id, UpdateDoctorRequest request, AppDbContext db, CancellationToken ct) =>
-        {
-            var doctor = await db.Doctors.FindAsync([id], ct);
-            if (doctor == null)
-                return Results.Ok(new { code = 404, data = (object?)null, message = "医生不存在" });
-
-            if (request.Name != null) doctor.Name = request.Name;
-            if (request.Title != null) doctor.Title = request.Title;
-            if (request.Department != null) doctor.Department = request.Department;
-            if (request.Phone != null) doctor.Phone = request.Phone;
-            if (request.ProfessionalDirection != null) doctor.ProfessionalDirection = request.ProfessionalDirection;
-
-            await db.SaveChangesAsync(ct);
-            return Results.Ok(new { code = 0, data = new { doctor.Id }, message = (string?)null });
-        });
-
-        // ===== 启用/停用医生 =====
-        group.MapPut("/doctors/{id:guid}/disable", async (
-            Guid id, AppDbContext db, CancellationToken ct) =>
-        {
-            var doctor = await db.Doctors.FindAsync([id], ct);
-            if (doctor == null)
-                return Results.Ok(new { code = 404, data = (object?)null, message = "医生不存在" });
-
-            doctor.IsActive = !doctor.IsActive;
-            await db.SaveChangesAsync(ct);
-
-            return Results.Ok(new { code = 0, data = new { doctor.Id, doctor.IsActive }, message = (string?)null });
-        });
-
-        // ===== 删除医生 =====
-        group.MapDelete("/doctors/{id:guid}", async (
-            Guid id, AppDbContext db, CancellationToken ct) =>
-        {
-            var doctor = await db.Doctors.FindAsync([id], ct);
-            if (doctor == null)
-                return Results.Ok(new { code = 404, data = (object?)null, message = "医生不存在" });
-
-            // 清除患者的 DoctorId 关联
-            await db.Users.Where(u => u.DoctorId == id)
-                .ExecuteUpdateAsync(s => s.SetProperty(u => u.DoctorId, (Guid?)null), ct);
-
-            db.Doctors.Remove(doctor);
-            await db.SaveChangesAsync(ct);
-
-            return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
-        });
-
-        // ===== 患者列表 =====
-        group.MapGet("/patients", async (
-            AppDbContext db,
-            string? search,
-            int? page,
-            int? pageSize) =>
-        {
-            var p = page ?? 1;
-            var ps = pageSize ?? 20;
-            var query = db.Users
-                .Where(u => u.Role == "User")
-                .AsQueryable();
-
-            if (!string.IsNullOrWhiteSpace(search))
-            {
-                query = query.Where(u => u.Name!.Contains(search) || u.Phone.Contains(search));
-            }
-
-            var total = await query.CountAsync();
-            var patients = await query
-                .OrderByDescending(u => u.CreatedAt)
-                .Skip((p - 1) * ps)
-                .Take(ps)
-                .Select(u => new
-                {
-                    u.Id, u.Name, u.Phone, u.Gender,
-                    u.BirthDate, u.CreatedAt,
-                    DoctorName = u.Doctor != null ? u.Doctor.Name : null,
-                    DoctorDepartment = u.Doctor != null ? u.Doctor.Department : null,
-                })
-                .ToListAsync();
-
-            return Results.Ok(new
-            {
-                code = 0,
-                data = new { patients, total, page = p, pageSize = ps },
-                message = (string?)null
-            });
-        });
+        group.MapGet("/doctors", async (IAdminService admin, CancellationToken ct) => ToResult(await admin.ListDoctorsAsync(ct)));
+        group.MapPost("/doctors", async (AddDoctorRequest request, IAdminService admin, CancellationToken ct) =>
+            ToResult(await admin.AddDoctorAsync(new AddDoctorCommand(request.Phone, request.Name, request.Title, request.Department, request.ProfessionalDirection), ct)));
+        group.MapPut("/doctors/{id:guid}", async (Guid id, UpdateDoctorRequest request, IAdminService admin, CancellationToken ct) =>
+            ToResult(await admin.UpdateDoctorAsync(id, new UpdateDoctorCommand(request.Phone, request.Name, request.Title, request.Department, request.ProfessionalDirection), ct)));
+        group.MapPut("/doctors/{id:guid}/disable", async (Guid id, IAdminService admin, CancellationToken ct) => ToResult(await admin.ToggleDoctorAsync(id, ct)));
+        group.MapDelete("/doctors/{id:guid}", async (Guid id, IAdminService admin, CancellationToken ct) => ToResult(await admin.DeleteDoctorAsync(id, ct)));
+        group.MapGet("/patients", async (IAdminService admin, string? search, int? page, int? pageSize, CancellationToken ct) =>
+            ToResult(await admin.ListPatientsAsync(search, page ?? 1, pageSize ?? 20, ct)));
     }
+
+    private static string GetRole(HttpContext http) =>
+        http.User.FindFirst("Role")?.Value ?? http.User.FindFirst(ClaimTypes.Role)?.Value ?? "User";
+    private static IResult ToResult(AdminResult result) => Results.Ok(new { code = result.Code, data = result.Data, message = result.Message });
 }
 
-// ---- DTO ----
 public sealed record AddDoctorRequest(string Phone, string Name, string? Title, string? Department, string? ProfessionalDirection);
 public sealed record UpdateDoctorRequest(string? Phone, string? Name, string? Title, string? Department, string? ProfessionalDirection);

backend/src/Health.WebApi/Endpoints/ai_chat_endpoints.cs

@@ -1,6 +1,11 @@
-using System.Drawing;
-using System.Drawing.Imaging;
 using System.Text.Json;
+using System.Text.RegularExpressions;
+using Health.Application.AI;
+using Health.Application.Diets;
+using Health.Application.Exercises;
+using Health.Application.HealthArchives;
+using Health.Application.HealthRecords;
+using Health.Application.Medications;
 using Health.Infrastructure.AI;
 using Health.Infrastructure.AI.AgentHandlers;
 
@@ -26,10 +31,12 @@ public static class AiChatEndpoints
             string token,
             string agentType,
             HttpContext http,
-            AppDbContext db,
             DeepSeekClient llmClient,
             PromptManager promptManager,
-            VisionClient visionClient,
+            IAiToolExecutionService toolExecution,
+            IAiWriteConfirmationStore confirmations,
+            IAiConversationService conversations,
+            IPatientContextService patientContexts,
             CancellationToken ct) =>
         {
             // 支持 token 通过 query string（浏览器 EventSource）或 header 传递
@@ -51,38 +58,57 @@ public static class AiChatEndpoints
             http.Response.Headers.Connection = "keep-alive";
             http.Response.Headers["X-Accel-Buffering"] = "no";
 
-            // 创建或获取对话
-            Conversation? conversation = null;
-            if (!string.IsNullOrEmpty(conversationId) && Guid.TryParse(conversationId, out var convId))
-                conversation = await db.Conversations.FindAsync([convId], ct);
-
-            if (conversation == null)
+            // 创建或获取对话。传入 conversationId 时必须校验归属，避免多账号切换或缓存异常导致串号。
+            Guid? requestedConversationId = null;
+            if (!string.IsNullOrWhiteSpace(conversationId))
             {
-                conversation = new Conversation
+                if (!Guid.TryParse(conversationId, out var convId))
                 {
-                    Id = Guid.NewGuid(), UserId = userId.Value, AgentType = parsedType,
-                    Title = message.Length > 30 ? message[..30] : message,
-                    CreatedAt = DateTime.UtcNow, UpdatedAt = DateTime.UtcNow,
-                };
-                db.Conversations.Add(conversation);
-                await db.SaveChangesAsync(ct);
-                await SseWriteAsync(http, new { action = "conversation_id", data = conversation.Id.ToString() }, ct);
+                    await SseWriteAsync(http, new { action = "answer", data = "当前会话参数异常，请重新开始一次对话。" }, ct);
+                    await SseWriteAsync(http, new { action = "status", data = "error" }, ct);
+                    await http.Response.WriteAsync("data: [DONE]\n\n", ct);
+                    return;
+                }
+                requestedConversationId = convId;
             }
 
-            // 保存用户消息
-            var userMsg = new ConversationMessage
+            var opened = await conversations.OpenAsync(userId.Value, requestedConversationId, parsedType, message, ct);
+            if (!opened.Found)
             {
-                Id = Guid.NewGuid(), ConversationId = conversation.Id, Role = MessageRole.User,
-                Content = message, CreatedAt = DateTime.UtcNow,
-            };
-            db.ConversationMessages.Add(userMsg);
-            conversation.MessageCount++;
-            conversation.UpdatedAt = DateTime.UtcNow;
-            await db.SaveChangesAsync(ct);
+                await SseWriteAsync(http, new { action = "answer", data = "当前会话不存在或不属于当前账号，请重新开始一次对话。" }, ct);
+                await SseWriteAsync(http, new { action = "status", data = "error" }, ct);
+                await http.Response.WriteAsync("data: [DONE]\n\n", ct);
+                return;
+            }
+            var activeConversationId = opened.ConversationId;
+            if (opened.Created)
+                await SseWriteAsync(http, new { action = "conversation_id", data = activeConversationId.ToString() }, ct);
+
+            await conversations.AddUserMessageAsync(activeConversationId, message, ct);
+
+            var urgentWarning = DetectUrgentRisk(message);
+            if (!string.IsNullOrEmpty(urgentWarning))
+            {
+                var urgentResponse = $"""
+                    {urgentWarning}
+
+                    这种情况需要把安全放在第一位。请先停止自行判断和等待 AI 分析，尽快联系医生、互联网医院或前往急诊评估；如果症状正在加重，建议立即拨打当地急救电话。若身边有人，请让家人或同伴陪同，不要独自开车就医。
+
+                    以上为 AI 安全提醒，不能替代医生诊断和治疗建议。
+                    """;
+
+                await conversations.AddAssistantMessageAsync(activeConversationId, urgentResponse, ct);
+
+                await SseWriteAsync(http, new { action = "notice", message = "检测到可能的危险信号，优先给出就医提醒" }, ct);
+                await SseWriteAsync(http, new { action = "answer", data = urgentResponse, type = "text" }, ct);
+                await SseWriteAsync(http, new { action = "status", data = "done" }, ct);
+                await http.Response.WriteAsync("data: [DONE]\n\n", ct);
+                return;
+            }
 
             // 加载上下文
             var systemPrompt = promptManager.GetSystemPrompt(parsedType);
-            var patientContext = await BuildPatientContext(db, userId.Value, ct);
+            var patientContext = await patientContexts.BuildAsync(userId.Value, ct);
 
             var messages = new List<ChatMessage>
             {
@@ -90,17 +116,13 @@ public static class AiChatEndpoints
             };
 
             // 加载历史对话（最近 10 条）
-            var history = await db.ConversationMessages
-                .Where(m => m.ConversationId == conversation.Id)
-                .OrderByDescending(m => m.CreatedAt)
-                .Take(12)
-                .ToListAsync(ct);
+            var history = await conversations.GetRecentMessagesAsync(activeConversationId, 12, ct);
 
-            foreach (var h in history.Reverse<ConversationMessage>())
+            foreach (var h in history)
             {
                 messages.Add(new ChatMessage
                 {
-                    Role = h.Role == MessageRole.User ? "user" : "assistant",
+                    Role = h.Role == MessageRole.User.ToString() ? "user" : "assistant",
                     Content = h.Content,
                 });
             }
@@ -155,7 +177,9 @@ public static class AiChatEndpoints
                         object toolResult;
                         try
                         {
-                            toolResult = await ExecuteToolCall(tc.Function.Name, tc.Function.Arguments, db, userId.Value, visionClient);
+                            toolResult = IsWriteToolCall(tc.Function.Name, tc.Function.Arguments)
+                                ? await PreparePendingWriteAsync(confirmations, userId.Value, tc.Function.Name, tc.Function.Arguments, ct)
+                                : await toolExecution.ExecuteAsync(tc.Function.Name, tc.Function.Arguments, userId.Value, ct);
                         }
                         catch (Exception ex)
                         {
@@ -173,71 +197,62 @@ public static class AiChatEndpoints
 
             // 保存 AI 回复
             if (!string.IsNullOrEmpty(fullResponse))
-            {
-                db.ConversationMessages.Add(new ConversationMessage
-                {
-                    Id = Guid.NewGuid(), ConversationId = conversation.Id, Role = MessageRole.Assistant,
-                    Content = fullResponse, CreatedAt = DateTime.UtcNow,
-                });
-                conversation.MessageCount++;
-                conversation.Summary = fullResponse.Length > 100 ? fullResponse[..100] : fullResponse;
-                conversation.UpdatedAt = DateTime.UtcNow;
-                await db.SaveChangesAsync(ct);
-            }
+                await conversations.AddAssistantMessageAsync(activeConversationId, fullResponse, ct);
 
             await SseWriteAsync(http, new { action = "status", data = completedNormally ? "done" : "error" }, ct);
             await http.Response.WriteAsync("data: [DONE]\n\n", ct);
         });
 
+        app.MapPost("/api/ai/confirm-write/{commandId:guid}", async (
+            Guid commandId,
+            HttpContext http,
+            IAiToolExecutionService toolExecution,
+            CancellationToken ct) =>
+        {
+            var userId = GetUserId(http);
+            if (userId == null)
+                return Results.Json(new { code = 40002, data = (object?)null, message = "未登录" }, statusCode: 401);
+
+            var result = await toolExecution.ConfirmAsync(commandId, userId.Value, ct);
+            return Results.Ok(new { code = result.Code, data = result.Data, message = result.Message });
+        }).RequireAuthorization();
+
         // 获取对话列表
-        app.MapGet("/api/ai/conversations", async (HttpContext http, AppDbContext db, CancellationToken ct) =>
+        app.MapGet("/api/ai/conversations", async (HttpContext http, IAiConversationService conversations, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
             if (userId == null) return Results.Json(new { code = 40002, data = (object?)null, message = "未登录" }, statusCode: 401);
 
-            var conversations = await db.Conversations
-                .Where(c => c.UserId == userId.Value)
-                .OrderByDescending(c => c.UpdatedAt)
-                .Select(c => new { c.Id, AgentType = c.AgentType.ToString(), c.Title, c.Summary, c.MessageCount, c.CreatedAt, c.UpdatedAt })
-                .ToListAsync(ct);
+            var result = await conversations.ListAsync(userId.Value, ct);
 
-            return Results.Ok(new { code = 0, data = conversations, message = (string?)null });
+            return Results.Ok(new { code = 0, data = result, message = (string?)null });
         });
 
         // 获取对话历史
-        app.MapGet("/api/ai/conversations/{id:guid}", async (Guid id, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        app.MapGet("/api/ai/conversations/{id:guid}", async (Guid id, HttpContext http, IAiConversationService conversations, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
             if (userId == null) return Results.Json(new { code = 40002 }, statusCode: 401);
 
-            var messages = await db.ConversationMessages
-                .Where(m => m.ConversationId == id && m.Conversation.UserId == userId.Value)
-                .OrderBy(m => m.CreatedAt)
-                .Select(m => new { m.Id, Role = m.Role.ToString(), m.Content, m.Intent, m.MetadataJson, m.CreatedAt })
-                .ToListAsync(ct);
+            var messages = await conversations.GetMessagesAsync(userId.Value, id, ct);
 
             return Results.Ok(new { code = 0, data = messages, message = (string?)null });
         });
 
         // 删除对话
-        app.MapDelete("/api/ai/conversations/{id:guid}", async (Guid id, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        app.MapDelete("/api/ai/conversations/{id:guid}", async (Guid id, HttpContext http, IAiConversationService conversations, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
             if (userId == null) return Results.Json(new { code = 40002 }, statusCode: 401);
 
-            var conv = await db.Conversations.FirstOrDefaultAsync(c => c.Id == id && c.UserId == userId.Value, ct);
-            if (conv != null)
-            {
-                db.Conversations.Remove(conv);
-                await db.SaveChangesAsync(ct);
-            }
+            await conversations.DeleteAsync(userId.Value, id, ct);
             return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
         });
 
-        // VLM 食物识别
         app.MapPost("/api/ai/analyze-food-image", async (
-            HttpRequest httpRequest, HttpContext http,
-            VisionClient visionClient, AppDbContext db,
+            HttpRequest httpRequest,
+            HttpContext http,
+            IDietImageAnalysisCoordinator dietAnalysis,
             CancellationToken ct) =>
         {
             var userId = GetUserId(http);
@@ -245,61 +260,19 @@ public static class AiChatEndpoints
 
             var form = await httpRequest.ReadFormAsync(ct);
             var files = form.Files.GetFiles("images");
-            if (files == null || files.Count == 0)
-                return Results.Ok(new { code = 40001, data = (object?)null, message = "请上传至少一张图片" });
-
-            var imageUrls = new List<string>();
-            var uploadsDir = Path.Combine(Directory.GetCurrentDirectory(), "uploads");
-            Directory.CreateDirectory(uploadsDir);
-
-            foreach (var file in files)
+            var uploads = files
+                .Select(file => new DietImageUploadFile(file.FileName, file.Length, file.OpenReadStream()))
+                .ToList();
+            try
             {
-                if (file.Length > 20 * 1024 * 1024)
-                    return Results.Ok(new { code = 40001, data = (object?)null, message = "文件大小超过 20MB 限制" });
-
-                var ext = Path.GetExtension(file.FileName).ToLowerInvariant();
-                if (ext is not ".jpg" and not ".jpeg" and not ".png" and not ".heic")
-                    return Results.Ok(new { code = 40001, data = (object?)null, message = "不支持的图片格式，仅支持 JPG/PNG/HEIC" });
-
-                var safeName = $"{Guid.NewGuid()}_{Path.GetFileName(file.FileName)}";
-                var filePath = Path.Combine(uploadsDir, safeName);
-                using (var stream = new FileStream(filePath, FileMode.Create))
-                    await file.CopyToAsync(stream, ct);
-
-                // 千问3.7-plus + vl_high_resolution_images=true 支持到 16M 像素，保留原图细节
-                // base64 ≥ 7MB（官方限制）时才压缩，否则原图上传
-                var fileBytes = await File.ReadAllBytesAsync(filePath, ct);
-                var base64 = Convert.ToBase64String(fileBytes);
-                if (base64.Length > 7 * 1024 * 1024)
-                {
-                    var compressedPath = Path.Combine(uploadsDir, $"compressed_{safeName}");
-                    CompressImage(filePath, compressedPath, maxWidth: 2048, quality: 85L);
-                    fileBytes = await File.ReadAllBytesAsync(compressedPath, ct);
-                    base64 = Convert.ToBase64String(fileBytes);
-                }
-                imageUrls.Add($"data:image/jpeg;base64,{base64}");
+                var result = await dietAnalysis.AnalyzeAsync(uploads, ct);
+                return Results.Ok(new { code = result.Code, data = result.Data, message = result.Message });
+            }
+            finally
+            {
+                foreach (var upload in uploads)
+                    await upload.Content.DisposeAsync();
             }
-
-            var prompt = """
-                识别图片中的食物和饮品，返回JSON数组：
-                [{"name":"名称","portion":"份量","calories":热量}]
-                只返回JSON，不要其他内容。
-                """;
-
-                try
-                {
-                    var response = await visionClient.VisionAsync(prompt, imageUrls, userText: null, maxTokens: 8192, ct: ct);
-                    var result = response.Choices?.FirstOrDefault()?.Message?.Content ?? "{}";
-                    // 记录VLM原始返回用于排查
-                    var uploadsDir2 = Path.Combine(Directory.GetCurrentDirectory(), "uploads");
-                    var logPath = Path.Combine(uploadsDir2, $"vlm_log_{DateTime.UtcNow:HHmmss}.txt");
-                    await File.WriteAllTextAsync(logPath, $"MODEL: {Environment.GetEnvironmentVariable("VLM_MODEL")}\nIMAGE_SIZE: {imageUrls.FirstOrDefault()?.Length ?? 0}\nRESPONSE:\n{result}", ct);
-                    return Results.Ok(new { code = 0, data = result, message = (string?)null });
-                }
-                catch (Exception ex)
-                {
-                    return Results.Ok(new { code = 50001, data = (object?)null, message = $"食物识别失败：{ex.Message}" });
-                }
         });
     }
 
@@ -348,60 +321,176 @@ public static class AiChatEndpoints
         _ => CommonAgentHandler.Tools,
     };
 
-    private static Task<object> ExecuteToolCall(string toolName, string arguments, AppDbContext db, Guid userId, VisionClient? visionClient = null)
+    private static bool IsWriteToolCall(string toolName, string arguments)
     {
-        using var jsonDoc = JsonDocument.Parse(arguments);
-        var root = jsonDoc.RootElement;
+        if (toolName == "record_health_data") return true;
+        if (toolName == "manage_archive") return GetToolAction(arguments) != "query";
+        if (toolName == "manage_medication") return GetToolAction(arguments) is "create" or "confirm";
+        if (toolName == "manage_exercise") return GetToolAction(arguments) is "create" or "checkin";
+        return false;
+    }
 
-        return toolName switch
+    private static string GetToolAction(string arguments)
+    {
+        try
         {
-            "record_health_data" => HealthDataAgentHandler.Execute(toolName, root, db, userId),
-            "query_health_records" => CommonAgentHandler.Execute(toolName, root, db, userId),
-            "check_archive" => CommonAgentHandler.Execute(toolName, root, db, userId),
-            "manage_medication" => MedicationAgentHandler.Execute(toolName, root, db, userId),
-            "analyze_report" => visionClient != null
-                ? ReportAgentHandler.AnalyzeReport(db, userId, root, visionClient)
-                : Task.FromResult<object>(new { success = false, message = "VLM服务未配置" }),
-            "manage_exercise" => ExerciseAgentHandler.Execute(toolName, root, db, userId),
-            "manage_archive" => CommonAgentHandler.ExecuteManageArchive(db, userId, root),
-            _ => Task.FromResult<object>(new { success = false, message = $"未知工具: {toolName}" })
+            using var json = JsonDocument.Parse(arguments);
+            return json.RootElement.TryGetProperty("action", out var action)
+                ? action.GetString()?.ToLowerInvariant() ?? ""
+                : "";
+        }
+        catch
+        {
+            return "";
+        }
+    }
+
+    private static async Task<object> PreparePendingWriteAsync(
+        IAiWriteConfirmationStore confirmations,
+        Guid userId,
+        string toolName,
+        string arguments,
+        CancellationToken ct)
+    {
+        var command = await confirmations.CreateAsync(userId, toolName, arguments, TimeSpan.FromMinutes(10), ct);
+        using var json = JsonDocument.Parse(arguments);
+        var args = json.RootElement;
+
+        var preview = new Dictionary<string, object?>
+        {
+            ["success"] = true,
+            ["pendingConfirmation"] = true,
+            ["confirmationId"] = command.Id,
+            ["message"] = "等待用户确认后写入",
         };
+
+        switch (toolName)
+        {
+            case "record_health_data":
+                AddHealthPreview(preview, args);
+                break;
+            case "manage_medication":
+                preview["type"] = "medication";
+                preview["name"] = GetString(args, "name") ?? "服药确认";
+                preview["dosage"] = GetString(args, "dosage") ?? "";
+                preview["frequency"] = GetString(args, "frequency") ?? "Daily";
+                preview["time"] = GetStringArray(args, "time_of_day");
+                preview["duration_days"] = GetInt(args, "duration_days") ?? 0;
+                preview["start_date"] = GetString(args, "start_date") ?? DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8)).ToString("yyyy-MM-dd");
+                break;
+            case "manage_exercise":
+                preview["type"] = "exercise";
+                preview["exercise_type"] = GetString(args, "exercise_type") ?? "运动";
+                preview["duration_minutes"] = GetInt(args, "duration_minutes") ?? 30;
+                preview["day_count"] = GetInt(args, "duration_days") ?? 7;
+                preview["start_date"] = GetString(args, "start_date") ?? DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8)).ToString("yyyy-MM-dd");
+                preview["reminder_time"] = GetString(args, "reminder_time") ?? "19:00";
+                break;
+            case "manage_archive":
+                preview["type"] = "archive";
+                preview["value"] = "健康档案更新";
+                preview["unit"] = "";
+                break;
+        }
+
+        return preview;
     }
 
-    // ── 患者上下文构建 ──
-
-    private static async Task<string> BuildPatientContext(AppDbContext db, Guid userId, CancellationToken ct)
+    private static void AddHealthPreview(Dictionary<string, object?> preview, JsonElement args)
     {
-        var archive = await db.HealthArchives.FirstOrDefaultAsync(a => a.UserId == userId, ct);
-        var recentRecords = await db.HealthRecords.Where(r => r.UserId == userId)
-            .OrderByDescending(r => r.RecordedAt).Take(10).ToListAsync(ct);
-
-        var sb = new System.Text.StringBuilder();
-        if (archive != null)
+        var type = GetString(args, "type") ?? "";
+        switch (type)
         {
-            if (!string.IsNullOrEmpty(archive.Diagnosis)) sb.AppendLine($"诊断: {archive.Diagnosis}");
-            if (!string.IsNullOrEmpty(archive.SurgeryType)) sb.AppendLine($"手术: {archive.SurgeryType} ({archive.SurgeryDate})");
-            if (archive.Allergies.Count > 0) sb.AppendLine($"过敏: {string.Join(", ", archive.Allergies)}");
-            if (archive.DietRestrictions.Count > 0) sb.AppendLine($"饮食限制: {string.Join(", ", archive.DietRestrictions)}");
+            case "blood_pressure":
+                var systolic = GetInt(args, "systolic");
+                var diastolic = GetInt(args, "diastolic");
+                preview["type"] = HealthMetricType.BloodPressure.ToString();
+                preview["value"] = $"{systolic}/{diastolic}";
+                preview["unit"] = "mmHg";
+                preview["isAbnormal"] = systolic >= 140 || diastolic >= 90 || systolic <= 89 || diastolic <= 59;
+                break;
+            case "heart_rate":
+                AddMetricPreview(preview, HealthMetricType.HeartRate, GetDecimal(args, "heart_rate"), "次/分", v => v > 100 || v < 60);
+                break;
+            case "glucose":
+                AddMetricPreview(preview, HealthMetricType.Glucose, GetDecimal(args, "glucose"), "mmol/L", v => v >= 7.0m || v <= 3.8m);
+                break;
+            case "spo2":
+                AddMetricPreview(preview, HealthMetricType.SpO2, GetDecimal(args, "spo2"), "%", v => v <= 94);
+                break;
+            case "weight":
+                AddMetricPreview(preview, HealthMetricType.Weight, GetDecimal(args, "weight"), "kg", _ => false);
+                break;
         }
-        if (recentRecords.Count > 0)
-        {
-            sb.AppendLine("近期健康数据:");
-            foreach (var r in recentRecords)
-                sb.AppendLine($"  {r.MetricType}: {RecordValue(r)} ({r.RecordedAt:MM-dd HH:mm})");
-        }
-        return sb.ToString();
     }
 
-    private static string RecordValue(HealthRecord r) => r.MetricType switch
+    private static void AddMetricPreview(
+        Dictionary<string, object?> preview,
+        HealthMetricType type,
+        decimal? value,
+        string unit,
+        Func<decimal, bool> isAbnormal)
     {
-        HealthMetricType.BloodPressure => $"{r.Systolic}/{r.Diastolic}",
-        HealthMetricType.HeartRate => $"{r.Value}次/分",
-        HealthMetricType.Glucose => $"{r.Value}",
-        HealthMetricType.SpO2 => $"{r.Value}%",
-        HealthMetricType.Weight => $"{r.Value}kg",
-        _ => "—"
-    };
+        preview["type"] = type.ToString();
+        preview["value"] = value?.ToString() ?? "";
+        preview["unit"] = unit;
+        preview["isAbnormal"] = value.HasValue && isAbnormal(value.Value);
+    }
+
+    private static string? GetString(JsonElement element, string name) =>
+        element.TryGetProperty(name, out var value) && value.ValueKind == JsonValueKind.String ? value.GetString() : null;
+
+    private static int? GetInt(JsonElement element, string name) =>
+        element.TryGetProperty(name, out var value) && value.TryGetInt32(out var result) ? result : null;
+
+    private static decimal? GetDecimal(JsonElement element, string name) =>
+        element.TryGetProperty(name, out var value) && value.TryGetDecimal(out var result) ? result : null;
+
+    private static string GetStringArray(JsonElement element, string name) =>
+        element.TryGetProperty(name, out var value) && value.ValueKind == JsonValueKind.Array
+            ? string.Join(", ", value.EnumerateArray().Select(x => x.GetString()).Where(x => !string.IsNullOrWhiteSpace(x)))
+            : "";
+
+    private static string? DetectUrgentRisk(string message)
+    {
+        var text = message.Trim();
+        if (string.IsNullOrEmpty(text)) return null;
+
+        if (ContainsAny(text, "剧烈胸痛", "胸口剧痛", "胸痛明显", "胸闷憋气", "喘不上气", "呼吸困难", "呼吸很困难", "意识模糊", "昏厥", "晕厥", "说话不清", "口角歪斜", "一侧无力"))
+            return "你描述的症状可能属于需要紧急评估的危险信号。";
+
+        var bp = Regex.Match(text, @"(?:血压|bp|BP)?\s*(?<sys>\d{2,3})\s*/\s*(?<dia>\d{2,3})");
+        if (bp.Success &&
+            int.TryParse(bp.Groups["sys"].Value, out var systolic) &&
+            int.TryParse(bp.Groups["dia"].Value, out var diastolic) &&
+            (systolic >= 180 || diastolic >= 120))
+        {
+            return $"你提到的血压 {systolic}/{diastolic} mmHg 已达到明显危险范围。";
+        }
+
+        var spo2 = MatchMetricValue(text, "血氧|氧饱和|SpO2|spo2");
+        if (spo2.HasValue && spo2.Value <= 90)
+            return $"你提到的血氧 {spo2.Value:0.#}% 明显偏低。";
+
+        var glucose = MatchMetricValue(text, "血糖|葡萄糖|glucose");
+        if (glucose.HasValue && (glucose.Value >= 16.7m || glucose.Value <= 3.0m))
+            return $"你提到的血糖 {glucose.Value:0.#} mmol/L 属于需要尽快处理的异常范围。";
+
+        var heartRate = MatchMetricValue(text, "心率|脉搏|heart rate|HR|hr");
+        if (heartRate.HasValue && (heartRate.Value >= 130 || heartRate.Value <= 45))
+            return $"你提到的心率 {heartRate.Value:0.#} 次/分属于明显异常范围。";
+
+        return null;
+    }
+
+    private static bool ContainsAny(string text, params string[] keywords) =>
+        keywords.Any(k => text.Contains(k, StringComparison.OrdinalIgnoreCase));
+
+    private static decimal? MatchMetricValue(string text, string metricPattern)
+    {
+        var match = Regex.Match(text, $@"(?:{metricPattern})[^\d]{{0,8}}(?<value>\d{{1,3}}(?:\.\d+)?)", RegexOptions.IgnoreCase);
+        return match.Success && decimal.TryParse(match.Groups["value"].Value, out var value) ? value : null;
+    }
 
     // ── JSON 类型安全转换 ──
     private static int _ToInt(object? v) => v switch
@@ -435,39 +524,59 @@ public static class AiChatEndpoints
             catch { resultDict = new Dictionary<string, object>(); }
         }
 
+        var isPendingConfirmation = resultDict != null
+            && resultDict.TryGetValue("pendingConfirmation", out var pendingValue)
+            && _ToBool(pendingValue);
+        if (isPendingConfirmation && resultDict!.TryGetValue("confirmationId", out var confirmationIdValue))
+        {
+            var confirmationId = confirmationIdValue?.ToString()?.Trim('"');
+            if (!string.IsNullOrWhiteSpace(confirmationId))
+            {
+                if (!metadata.TryGetValue("confirmationIds", out var idsValue) || idsValue is not List<string> ids)
+                {
+                    ids = [];
+                    metadata["confirmationIds"] = ids;
+                }
+                ids.Add(confirmationId);
+            }
+        }
+
         switch (toolName)
         {
             case "record_health_data":
+                if (!isPendingConfirmation) break;
                 messageType = "data_confirm";
                 if (resultDict != null)
                 {
-                    if (resultDict.TryGetValue("type", out var type)) metadata["type"] = type.ToString();
-                    if (resultDict.TryGetValue("value", out var val)) metadata["value"] = val.ToString();
-                    if (resultDict.TryGetValue("unit", out var unit)) metadata["unit"] = unit.ToString();
-                    if (resultDict.TryGetValue("isAbnormal", out var abn)) metadata["abnormal"] = abn is bool b2 ? b2 : false;
-                    if (resultDict.TryGetValue("success", out var success)) metadata["success"] = success is bool b && b;
+                    if (resultDict.TryGetValue("type", out var type)) metadata["type"] = type?.ToString() ?? "";
+                    if (resultDict.TryGetValue("value", out var val)) metadata["value"] = val?.ToString() ?? "";
+                    if (resultDict.TryGetValue("unit", out var unit)) metadata["unit"] = unit?.ToString() ?? "";
+                    if (resultDict.TryGetValue("isAbnormal", out var abn)) metadata["abnormal"] = _ToBool(abn);
+                    if (resultDict.TryGetValue("success", out var success)) metadata["success"] = _ToBool(success);
                     metadata["recordTime"] = DateTime.UtcNow.AddHours(8).ToString("MM月dd日 HH:mm");
                 }
                 break;
             case "manage_medication":
+                if (!isPendingConfirmation) break;
                 messageType = "medication_confirm";
                 if (resultDict != null)
                 {
                     if (resultDict.TryGetValue("name", out var name))
-                        metadata["name"] = name.ToString();
+                        metadata["name"] = name?.ToString() ?? "";
                     if (resultDict.TryGetValue("dosage", out var dosage))
-                        metadata["dosage"] = dosage.ToString();
+                        metadata["dosage"] = dosage?.ToString() ?? "";
                     if (resultDict.TryGetValue("time", out var time))
-                        metadata["time"] = time.ToString();
+                        metadata["time"] = time?.ToString() ?? "";
                     if (resultDict.TryGetValue("frequency", out var freq))
-                        metadata["frequency"] = freq.ToString();
-                    if (resultDict.TryGetValue("duration_days", out var dd2) && dd2 is int d2)
-                        metadata["duration_days"] = d2;
+                        metadata["frequency"] = freq?.ToString() ?? "";
+                    if (resultDict.TryGetValue("duration_days", out var dd2))
+                        metadata["duration_days"] = _ToInt(dd2);
                     if (resultDict.TryGetValue("start_date", out var sd))
-                        metadata["startDate"] = sd.ToString();
+                        metadata["startDate"] = sd?.ToString() ?? "";
                 }
                 break;
             case "manage_exercise":
+                if (!isPendingConfirmation) break;
                 messageType = "data_confirm";
                 if (resultDict != null)
                 {
@@ -477,40 +586,27 @@ public static class AiChatEndpoints
                     resultDict.TryGetValue("duration_minutes", out var dm);
                     metadata["unit"] = dm != null ? $"每天{dm}分钟" : "";
                     resultDict.TryGetValue("day_count", out var dc);
-                    if (dc != null) metadata["durationDays"] = dc.ToString();
+                    if (dc != null) metadata["durationDays"] = dc.ToString() ?? "";
                     resultDict.TryGetValue("success", out var ok);
-                    metadata["success"] = ok?.ToString() == "True";
+                    metadata["success"] = _ToBool(ok);
                     metadata["recordTime"] = DateTime.UtcNow.AddHours(8).ToString("MM月dd日 HH:mm");
                 }
                 break;
+            case "manage_archive":
+                if (!isPendingConfirmation) break;
+                messageType = "data_confirm";
+                metadata["type"] = "archive";
+                metadata["value"] = "健康档案更新";
+                metadata["unit"] = "";
+                metadata["success"] = true;
+                metadata["recordTime"] = DateTime.UtcNow.AddHours(8).ToString("MM月dd日 HH:mm");
+                break;
             case "analyze_report":
                 messageType = "report_analysis";
                 break;
         }
     }
 
-    // ── 图片处理 ──
-
-    private static void CompressImage(string inputPath, string outputPath, int maxWidth, long quality)
-    {
-        using var image = Image.FromFile(inputPath);
-        var width = image.Width;
-        var height = image.Height;
-        if (width > maxWidth)
-        {
-            height = (int)((double)height / width * maxWidth);
-            width = maxWidth;
-        }
-        using var bitmap = new Bitmap(width, height);
-        using var graphics = Graphics.FromImage(bitmap);
-        graphics.InterpolationMode = System.Drawing.Drawing2D.InterpolationMode.HighQualityBicubic;
-        graphics.DrawImage(image, 0, 0, width, height);
-
-        var jpegCodec = ImageCodecInfo.GetImageEncoders().First(c => c.MimeType == "image/jpeg");
-        var parameters = new EncoderParameters(1);
-        parameters.Param[0] = new EncoderParameter(Encoder.Quality, quality);
-        bitmap.Save(outputPath, jpegCodec, parameters);
-    }
 }
 
 public sealed record ChatRequest(string Message, string? ConversationId);

backend/src/Health.WebApi/Endpoints/auth_endpoints.cs

@@ -1,281 +1,30 @@
-using Health.Infrastructure.Services;
+using Health.Application.Auth;
 
 namespace Health.WebApi.Endpoints;
 
-/// <summary>
-/// 认证相关 API 端点
-/// </summary>
 public static class AuthEndpoints
 {
-    private const string AdminPhone = "12345678910";
-    private const string AdminSmsCode = "000000";
-
     public static void MapAuthEndpoints(this WebApplication app)
     {
-        // 发送短信验证码
-        app.MapPost("/api/auth/send-sms", async (
-            SendSmsRequest request,
-            AppDbContext db,
-            SmsService sms,
-            CancellationToken ct) =>
+        app.MapPost("/api/auth/send-sms", async (SendSmsRequest request, IAuthService auth, CancellationToken ct) =>
+            ToResult(await auth.SendCodeAsync(request.Phone, app.Environment.IsDevelopment(), ct)));
+        app.MapPost("/api/auth/register", async (RegisterRequest request, IAuthService auth, CancellationToken ct) =>
+            ToResult(await auth.RegisterAsync(new RegisterCommand(request.Phone, request.SmsCode, request.Name, request.DoctorId), ct)));
+        app.MapPost("/api/auth/login", async (LoginRequest request, IAuthService auth, CancellationToken ct) =>
+            ToResult(await auth.LoginAsync(request.Phone, request.SmsCode, ct)));
+        app.MapPost("/api/auth/refresh", async (RefreshRequest request, IAuthService auth, CancellationToken ct) =>
+            ToResult(await auth.RefreshAsync(request.RefreshToken, ct)));
+        app.MapPost("/api/auth/logout", async (RefreshRequest request, IAuthService auth, CancellationToken ct) =>
         {
-            var code = request.Phone == AdminPhone ? AdminSmsCode : sms.GenerateCode();
-            var vc = new VerificationCode
-            {
-                Id = Guid.NewGuid(),
-                Phone = request.Phone,
-                Code = code,
-                ExpiresAt = DateTime.UtcNow.AddMinutes(5),
-            };
-            db.VerificationCodes.Add(vc);
-            await db.SaveChangesAsync(ct);
-
-            if (request.Phone != AdminPhone)
-                await sms.SendCodeAsync(request.Phone, code);
-
-            return Results.Ok(new { code = 0, data = new { success = true, devCode = code }, message = (string?)null });
-        });
-
-        // ── 注册（仅限用户注册，需选择医生）──
-        app.MapPost("/api/auth/register", async (
-            RegisterRequest request,
-            AppDbContext db,
-            JwtProvider jwt,
-            CancellationToken ct) =>
-        {
-            // 验证码
-            var validCode = await db.VerificationCodes
-                .Where(v => v.Phone == request.Phone
-                    && v.Code == request.SmsCode
-                    && v.ExpiresAt > DateTime.UtcNow
-                    && !v.IsUsed)
-                .OrderByDescending(v => v.CreatedAt)
-                .FirstOrDefaultAsync(ct);
-
-            if (validCode == null)
-                return Results.Ok(new { code = 40001, data = (object?)null, message = "验证码错误或已过期" });
-
-            validCode.IsUsed = true;
-
-            // 检查手机号是否已注册
-            var existing = await db.Users.FirstOrDefaultAsync(u => u.Phone == request.Phone, ct);
-            if (existing != null)
-                return Results.Ok(new { code = 40002, data = (object?)null, message = "该手机号已注册，请直接登录" });
-
-            // 校验姓名
-            if (string.IsNullOrWhiteSpace(request.Name))
-                return Results.Ok(new { code = 40003, data = (object?)null, message = "请输入姓名" });
-
-            // 校验医生
-            var doctor = await db.Doctors.FirstOrDefaultAsync(d => d.Id == request.DoctorId && d.IsActive, ct);
-            if (doctor == null)
-                return Results.Ok(new { code = 40004, data = (object?)null, message = "所选医生不存在或已停诊" });
-
-            var user = new User
-            {
-                Id = Guid.NewGuid(),
-                Phone = request.Phone,
-                Role = "User",
-                Name = request.Name,
-                DoctorId = request.DoctorId,
-                CreatedAt = DateTime.UtcNow,
-                UpdatedAt = DateTime.UtcNow,
-            };
-            db.Users.Add(user);
-
-            db.NotificationPreferences.Add(new NotificationPreference { Id = Guid.NewGuid(), UserId = user.Id });
-            db.HealthArchives.Add(new HealthArchive { Id = Guid.NewGuid(), UserId = user.Id });
-
-            await db.SaveChangesAsync(ct);
-
-            var accessToken = jwt.GenerateAccessToken(user.Id, user.Phone, "User");
-            var refreshToken = jwt.GenerateRefreshToken();
-
-            db.RefreshTokens.Add(new RefreshToken
-            {
-                Id = Guid.NewGuid(),
-                UserId = user.Id,
-                Token = refreshToken,
-                ExpiresAt = DateTime.UtcNow.AddDays(30),
-            });
-            await db.SaveChangesAsync(ct);
-
-            return Results.Ok(new
-            {
-                code = 0,
-                data = new
-                {
-                    accessToken,
-                    refreshToken,
-                    user = new { user.Id, user.Phone, user.Role, isNew = true }
-                },
-                message = (string?)null
-            });
-        });
-
-        // ── 登录（已有账号 / 管理员）──
-        app.MapPost("/api/auth/login", async (
-            LoginRequest request,
-            AppDbContext db,
-            JwtProvider jwt,
-            CancellationToken ct) =>
-        {
-            var validCode = await db.VerificationCodes
-                .Where(v => v.Phone == request.Phone
-                    && v.Code == request.SmsCode
-                    && v.ExpiresAt > DateTime.UtcNow
-                    && !v.IsUsed)
-                .OrderByDescending(v => v.CreatedAt)
-                .FirstOrDefaultAsync(ct);
-
-            if (validCode == null)
-                return Results.Ok(new { code = 40001, data = (object?)null, message = "验证码错误或已过期" });
-
-            validCode.IsUsed = true;
-
-            // 管理员登录
-            if (request.Phone == AdminPhone)
-            {
-                var adminAccessToken = jwt.GenerateAccessToken(
-                    Guid.Parse("00000000-0000-0000-0000-000000000001"), AdminPhone, "Admin");
-                var adminRefreshToken = jwt.GenerateRefreshToken();
-                db.RefreshTokens.Add(new RefreshToken
-                {
-                    Id = Guid.NewGuid(),
-                    UserId = Guid.Parse("00000000-0000-0000-0000-000000000001"),
-                    Token = adminRefreshToken,
-                    ExpiresAt = DateTime.UtcNow.AddDays(30),
-                });
-                await db.SaveChangesAsync(ct);
-
-                return Results.Ok(new
-                {
-                    code = 0,
-                    data = new
-                    {
-                        accessToken = adminAccessToken,
-                        refreshToken = adminRefreshToken,
-                        user = new { id = "00000000-0000-0000-0000-000000000001", phone = AdminPhone, role = "Admin", name = "管理员", isNew = false }
-                    },
-                    message = (string?)null
-                });
-            }
-
-            var user = await db.Users.FirstOrDefaultAsync(u => u.Phone == request.Phone, ct);
-            if (user == null)
-                return Results.Ok(new { code = 40004, data = (object?)null, message = "该手机号未注册，请先登录" });
-
-            user.UpdatedAt = DateTime.UtcNow;
-            await db.SaveChangesAsync(ct);
-
-            var accessToken = jwt.GenerateAccessToken(user.Id, user.Phone, user.Role);
-            var refreshToken = jwt.GenerateRefreshToken();
-
-            db.RefreshTokens.Add(new RefreshToken
-            {
-                Id = Guid.NewGuid(),
-                UserId = user.Id,
-                Token = refreshToken,
-                ExpiresAt = DateTime.UtcNow.AddDays(30),
-            });
-            await db.SaveChangesAsync(ct);
-
-            return Results.Ok(new
-            {
-                code = 0,
-                data = new
-                {
-                    accessToken,
-                    refreshToken,
-                    user = new {
-                        user.Id, user.Phone, user.Role, user.Name,
-                        user.Gender, user.AvatarUrl,
-                        BirthDate = user.BirthDate?.ToString("yyyy-MM-dd"),
-                        isNew = false
-                    }
-                },
-                message = (string?)null
-            });
-        });
-
-        // 刷新 token
-        app.MapPost("/api/auth/refresh", async (
-            RefreshRequest request,
-            AppDbContext db,
-            JwtProvider jwt,
-            CancellationToken ct) =>
-        {
-            var oldToken = await db.RefreshTokens
-                .FirstOrDefaultAsync(t => t.Token == request.RefreshToken && !t.IsRevoked, ct);
-
-            if (oldToken == null || oldToken.ExpiresAt < DateTime.UtcNow)
-                return Results.Ok(new { code = 40002, data = (object?)null, message = "登录已过期，请重新登录" });
-
-            oldToken.IsRevoked = true;
-
-            var user = await db.Users.FindAsync([oldToken.UserId], ct);
-
-            // 管理员刷新：无 User 记录，直接用固定信息
-            if (user == null && oldToken.UserId == Guid.Parse("00000000-0000-0000-0000-000000000001"))
-            {
-                var adminAccessToken = jwt.GenerateAccessToken(
-                    Guid.Parse("00000000-0000-0000-0000-000000000001"), AdminPhone, "Admin");
-                var adminNewRefresh = jwt.GenerateRefreshToken();
-                db.RefreshTokens.Add(new RefreshToken
-                {
-                    Id = Guid.NewGuid(),
-                    UserId = Guid.Parse("00000000-0000-0000-0000-000000000001"),
-                    Token = adminNewRefresh,
-                    ExpiresAt = DateTime.UtcNow.AddDays(30),
-                });
-                await db.SaveChangesAsync(ct);
-                return Results.Ok(new
-                {
-                    code = 0,
-                    data = new { accessToken = adminAccessToken, refreshToken = adminNewRefresh, user = new { role = "Admin" } },
-                    message = (string?)null
-                });
-            }
-
-            if (user == null)
-                return Results.Ok(new { code = 40002, data = (object?)null, message = "用户不存在" });
-
-            var accessToken = jwt.GenerateAccessToken(user.Id, user.Phone, user.Role);
-            var newRefreshToken = jwt.GenerateRefreshToken();
-            db.RefreshTokens.Add(new RefreshToken
-            {
-                Id = Guid.NewGuid(),
-                UserId = user.Id,
-                Token = newRefreshToken,
-                ExpiresAt = DateTime.UtcNow.AddDays(30),
-            });
-            await db.SaveChangesAsync(ct);
-
-            return Results.Ok(new
-            {
-                code = 0,
-                data = new { accessToken, refreshToken = newRefreshToken, user = new { user.Role } },
-                message = (string?)null
-            });
-        });
-
-        // 登出
-        app.MapPost("/api/auth/logout", async (
-            RefreshRequest request,
-            AppDbContext db,
-            CancellationToken ct) =>
-        {
-            var token = await db.RefreshTokens
-                .FirstOrDefaultAsync(t => t.Token == request.RefreshToken, ct);
-            if (token != null) token.IsRevoked = true;
-            await db.SaveChangesAsync(ct);
-
+            await auth.LogoutAsync(request.RefreshToken, ct);
             return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
         });
     }
+
+    private static IResult ToResult(AuthResult result) =>
+        Results.Ok(new { code = result.Code, data = result.Data, message = result.Message });
 }
 
-// ---- 请求 DTO ----
 public sealed record SendSmsRequest(string Phone);
 public sealed record RegisterRequest(string Phone, string SmsCode, string Name, Guid DoctorId);
 public sealed record LoginRequest(string Phone, string SmsCode);

backend/src/Health.WebApi/Endpoints/calendar_endpoints.cs

@@ -1,3 +1,5 @@
+using Health.Application.Calendars;
+
 namespace Health.WebApi.Endpoints;
 
 public static class CalendarEndpoints
@@ -6,91 +8,22 @@ public static class CalendarEndpoints
     {
         var group = app.MapGroup("/api/calendar").RequireAuthorization();
 
-        group.MapGet("/", async (int year, int month, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapGet("/", async (int year, int month, HttpContext http, ICalendarService calendar, CancellationToken ct) =>
         {
-            var userId = GetUserId(http);
-            var start = new DateOnly(year, month, 1);
-            var end = start.AddMonths(1);
-            var startDt = start.ToDateTime(TimeOnly.MinValue, DateTimeKind.Utc);
-            var endDt = end.ToDateTime(TimeOnly.MinValue, DateTimeKind.Utc);
-
-            var medications = await db.Medications
-                .Where(m => m.UserId == userId && m.IsActive && m.TimeOfDay.Count > 0)
-                .ToListAsync(ct);
-            var plans = await db.ExercisePlans
-                .Where(p => p.UserId == userId).Include(p => p.Items).ToListAsync(ct);
-            var followups = await db.FollowUps
-                .Where(f => f.UserId == userId && f.ScheduledAt >= startDt && f.ScheduledAt < endDt)
-                .ToListAsync(ct);
-
-            var result = new List<object>();
-            for (var d = start; d < end; d = d.AddDays(1))
-            {
-                var detailList = new List<object>();
-
-                // 用药：当前日期在用药有效期内
-                var todayMedications = medications
-                    .Where(m => m.StartDate <= d && (m.EndDate == null || m.EndDate >= d));
-                foreach (var m in todayMedications)
-                {
-                    detailList.Add(new { type = "medication", name = m.Name, dosage = m.Dosage, timeOfDay = m.TimeOfDay.Select(t => t.ToString(@"hh\:mm")).ToList() });
-                }
-
-                // 运动：按计划有效周范围 + 星期几匹配
-            foreach (var p in plans)
-            {
-                var weekEnd = p.WeekStartDate.AddDays(6);
-                if (d >= p.WeekStartDate && d <= weekEnd)
-                {
-                    var dayItems = p.Items.Where(i => i.DayOfWeek == (int)d.DayOfWeek && !i.IsRestDay);
-                    foreach (var i in dayItems)
-                        detailList.Add(new { type = "exercise", name = i.ExerciseType, duration = i.DurationMinutes, isCompleted = i.IsCompleted });
-                }
-            }
-
-                // 随访
-                var todayFollowups = followups.Where(f => DateOnly.FromDateTime(f.ScheduledAt) == d);
-                foreach (var f in todayFollowups)
-                    detailList.Add(new { type = "followup", title = f.Title, doctorName = f.DoctorName, department = f.Department, status = f.Status.ToString() });
-
-                if (detailList.Count > 0)
-                    result.Add(new { date = d.ToString("yyyy-MM-dd"), events = detailList.Select(x => ((dynamic)x).type as string).Distinct().ToList(), details = detailList });
-            }
+            if (year is < 2000 or > 2100 || month is < 1 or > 12)
+                return Results.Ok(new { code = 400, data = (object?)null, message = "年月格式错误" });
 
+            var result = await calendar.GetMonthAsync(GetUserId(http), year, month, ct);
             return Results.Ok(new { code = 0, data = result, message = (string?)null });
         });
 
-        // 获取某一天的详细安排
-        group.MapGet("/day", async (string date, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapGet("/day", async (string date, HttpContext http, ICalendarService calendar, CancellationToken ct) =>
         {
-            var userId = GetUserId(http);
-            if (!DateOnly.TryParse(date, out var d))
+            if (!DateOnly.TryParse(date, out var parsedDate))
                 return Results.Ok(new { code = 400, data = (object?)null, message = "日期格式错误" });
 
-            var medications = await db.Medications
-                .Where(m => m.UserId == userId && m.IsActive && m.StartDate <= d && (m.EndDate == null || m.EndDate >= d))
-                .Select(m => new { m.Name, m.Dosage, timeOfDay = m.TimeOfDay.Select(t => t.ToString(@"hh\:mm")).ToList() })
-                .ToListAsync(ct);
-
-            var plans = await db.ExercisePlans
-                .Where(p => p.UserId == userId)
-                .Include(p => p.Items).ToListAsync(ct);
-            var exercises = new List<object>();
-            foreach (var p in plans)
-            {
-                if (d >= p.WeekStartDate && d <= p.WeekStartDate.AddDays(6))
-                {
-                    foreach (var i in p.Items.Where(i => i.DayOfWeek == (int)d.DayOfWeek && !i.IsRestDay))
-                        exercises.Add(new { type = i.ExerciseType, duration = i.DurationMinutes, isCompleted = i.IsCompleted });
-                }
-            }
-
-            var followUps = await db.FollowUps
-                .Where(f => f.UserId == userId && DateOnly.FromDateTime(f.ScheduledAt) == d)
-                .Select(f => new { f.Title, f.DoctorName, f.Department, status = f.Status.ToString() })
-                .ToListAsync(ct);
-
-            return Results.Ok(new { code = 0, data = new { medications, exercises, followUps }, message = (string?)null });
+            var result = await calendar.GetDayAsync(GetUserId(http), parsedDate, ct);
+            return Results.Ok(new { code = 0, data = result, message = (string?)null });
         });
     }
 

backend/src/Health.WebApi/Endpoints/consultation_endpoints.cs

@@ -49,11 +49,14 @@ public static class ConsultationEndpoints
         group.MapPost("/consultations/{id:guid}/messages", async (Guid id, SendMessageRequest req, HttpContext http, AppDbContext db, IHubContext<Hubs.ConsultationHub> hubContext, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var msg = new ConsultationMessage { Id = Guid.NewGuid(), ConsultationId = id, SenderType = ConsultationSenderType.User, Content = req.Content, SenderName = null, CreatedAt = DateTime.UtcNow };
+            var consultation = await db.Consultations.FirstOrDefaultAsync(c => c.Id == id && c.UserId == userId, ct);
+            if (consultation == null)
+                return Results.Ok(new { code = 404, data = (object?)null, message = "问诊不存在" });
+
+            var msg = new ConsultationMessage { Id = Guid.NewGuid(), ConsultationId = consultation.Id, SenderType = ConsultationSenderType.User, Content = req.Content, SenderName = null, CreatedAt = DateTime.UtcNow };
             db.ConsultationMessages.Add(msg);
 
             // 用户发消息后，状态从 AiTalking → WaitingDoctor
-            var consultation = await db.Consultations.FirstOrDefaultAsync(c => c.Id == id, ct);
             if (consultation != null && consultation.Status == ConsultationStatus.AiTalking)
             {
                 consultation.Status = ConsultationStatus.WaitingDoctor;

backend/src/Health.WebApi/Endpoints/diet_endpoints.cs

@@ -1,3 +1,5 @@
+using Health.Application.Diets;
+
 namespace Health.WebApi.Endpoints;
 
 public static class DietEndpoints
@@ -6,82 +8,91 @@ public static class DietEndpoints
     {
         var group = app.MapGroup("/api/diet-records").RequireAuthorization();
 
-        group.MapGet("/", async (string? date, string? mealType, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapGet("/", async (string? date, string? mealType, HttpContext http, IDietService diets, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var query = db.DietRecords.Include(d => d.FoodItems).Where(d => d.UserId == userId);
-            if (DateOnly.TryParse(date, out var d)) query = query.Where(r => r.RecordedAt == d);
-            if (Enum.TryParse<MealType>(mealType, ignoreCase: true, out var mt)) query = query.Where(r => r.MealType == mt);
-            var records = await query.OrderByDescending(r => r.RecordedAt).Select(r => new
-            {
-                r.Id, MealType = r.MealType.ToString(), r.TotalCalories, r.HealthScore, r.RecordedAt,
-                foodItems = r.FoodItems.Select(f => new { f.Name, f.Portion, f.Calories })
-            }).ToListAsync(ct);
+            var records = await diets.ListAsync(userId, date, mealType, ct);
             return Results.Ok(new { code = 0, data = records, message = (string?)null });
         });
 
-        group.MapPost("/", async (HttpRequest request, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapPost("/", async (HttpRequest request, HttpContext http, IDietService diets, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            request.EnableBuffering();
-            using var reader = new StreamReader(request.Body);
-            var body = await reader.ReadToEndAsync(ct);
-            request.Body.Position = 0;
-            using var json = JsonDocument.Parse(body);
-            var root = json.RootElement;
-            var record = new DietRecord
-            {
-                Id = Guid.NewGuid(), UserId = userId,
-                MealType = Enum.TryParse<MealType>(root.TryGetProperty("mealType", out var mt) ? mt.GetString() : "Lunch", out var meal) ? meal : MealType.Lunch,
-                TotalCalories = root.TryGetProperty("totalCalories", out var tc) ? tc.GetInt32() : null,
-                HealthScore = root.TryGetProperty("healthScore", out var hs) ? hs.GetInt32() : null,
-                RecordedAt = root.TryGetProperty("recordedAt", out var ra) && DateOnly.TryParse(ra.GetString(), out var d) ? d : DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8)),
-            };
-            if (root.TryGetProperty("foodItems", out var items))
-            {
-                var i = 0;
-                foreach (var fi in items.EnumerateArray())
-                {
-                    record.FoodItems.Add(new DietFoodItem
-                    {
-                        Id = Guid.NewGuid(), Name = fi.TryGetProperty("name", out var n) ? n.GetString()! : "",
-                        Portion = fi.TryGetProperty("portion", out var p) ? p.GetString() : null,
-                        Calories = fi.TryGetProperty("calories", out var c) ? c.GetInt32() : null,
-                        SortOrder = fi.TryGetProperty("sortOrder", out var so) ? so.GetInt32() : i,
-                    });
-                    i++;
-                }
-            }
-            db.DietRecords.Add(record);
-            await db.SaveChangesAsync(ct);
-            return Results.Ok(new { code = 0, data = new { record.Id }, message = (string?)null });
+            using var json = JsonDocument.Parse(await ReadBodyAsync(request, ct));
+            var recordId = await diets.CreateAsync(userId, ReadCreateRequest(json.RootElement), ct);
+            return Results.Ok(new { code = 0, data = new { id = recordId }, message = (string?)null });
         });
 
-        group.MapDelete("/{id:guid}", async (Guid id, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapDelete("/{id:guid}", async (Guid id, HttpContext http, IDietService diets, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var record = await db.DietRecords.FirstOrDefaultAsync(r => r.Id == id && r.UserId == userId, ct);
-            if (record != null) { db.DietRecords.Remove(record); await db.SaveChangesAsync(ct); }
+            await diets.DeleteAsync(userId, id, ct);
             return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
         });
 
-        group.MapPut("/{id:guid}", async (Guid id, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapPut("/{id:guid}", async (Guid id, HttpContext http, IDietService diets, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var record = await db.DietRecords.FirstOrDefaultAsync(r => r.Id == id && r.UserId == userId, ct);
-            if (record == null) return Results.Ok(new { code = 40004, message = "记录不存在" });
+            using var json = JsonDocument.Parse(await ReadBodyAsync(http.Request, ct));
+            var updated = await diets.UpdateAsync(userId, id, ReadPatchRequest(json.RootElement), ct);
+            if (!updated) return Results.Ok(new { code = 40004, message = "记录不存在" });
 
-            using var reader = new StreamReader(http.Request.Body);
-            var body = await reader.ReadToEndAsync(ct);
-            var json = System.Text.Json.JsonDocument.Parse(body);
-            if (json.RootElement.TryGetProperty("totalCalories", out var cal)) record.TotalCalories = (int?)cal.GetInt32();
-            if (json.RootElement.TryGetProperty("healthScore", out var hs)) record.HealthScore = (int?)hs.GetInt32();
-            await db.SaveChangesAsync(ct);
             return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
         });
     }
 
+    private static DietRecordCreateRequest ReadCreateRequest(JsonElement root)
+    {
+        var mealType = Enum.TryParse<MealType>(
+            root.TryGetProperty("mealType", out var mt) ? mt.GetString() : "Lunch",
+            out var meal)
+            ? meal
+            : MealType.Lunch;
+        var recordedAt = root.TryGetProperty("recordedAt", out var ra) && DateOnly.TryParse(ra.GetString(), out var d)
+            ? d
+            : DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8));
+
+        return new DietRecordCreateRequest(
+            mealType,
+            root.TryGetProperty("totalCalories", out var tc) ? tc.GetInt32() : null,
+            root.TryGetProperty("healthScore", out var hs) ? hs.GetInt32() : null,
+            recordedAt,
+            ReadFoodItems(root));
+    }
+
+    private static DietRecordPatchRequest ReadPatchRequest(JsonElement root) => new(
+        root.TryGetProperty("totalCalories", out var cal) ? cal.GetInt32() : null,
+        root.TryGetProperty("healthScore", out var hs) ? hs.GetInt32() : null);
+
+    private static List<DietFoodItemInput> ReadFoodItems(JsonElement root)
+    {
+        var result = new List<DietFoodItemInput>();
+        if (!root.TryGetProperty("foodItems", out var items) || items.ValueKind != JsonValueKind.Array)
+            return result;
+
+        var i = 0;
+        foreach (var fi in items.EnumerateArray())
+        {
+            result.Add(new DietFoodItemInput(
+                fi.TryGetProperty("name", out var n) ? n.GetString() ?? "" : "",
+                fi.TryGetProperty("portion", out var p) ? p.GetString() : null,
+                fi.TryGetProperty("calories", out var c) ? c.GetInt32() : null,
+                fi.TryGetProperty("sortOrder", out var so) ? so.GetInt32() : i));
+            i++;
+        }
+
+        return result;
+    }
+
+    private static async Task<string> ReadBodyAsync(HttpRequest request, CancellationToken ct)
+    {
+        request.EnableBuffering();
+        using var reader = new StreamReader(request.Body, leaveOpen: true);
+        var body = await reader.ReadToEndAsync(ct);
+        request.Body.Position = 0;
+        return string.IsNullOrWhiteSpace(body) ? "{}" : body;
+    }
+
     private static Guid GetUserId(HttpContext http) =>
         Guid.TryParse(http.User.FindFirst(System.Security.Claims.ClaimTypes.NameIdentifier)?.Value, out var id) ? id : Guid.Empty;
 }
-

backend/src/Health.WebApi/Endpoints/doctor_endpoints.cs

@@ -49,31 +49,34 @@ public static class DoctorEndpoints
             var profile = await GetDoctorProfile(http, db);
             if (profile == null)
                 return Results.Ok(new { code = 404, data = (object?)null, message = "医生档案不存在，请先完善个人信息" });
+            if (profile.DoctorId == null)
+                return Results.Ok(new { code = 500, data = (object?)null, message = "医生档案未关联" });
 
-            var totalPatients = await db.Users.CountAsync(u => u.Role == "User");
-            var activeConsultations = await db.Consultations.CountAsync(c => c.Status != ConsultationStatus.Closed);
-            var pendingReports = await db.Reports.CountAsync(r => r.Status == ReportStatus.PendingDoctor);
+            var doctorId = profile.DoctorId.Value;
+            var totalPatients = await db.Users.CountAsync(u => u.Role == "User" && u.DoctorId == doctorId);
+            var activeConsultations = await db.Consultations.CountAsync(c => c.User.DoctorId == doctorId && c.Status != ConsultationStatus.Closed);
+            var pendingReports = await db.Reports.CountAsync(r => r.User.DoctorId == doctorId && r.Status == ReportStatus.PendingDoctor);
             var todayStart = DateTime.UtcNow.Date;
             var todayEnd = todayStart.AddDays(1);
-            var todayFollowUps = await db.FollowUps.CountAsync(f => f.ScheduledAt >= todayStart && f.ScheduledAt < todayEnd && f.Status == FollowUpStatus.Upcoming);
+            var todayFollowUps = await db.FollowUps.CountAsync(f => f.User.DoctorId == doctorId && f.ScheduledAt >= todayStart && f.ScheduledAt < todayEnd && f.Status == FollowUpStatus.Upcoming);
 
             // 待办列表
             var pendingConsultations = await db.Consultations
-                .Where(c => c.Status == ConsultationStatus.WaitingDoctor)
+                .Where(c => c.User.DoctorId == doctorId && c.Status == ConsultationStatus.WaitingDoctor)
                 .OrderByDescending(c => c.CreatedAt)
                 .Take(5)
                 .Select(c => new { c.Id, PatientName = c.User.Name ?? c.User.Phone, c.CreatedAt })
                 .ToListAsync();
 
             var pendingReportList = await db.Reports
-                .Where(r => r.Status == ReportStatus.PendingDoctor)
+                .Where(r => r.User.DoctorId == doctorId && r.Status == ReportStatus.PendingDoctor)
                 .OrderByDescending(r => r.CreatedAt)
                 .Take(5)
                 .Select(r => new { r.Id, PatientName = r.User.Name ?? r.User.Phone, r.Category, r.CreatedAt })
                 .ToListAsync();
 
             var todayFollowUpList = await db.FollowUps
-                .Where(f => f.ScheduledAt >= todayStart && f.ScheduledAt < todayEnd && f.Status == FollowUpStatus.Upcoming)
+                .Where(f => f.User.DoctorId == doctorId && f.ScheduledAt >= todayStart && f.ScheduledAt < todayEnd && f.Status == FollowUpStatus.Upcoming)
                 .OrderBy(f => f.ScheduledAt)
                 .Select(f => new { f.Id, f.Title, PatientName = f.User.Name ?? f.User.Phone, f.ScheduledAt })
                 .ToListAsync();
@@ -121,11 +124,15 @@ public static class DoctorEndpoints
         });
 
         // ===== 患者详情 =====
-        group.MapGet("/patients/{id:guid}", async (Guid id, AppDbContext db) =>
+        group.MapGet("/patients/{id:guid}", async (Guid id, HttpContext http, AppDbContext db) =>
         {
+            var doctorId = await GetDoctorEntityId(http, db);
+            if (doctorId == null)
+                return Results.Ok(new { code = 500, data = (object?)null, message = "医生档案未关联" });
+
             var user = await db.Users
                 .Include(u => u.HealthArchive)
-                .FirstOrDefaultAsync(u => u.Id == id);
+                .FirstOrDefaultAsync(u => u.Id == id && u.DoctorId == doctorId);
             if (user == null)
                 return Results.Ok(new { code = 404, data = (object?)null, message = "患者不存在" });
 
@@ -153,7 +160,7 @@ public static class DoctorEndpoints
                 .ToListAsync();
 
             var exercisePlans = await db.ExercisePlans
-                .Where(p => p.UserId == id).OrderByDescending(p => p.WeekStartDate).Take(1).Include(p => p.Items)
+                .Where(p => p.UserId == id).OrderByDescending(p => p.StartDate).Take(1).Include(p => p.Items)
                 .FirstOrDefaultAsync();
 
             var reports = await db.Reports
@@ -177,7 +184,7 @@ public static class DoctorEndpoints
                     trendRecords,
                     medications,
                     dietRecords = dietRecords.Select(d => new { d.Id, MealType = d.MealType.ToString(), d.TotalCalories, d.HealthScore, d.RecordedAt, foods = d.FoodItems.Select(f => new { f.Name, f.Portion, f.Calories, f.Warning }) }),
-                    exercisePlan = exercisePlans == null ? null : new { exercisePlans.WeekStartDate, items = exercisePlans.Items.Select(i => new { i.DayOfWeek, i.ExerciseType, i.DurationMinutes, i.IsCompleted, i.IsRestDay, i.CompletedAt }) },
+                    exercisePlan = exercisePlans == null ? null : new { exercisePlans.StartDate, exercisePlans.EndDate, exercisePlans.ReminderTime, items = exercisePlans.Items.Select(i => new { i.ScheduledDate, i.ExerciseType, i.DurationMinutes, i.IsCompleted, i.IsRestDay, i.CompletedAt }) },
                     reports, followUps
                 },
                 message = (string?)null
@@ -189,8 +196,10 @@ public static class DoctorEndpoints
         {
             var profile = await GetDoctorProfile(http, db);
             if (profile == null) return Results.Ok(new { code = 404, data = (object?)null, message = "医生档案不存在" });
+            if (profile.DoctorId == null) return Results.Ok(new { code = 500, data = (object?)null, message = "医生档案未关联" });
 
             var consultations = await db.Consultations
+                .Where(c => c.User.DoctorId == profile.DoctorId)
                 .OrderByDescending(c => c.CreatedAt)
                 .Select(c => new { c.Id, c.UserId, PatientName = c.User.Name, PatientPhone = c.User.Phone, Status = c.Status.ToString(), c.CreatedAt, c.ClosedAt, LastMessage = c.Messages.OrderByDescending(m => m.CreatedAt).Select(m => new { m.Content, SenderType = m.SenderType.ToString(), m.CreatedAt }).FirstOrDefault() })
                 .ToListAsync();
@@ -199,15 +208,22 @@ public static class DoctorEndpoints
         });
 
         // ===== 问诊消息 =====
-        group.MapGet("/consultations/{id:guid}/messages", async (Guid id, AppDbContext db) =>
+        group.MapGet("/consultations/{id:guid}/messages", async (Guid id, HttpContext http, AppDbContext db) =>
         {
+            var doctorId = await GetDoctorEntityId(http, db);
+            if (doctorId == null)
+                return Results.Ok(new { code = 500, data = (object?)null, message = "医生档案未关联" });
+
+            var consultation = await db.Consultations
+                .FirstOrDefaultAsync(c => c.Id == id && c.User.DoctorId == doctorId);
+            if (consultation == null)
+                return Results.Ok(new { code = 404, data = (object?)null, message = "问诊不存在" });
+
             var messages = await db.ConsultationMessages
-                .Where(m => m.ConsultationId == id).OrderBy(m => m.CreatedAt)
+                .Where(m => m.ConsultationId == consultation.Id).OrderBy(m => m.CreatedAt)
                 .Select(m => new { m.Id, SenderType = m.SenderType.ToString(), m.SenderName, m.Content, m.CreatedAt })
                 .ToListAsync();
 
-            var consultation = await db.Consultations.FirstOrDefaultAsync(c => c.Id == id);
-
             return Results.Ok(new { code = 0, data = new { status = consultation?.Status.ToString() ?? "Closed", messages }, message = (string?)null });
         });
 
@@ -216,8 +232,9 @@ public static class DoctorEndpoints
         {
             var profile = await GetDoctorProfile(http, db);
             if (profile == null) return Results.Ok(new { code = 404, data = (object?)null, message = "医生档案不存在" });
+            if (profile.DoctorId == null) return Results.Ok(new { code = 500, data = (object?)null, message = "医生档案未关联" });
 
-            var consultation = await db.Consultations.FirstOrDefaultAsync(c => c.Id == id, ct);
+            var consultation = await db.Consultations.FirstOrDefaultAsync(c => c.Id == id && c.User.DoctorId == profile.DoctorId, ct);
             if (consultation == null) return Results.Ok(new { code = 404, data = (object?)null, message = "问诊不存在" });
 
             using var reader = new StreamReader(http.Request.Body);
@@ -249,9 +266,13 @@ public static class DoctorEndpoints
         });
 
         // ===== 报告列表 =====
-        group.MapGet("/reports", async (string? status, AppDbContext db) =>
+        group.MapGet("/reports", async (string? status, HttpContext http, AppDbContext db) =>
         {
-            var query = db.Reports.AsQueryable();
+            var doctorId = await GetDoctorEntityId(http, db);
+            if (doctorId == null)
+                return Results.Ok(new { code = 500, data = (object?)null, message = "医生档案未关联" });
+
+            var query = db.Reports.Where(r => r.User.DoctorId == doctorId);
             if (!string.IsNullOrWhiteSpace(status) && Enum.TryParse<ReportStatus>(status, out var s))
                 query = query.Where(r => r.Status == s);
 
@@ -262,9 +283,13 @@ public static class DoctorEndpoints
         });
 
         // ===== 报告详情 =====
-        group.MapGet("/reports/{id:guid}", async (Guid id, AppDbContext db) =>
+        group.MapGet("/reports/{id:guid}", async (Guid id, HttpContext http, AppDbContext db) =>
         {
-            var report = await db.Reports.Where(r => r.Id == id)
+            var doctorId = await GetDoctorEntityId(http, db);
+            if (doctorId == null)
+                return Results.Ok(new { code = 500, data = (object?)null, message = "医生档案未关联" });
+
+            var report = await db.Reports.Where(r => r.Id == id && r.User.DoctorId == doctorId)
                 .Select(r => new { r.Id, r.UserId, PatientName = r.User.Name, r.FileUrl, FileType = r.FileType.ToString(), Category = r.Category.ToString(), Status = r.Status.ToString(), r.Severity, r.AiSummary, r.AiIndicators, r.DoctorComment, r.DoctorRecommendation, r.DoctorName, r.ReviewedAt, r.CreatedAt })
                 .FirstOrDefaultAsync();
             if (report == null) return Results.Ok(new { code = 404, data = (object?)null, message = "报告不存在" });
@@ -276,8 +301,9 @@ public static class DoctorEndpoints
         {
             var profile = await GetDoctorProfile(http, db);
             if (profile == null) return Results.Ok(new { code = 404, data = (object?)null, message = "医生档案不存在" });
+            if (profile.DoctorId == null) return Results.Ok(new { code = 500, data = (object?)null, message = "医生档案未关联" });
 
-            var report = await db.Reports.FirstOrDefaultAsync(r => r.Id == id, ct);
+            var report = await db.Reports.FirstOrDefaultAsync(r => r.Id == id && r.User.DoctorId == profile.DoctorId, ct);
             if (report == null) return Results.Ok(new { code = 404, data = (object?)null, message = "报告不存在" });
 
             using var reader = new StreamReader(http.Request.Body);
@@ -299,9 +325,13 @@ public static class DoctorEndpoints
         });
 
         // ===== 随访列表 =====
-        group.MapGet("/follow-ups", async (string? status, string? patientId, AppDbContext db) =>
+        group.MapGet("/follow-ups", async (string? status, string? patientId, HttpContext http, AppDbContext db) =>
         {
-            var query = db.FollowUps.AsQueryable();
+            var doctorId = await GetDoctorEntityId(http, db);
+            if (doctorId == null)
+                return Results.Ok(new { code = 500, data = (object?)null, message = "医生档案未关联" });
+
+            var query = db.FollowUps.Where(f => f.User.DoctorId == doctorId);
             if (!string.IsNullOrWhiteSpace(status) && Enum.TryParse<FollowUpStatus>(status, out var s))
                 query = query.Where(f => f.Status == s);
             if (Guid.TryParse(patientId, out var pid))
@@ -318,15 +348,19 @@ public static class DoctorEndpoints
         {
             var profile = await GetDoctorProfile(http, db);
             if (profile == null) return Results.Ok(new { code = 404, data = (object?)null, message = "医生档案不存在" });
+            if (profile.DoctorId == null) return Results.Ok(new { code = 500, data = (object?)null, message = "医生档案未关联" });
 
             using var reader = new StreamReader(http.Request.Body);
             var body = await reader.ReadToEndAsync(ct);
             var json = System.Text.Json.JsonDocument.Parse(body);
+            var patientId = Guid.Parse(json.RootElement.GetProperty("userId").GetString()!);
+            var patientExists = await db.Users.AnyAsync(u => u.Id == patientId && u.DoctorId == profile.DoctorId, ct);
+            if (!patientExists) return Results.Ok(new { code = 404, data = (object?)null, message = "患者不存在" });
 
             var followUp = new FollowUp
             {
                 Id = Guid.NewGuid(),
-                UserId = Guid.Parse(json.RootElement.GetProperty("userId").GetString()!),
+                UserId = patientId,
                 Title = json.RootElement.GetProperty("title").GetString() ?? "",
                 DoctorName = profile.Name,
                 Department = profile.Department,
@@ -343,7 +377,11 @@ public static class DoctorEndpoints
         // ===== 更新随访 =====
         group.MapPut("/follow-ups/{id:guid}", async (Guid id, HttpContext http, AppDbContext db, CancellationToken ct) =>
         {
-            var followUp = await db.FollowUps.FirstOrDefaultAsync(f => f.Id == id, ct);
+            var doctorId = await GetDoctorEntityId(http, db);
+            if (doctorId == null)
+                return Results.Ok(new { code = 500, data = (object?)null, message = "医生档案未关联" });
+
+            var followUp = await db.FollowUps.FirstOrDefaultAsync(f => f.Id == id && f.User.DoctorId == doctorId, ct);
             if (followUp == null) return Results.Ok(new { code = 404, data = (object?)null, message = "随访不存在" });
 
             using var reader = new StreamReader(http.Request.Body);
@@ -358,9 +396,13 @@ public static class DoctorEndpoints
         });
 
         // ===== 删除随访 =====
-        group.MapDelete("/follow-ups/{id:guid}", async (Guid id, AppDbContext db, CancellationToken ct) =>
+        group.MapDelete("/follow-ups/{id:guid}", async (Guid id, HttpContext http, AppDbContext db, CancellationToken ct) =>
         {
-            var followUp = await db.FollowUps.FirstOrDefaultAsync(f => f.Id == id, ct);
+            var doctorId = await GetDoctorEntityId(http, db);
+            if (doctorId == null)
+                return Results.Ok(new { code = 500, data = (object?)null, message = "医生档案未关联" });
+
+            var followUp = await db.FollowUps.FirstOrDefaultAsync(f => f.Id == id && f.User.DoctorId == doctorId, ct);
             if (followUp == null) return Results.Ok(new { code = 404, data = (object?)null, message = "随访不存在" });
             db.FollowUps.Remove(followUp);
             await db.SaveChangesAsync(ct);
@@ -371,9 +413,9 @@ public static class DoctorEndpoints
         group.MapGet("/patients-simple", async (HttpContext http, AppDbContext db) =>
         {
             var doctorId = await GetDoctorEntityId(http, db);
-            var query = db.Users.Where(u => u.Role == "User");
-            if (doctorId != null)
-                query = query.Where(u => u.DoctorId == doctorId);
+            if (doctorId == null)
+                return Results.Ok(new { code = 500, data = (object?)null, message = "医生档案未关联" });
+            var query = db.Users.Where(u => u.Role == "User" && u.DoctorId == doctorId);
             var patients = await query.OrderBy(u => u.Name).Select(u => new { u.Id, u.Name, u.Phone }).ToListAsync();
             return Results.Ok(new { code = 0, data = patients, message = (string?)null });
         });

backend/src/Health.WebApi/Endpoints/exercise_endpoints.cs

@@ -1,3 +1,5 @@
+using Health.Application.Exercises;
+
 namespace Health.WebApi.Endpoints;
 
 public static class ExerciseEndpoints
@@ -6,126 +8,78 @@ public static class ExerciseEndpoints
     {
         var group = app.MapGroup("/api/exercise-plans").RequireAuthorization();
 
-        group.MapGet("/current", async (HttpContext http, AppDbContext db) =>
+        group.MapGet("/current", async (HttpContext http, IExerciseService exercises, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var today = DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8)); // 北京时间
-            // 查找覆盖今天的所有计划（不仅限于周一开始的）
-            var plans = await db.ExercisePlans.Include(p => p.Items)
-                .Where(p => p.UserId == userId && p.WeekStartDate <= today)
-                .OrderByDescending(p => p.WeekStartDate)
-                .ToListAsync();
-            var plan = plans.FirstOrDefault(p => p.Items.Any(i => i.DayOfWeek == (int)today.DayOfWeek));
-            if (plan == null) return Results.Ok(new { code = 0, data = (object?)null, message = (string?)null });
-            return Results.Ok(new
-            {
-                code = 0,
-                data = new
-                {
-                    plan.Id, plan.WeekStartDate, plan.CreatedAt, plan.UpdatedAt,
-                    items = plan.Items.Select(i => new
-                    {
-                        i.Id, i.DayOfWeek,
-                        i.ExerciseType, i.DurationMinutes,
-                        i.IsCompleted, i.CompletedAt, i.IsRestDay
-                    })
-                },
-                message = (string?)null
-            });
+            var plan = await exercises.GetCurrentAsync(userId, ct);
+            return Results.Ok(new { code = 0, data = plan, message = (string?)null });
         });
 
-        group.MapPost("/", async (HttpRequest request, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapPost("/", async (HttpRequest request, HttpContext http, IExerciseService exercises, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            request.EnableBuffering();
-            using var reader = new StreamReader(request.Body);
-            var body = await reader.ReadToEndAsync(ct);
-            request.Body.Position = 0;
+            var body = await ReadBodyAsync(request, ct);
             using var json = JsonDocument.Parse(body);
             var root = json.RootElement;
-            var exerciseType = root.TryGetProperty("exerciseType", out var et) ? et.GetString()! : "运动";
+
+            var exerciseType = root.TryGetProperty("exerciseType", out var et) ? et.GetString() : "运动";
             var duration = root.TryGetProperty("durationMinutes", out var dm) ? dm.GetInt32() : 30;
-            var startDate = DateOnly.Parse((root.TryGetProperty("startDate", out var sd) ? sd.GetString()! : DateTime.UtcNow.AddHours(8).ToString("yyyy-MM-dd")));
-            var endDate = DateOnly.Parse((root.TryGetProperty("endDate", out var ed) ? ed.GetString()! : DateTime.UtcNow.AddHours(8).AddDays(6).ToString("yyyy-MM-dd")));
-            var plan = new ExercisePlan { Id = Guid.NewGuid(), UserId = userId, WeekStartDate = startDate };
-            for (var d = startDate; d <= endDate; d = d.AddDays(1))
-            {
-                plan.Items.Add(new ExercisePlanItem
-                {
-                    Id = Guid.NewGuid(),
-                    DayOfWeek = (int)d.DayOfWeek,
-                                        ExerciseType = exerciseType,
-                    DurationMinutes = duration,
-                    IsRestDay = false,
-                });
-            }
-            db.ExercisePlans.Add(plan);
-            await db.SaveChangesAsync(ct);
-            return Results.Ok(new { code = 0, data = new { plan.Id }, message = (string?)null });
+            var startDate = DateOnly.Parse(root.TryGetProperty("startDate", out var sd)
+                ? sd.GetString()!
+                : DateTime.UtcNow.AddHours(8).ToString("yyyy-MM-dd"));
+            var endDate = DateOnly.Parse(root.TryGetProperty("endDate", out var ed)
+                ? ed.GetString()!
+                : DateTime.UtcNow.AddHours(8).AddDays(6).ToString("yyyy-MM-dd"));
+            var reminderTime = root.TryGetProperty("reminderTime", out var rt) && TimeOnly.TryParse(rt.GetString(), out var parsedTime)
+                ? parsedTime
+                : new TimeOnly(19, 0);
+
+            var planId = await exercises.CreateAsync(userId, new ExercisePlanCreateRequest(startDate, endDate, exerciseType, duration, reminderTime), ct);
+            return Results.Ok(new { code = 0, data = new { id = planId }, message = (string?)null });
         });
 
-        group.MapGet("/", async (HttpContext http, AppDbContext db) =>
+        group.MapGet("/", async (HttpContext http, IExerciseService exercises, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var plans = await db.ExercisePlans.Where(p => p.UserId == userId)
-                .OrderByDescending(p => p.WeekStartDate).Take(20)
-                .Select(p => new
-                {
-                    p.Id, p.WeekStartDate, p.CreatedAt,
-                    totalDays = p.Items.Count,
-                    completedDays = p.Items.Count(i => i.IsCompleted),
-                    items = p.Items.OrderBy(i => i.DayOfWeek).Select(i => new
-                    {
-                        i.Id, i.DayOfWeek,
-                        i.ExerciseType, i.DurationMinutes,
-                        i.IsCompleted, i.IsRestDay
-                    })
-                }).ToListAsync();
+            var plans = await exercises.ListAsync(userId, ct);
             return Results.Ok(new { code = 0, data = plans, message = (string?)null });
         });
 
-        group.MapGet("/{id:guid}", async (Guid id, HttpContext http, AppDbContext db) =>
+        group.MapGet("/{id:guid}", async (Guid id, HttpContext http, IExerciseService exercises, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var plan = await db.ExercisePlans.Include(p => p.Items)
-                .FirstOrDefaultAsync(p => p.Id == id && p.UserId == userId);
+            var plan = await exercises.GetByIdAsync(userId, id, ct);
             if (plan == null) return Results.Ok(new { code = 40004, message = "不存在" });
-            return Results.Ok(new
-            {
-                code = 0,
-                data = new
-                {
-                    plan.Id, plan.WeekStartDate, plan.CreatedAt,
-                    items = plan.Items.OrderBy(i => i.DayOfWeek).Select(i => new
-                    {
-                        i.Id, i.DayOfWeek, i.ExerciseType, i.DurationMinutes,
-                        i.IsCompleted, i.CompletedAt, i.IsRestDay
-                    })
-                },
-                message = (string?)null
-            });
+
+            return Results.Ok(new { code = 0, data = plan, message = (string?)null });
         });
 
-        group.MapDelete("/{id:guid}", async (Guid id, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapDelete("/{id:guid}", async (Guid id, HttpContext http, IExerciseService exercises, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var plan = await db.ExercisePlans.Include(p => p.Items).FirstOrDefaultAsync(p => p.Id == id && p.UserId == userId, ct);
-            if (plan != null) { db.ExercisePlans.Remove(plan); await db.SaveChangesAsync(ct); }
+            await exercises.DeleteAsync(userId, id, ct);
             return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
         });
 
-        group.MapPost("/items/{itemId:guid}/checkin", async (Guid itemId, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapPost("/items/{itemId:guid}/checkin", async (Guid itemId, HttpContext http, IExerciseService exercises, CancellationToken ct) =>
         {
-            var item = await db.ExercisePlanItems.FindAsync([itemId], ct);
-            if (item == null) return Results.Ok(new { code = 40004, message = "不存在" });
-            item.IsCompleted = !item.IsCompleted;
-            item.CompletedAt = item.IsCompleted ? DateTime.UtcNow : null;
-            await db.SaveChangesAsync(ct);
-            return Results.Ok(new { code = 0, data = new { completed = item.IsCompleted }, message = (string?)null });
+            var userId = GetUserId(http);
+            var completed = await exercises.ToggleCheckInAsync(userId, itemId, ct);
+            if (completed == null) return Results.Ok(new { code = 40004, message = "不存在" });
+
+            return Results.Ok(new { code = 0, data = new { completed }, message = (string?)null });
         });
     }
 
+    private static async Task<string> ReadBodyAsync(HttpRequest request, CancellationToken ct)
+    {
+        request.EnableBuffering();
+        using var reader = new StreamReader(request.Body, leaveOpen: true);
+        var body = await reader.ReadToEndAsync(ct);
+        request.Body.Position = 0;
+        return string.IsNullOrWhiteSpace(body) ? "{}" : body;
+    }
+
     private static Guid GetUserId(HttpContext http) =>
         Guid.TryParse(http.User.FindFirst(System.Security.Claims.ClaimTypes.NameIdentifier)?.Value, out var id) ? id : Guid.Empty;
 }
-

backend/src/Health.WebApi/Endpoints/file_endpoints.cs

@@ -2,26 +2,55 @@ namespace Health.WebApi.Endpoints;
 
 public static class FileEndpoints
 {
+    private const long MaxFileSize = 20 * 1024 * 1024;
+    private static readonly HashSet<string> AllowedExtensions = new(StringComparer.OrdinalIgnoreCase)
+    {
+        ".jpg", ".jpeg", ".png", ".webp", ".gif", ".pdf"
+    };
+
     public static void MapFileEndpoints(this WebApplication app)
     {
         var group = app.MapGroup("/api/files").RequireAuthorization();
 
-        group.MapPost("/upload", async (HttpRequest request) =>
+        group.MapPost("/upload", async (HttpRequest request, CancellationToken ct) =>
         {
-            var form = await request.ReadFormAsync();
+            if (!request.HasFormContentType)
+                return Results.Ok(new { code = 40001, data = (object?)null, message = "需要 multipart/form-data" });
+
+            var form = await request.ReadFormAsync(ct);
             var files = form.Files;
+            if (files.Count == 0)
+                return Results.Ok(new { code = 40001, data = (object?)null, message = "未上传文件" });
+
             var results = new List<object>();
             var uploadsDir = Path.Combine(Directory.GetCurrentDirectory(), "uploads");
             Directory.CreateDirectory(uploadsDir);
 
             foreach (var file in files)
             {
+                if (file.Length <= 0)
+                    continue;
+
+                if (file.Length > MaxFileSize)
+                    return Results.Ok(new { code = 40001, data = (object?)null, message = "文件大小不能超过 20MB" });
+
                 var fileId = Guid.NewGuid().ToString();
-                var ext = Path.GetExtension(file.FileName);
+                var ext = Path.GetExtension(file.FileName).ToLowerInvariant();
+                if (!AllowedExtensions.Contains(ext))
+                    return Results.Ok(new { code = 40001, data = (object?)null, message = "不支持的文件类型" });
+
+                var storedName = $"{fileId}{ext}";
                 var filePath = Path.Combine(uploadsDir, $"{fileId}{ext}");
-                using var stream = new FileStream(filePath, FileMode.Create);
-                await file.CopyToAsync(stream);
-                results.Add(new { id = fileId, name = file.FileName, size = file.Length });
+                await using var stream = new FileStream(filePath, FileMode.Create);
+                await file.CopyToAsync(stream, ct);
+                results.Add(new
+                {
+                    id = fileId,
+                    name = file.FileName,
+                    size = file.Length,
+                    url = $"/uploads/{storedName}",
+                    contentType = string.IsNullOrWhiteSpace(file.ContentType) ? "application/octet-stream" : file.ContentType
+                });
             }
 
             return Results.Ok(new { code = 0, data = results, message = (string?)null });

backend/src/Health.WebApi/Endpoints/health_endpoints.cs

@@ -1,3 +1,5 @@
+using Health.Application.HealthRecords;
+
 namespace Health.WebApi.Endpoints;
 
 /// <summary>
@@ -9,127 +11,82 @@ public static class HealthEndpoints
     {
         var group = app.MapGroup("/api/health-records").RequireAuthorization();
 
-        // 查询健康记录
         group.MapGet("/", async (
-            string? type, int? days,
-            HttpContext http, AppDbContext db, CancellationToken ct) =>
+            string? type,
+            int? days,
+            HttpContext http,
+            IHealthRecordService healthRecords,
+            CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var query = db.HealthRecords.Where(r => r.UserId == userId);
-
-            if (!string.IsNullOrEmpty(type) && Enum.TryParse<HealthMetricType>(type, ignoreCase: true, out var mt))
-                query = query.Where(r => r.MetricType == mt);
-
-            if (days.HasValue)
-                query = query.Where(r => r.RecordedAt >= DateTime.UtcNow.AddDays(-days.Value));
-
-            var records = await query.OrderByDescending(r => r.RecordedAt).Take(100)
-                .Select(r => new
-                {
-                    r.Id, Type = r.MetricType.ToString(), r.Systolic, r.Diastolic, r.Value, r.Unit,
-                    Source = r.Source.ToString(), r.IsAbnormal, r.RecordedAt
-                }).ToListAsync(ct);
-
+            var records = await healthRecords.GetRecordsAsync(userId, type, days, ct);
             return Results.Ok(new { code = 0, data = records, message = (string?)null });
         });
 
-        // 新增健康记录
-        group.MapPost("/", async (CreateHealthRecordRequest req, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapPost("/", async (
+            CreateHealthRecordRequest req,
+            HttpContext http,
+            IHealthRecordService healthRecords,
+            CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var record = new HealthRecord
-            {
-                Id = Guid.NewGuid(), UserId = userId, MetricType = req.Type,
-                Systolic = req.Systolic, Diastolic = req.Diastolic, Value = req.Value,
-                Unit = req.Unit, Source = req.Source, RecordedAt = req.RecordedAt ?? DateTime.UtcNow,
-                IsAbnormal = CheckAbnormal(req),
-            };
-            db.HealthRecords.Add(record);
-            await db.SaveChangesAsync(ct);
-
-            return Results.Ok(new { code = 0, data = new { record.Id }, message = (string?)null });
+            var id = await healthRecords.CreateAsync(userId, req.ToServiceRequest(), ct);
+            return Results.Ok(new { code = 0, data = new { id }, message = (string?)null });
         });
 
-        // 修改健康记录
-        group.MapPut("/{id:guid}", async (Guid id, CreateHealthRecordRequest req, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapPut("/{id:guid}", async (
+            Guid id,
+            CreateHealthRecordRequest req,
+            HttpContext http,
+            IHealthRecordService healthRecords,
+            CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var record = await db.HealthRecords.FirstOrDefaultAsync(r => r.Id == id && r.UserId == userId, ct);
-            if (record == null) return Results.Ok(new { code = 40004, data = (object?)null, message = "记录不存在" });
-
-            record.Systolic = req.Systolic;
-            record.Diastolic = req.Diastolic;
-            record.Value = req.Value;
-            record.Unit = req.Unit;
-            record.RecordedAt = req.RecordedAt ?? record.RecordedAt;
-            record.IsAbnormal = CheckAbnormal(req);
-            await db.SaveChangesAsync(ct);
-
-            return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
+            var ok = await healthRecords.UpdateAsync(userId, id, req.ToServiceRequest(), ct);
+            return ok
+                ? Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null })
+                : Results.Ok(new { code = 40004, data = (object?)null, message = "记录不存在" });
         });
 
-        // 删除健康记录
-        group.MapDelete("/{id:guid}", async (Guid id, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapDelete("/{id:guid}", async (
+            Guid id,
+            HttpContext http,
+            IHealthRecordService healthRecords,
+            CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var record = await db.HealthRecords.FirstOrDefaultAsync(r => r.Id == id && r.UserId == userId, ct);
-            if (record == null) return Results.Ok(new { code = 40004, data = (object?)null, message = "记录不存在" });
-            db.HealthRecords.Remove(record);
-            await db.SaveChangesAsync(ct);
-            return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
+            var ok = await healthRecords.DeleteAsync(userId, id, ct);
+            return ok
+                ? Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null })
+                : Results.Ok(new { code = 40004, data = (object?)null, message = "记录不存在" });
         });
 
-        // 获取各指标最新值
-        group.MapGet("/latest", async (HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapGet("/latest", async (
+            HttpContext http,
+            IHealthRecordService healthRecords,
+            CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var types = new[] { HealthMetricType.BloodPressure, HealthMetricType.HeartRate, HealthMetricType.Glucose, HealthMetricType.SpO2, HealthMetricType.Weight };
-            var result = new Dictionary<string, object?>();
-
-            foreach (var t in types)
-            {
-                var latest = await db.HealthRecords
-                    .Where(r => r.UserId == userId && r.MetricType == t)
-                    .OrderByDescending(r => r.RecordedAt)
-                    .FirstOrDefaultAsync(ct);
-
-                result[t.ToString()] = latest == null ? null : new
-                {
-                    latest.Systolic, latest.Diastolic, latest.Value, latest.Unit, latest.RecordedAt
-                };
-            }
-
-            return Results.Ok(new { code = 0, data = result, message = (string?)null });
+            var latest = await healthRecords.GetLatestAsync(userId, ct);
+            return Results.Ok(new { code = 0, data = latest, message = (string?)null });
         });
 
-        // 趋势数据
-        group.MapGet("/trend", async (string type, int period, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapGet("/trend", async (
+            string type,
+            int period,
+            HttpContext http,
+            IHealthRecordService healthRecords,
+            CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            if (!Enum.TryParse<HealthMetricType>(type, ignoreCase: true, out var mt))
+            if (!Enum.TryParse<HealthMetricType>(type, ignoreCase: true, out var metricType))
                 return Results.Ok(new { code = 40001, data = (object?)null, message = "不支持的指标类型" });
 
-            var days = period switch { 7 => 7, 30 => 30, 90 => 90, _ => 7 };
-            var records = await db.HealthRecords
-                .Where(r => r.UserId == userId && r.MetricType == mt && r.RecordedAt >= DateTime.UtcNow.AddDays(-days))
-                .OrderBy(r => r.RecordedAt)
-                .Select(r => new { r.Id, r.Systolic, r.Diastolic, r.Value, r.IsAbnormal, r.RecordedAt })
-                .ToListAsync(ct);
-
+            var records = await healthRecords.GetTrendAsync(userId, metricType, period, ct);
             return Results.Ok(new { code = 0, data = records, message = (string?)null });
         });
     }
 
-    private static bool CheckAbnormal(CreateHealthRecordRequest req) => req.Type switch
-    {
-        HealthMetricType.BloodPressure => req.Systolic >= 140 || req.Diastolic >= 90 || req.Systolic <= 89 || req.Diastolic <= 59,
-        HealthMetricType.HeartRate => req.Value > 100 || req.Value < 60,
-        HealthMetricType.Glucose => req.Value >= 7.0m || req.Value <= 3.8m,
-        HealthMetricType.SpO2 => req.Value <= 94,
-        HealthMetricType.Weight => false, // 体重无标准异常范围
-        _ => false
-    };
-
     private static Guid GetUserId(HttpContext http) =>
         Guid.TryParse(http.User.FindFirst(System.Security.Claims.ClaimTypes.NameIdentifier)?.Value, out var id) ? id : Guid.Empty;
 }
@@ -143,4 +100,13 @@ public sealed class CreateHealthRecordRequest
     public string? Unit { get; init; }
     public HealthRecordSource Source { get; init; }
     public DateTime? RecordedAt { get; init; }
+
+    public HealthRecordUpsertRequest ToServiceRequest() => new(
+        Type,
+        Systolic,
+        Diastolic,
+        Value,
+        Unit,
+        Source,
+        RecordedAt);
 }

backend/src/Health.WebApi/Endpoints/medication_endpoints.cs

@@ -1,3 +1,5 @@
+using Health.Application.Medications;
+
 namespace Health.WebApi.Endpoints;
 
 public static class MedicationEndpoints
@@ -6,255 +8,139 @@ public static class MedicationEndpoints
     {
         var group = app.MapGroup("/api/medications").RequireAuthorization();
 
-        group.MapGet("/", async (string? filter, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapGet("/", async (string? filter, HttpContext http, IMedicationService medications, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var query = db.Medications.Where(m => m.UserId == userId);
-            if (filter == "active") query = query.Where(m => m.IsActive);
-            else if (filter == "inactive") query = query.Where(m => !m.IsActive);
-            // 北京时间今天对应的 UTC 区间
-            var beijingToday = DateTime.UtcNow.AddHours(8).Date;
-            var todayStartUtc = beijingToday.AddHours(-8);
-            var todayEndUtc = todayStartUtc.AddDays(1);
-            var meds = await query.OrderByDescending(m => m.CreatedAt).Select(m => new
-            {
-                m.Id, m.Name, m.Dosage, Frequency = m.Frequency.ToString(),
-                m.TimeOfDay, m.StartDate, m.EndDate, m.IsActive, m.Notes,
-                Source = m.Source.ToString(), m.CreatedAt, m.UpdatedAt,
-                todayTaken = m.Logs.Any(l => l.CreatedAt >= todayStartUtc && l.CreatedAt < todayEndUtc && l.Status == MedicationLogStatus.Taken)
-            }).ToListAsync(ct);
+            var meds = await medications.ListAsync(userId, filter, ct);
             return Results.Ok(new { code = 0, data = meds, message = (string?)null });
         });
 
-        group.MapPost("/", async (HttpRequest request, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapPost("/", async (HttpRequest request, HttpContext http, IMedicationService medications, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            request.EnableBuffering();
-            using var reader = new StreamReader(request.Body);
-            var body = await reader.ReadToEndAsync(ct);
-            request.Body.Position = 0;
-            using var json = JsonDocument.Parse(body);
-            var root = json.RootElement;
-            var med = new Medication
-            {
-                Id = Guid.NewGuid(), UserId = userId,
-                Name = root.GetProperty("name").GetString()!,
-                Dosage = root.TryGetProperty("dosage", out var dg) ? dg.GetString() : null,
-                Frequency = Enum.TryParse<MedicationFrequency>(root.TryGetProperty("frequency", out var f) ? f.GetString() : "Daily", out var freq) ? freq : MedicationFrequency.Daily,
-                Source = Enum.TryParse<MedicationSource>(root.TryGetProperty("source", out var s) ? s.GetString() : "Manual", out var src) ? src : MedicationSource.Manual,
-                IsActive = true,
-            };
-            if (root.TryGetProperty("timeOfDay", out var tod))
-                med.TimeOfDay = tod.EnumerateArray().Select(t => TimeOnly.Parse(t.GetString()!)).ToList();
-            if (root.TryGetProperty("startDate", out var sd))
-                med.StartDate = DateOnly.TryParse(sd.GetString(), out var d) ? d : null;
-            if (root.TryGetProperty("endDate", out var ed))
-                med.EndDate = DateOnly.TryParse(ed.GetString(), out var d2) ? d2 : null;
-            if (root.TryGetProperty("notes", out var nt)) med.Notes = nt.GetString();
-            db.Medications.Add(med);
-            await db.SaveChangesAsync(ct);
-            return Results.Ok(new { code = 0, data = new { med.Id }, message = (string?)null });
+            using var json = JsonDocument.Parse(await ReadBodyAsync(request, ct));
+            var medId = await medications.CreateAsync(userId, ReadCreateRequest(json.RootElement), ct);
+            return Results.Ok(new { code = 0, data = new { id = medId }, message = (string?)null });
         });
 
-        group.MapPut("/{id:guid}", async (Guid id, HttpRequest request, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapPut("/{id:guid}", async (Guid id, HttpRequest request, HttpContext http, IMedicationService medications, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var med = await db.Medications.FirstOrDefaultAsync(m => m.Id == id && m.UserId == userId, ct);
-            if (med == null) return Results.Ok(new { code = 40004, message = "不存在" });
-            request.EnableBuffering();
-            using var reader = new StreamReader(request.Body);
-            var body = await reader.ReadToEndAsync(ct);
-            request.Body.Position = 0;
-            using var json = JsonDocument.Parse(body);
-            var root = json.RootElement;
-            if (root.TryGetProperty("name", out var n)) med.Name = n.GetString()!;
-            if (root.TryGetProperty("dosage", out var dg2)) med.Dosage = dg2.GetString();
-            if (root.TryGetProperty("frequency", out var f2) && Enum.TryParse<MedicationFrequency>(f2.GetString(), out var freq2)) med.Frequency = freq2;
-            if (root.TryGetProperty("timeOfDay", out var tod2)) med.TimeOfDay = tod2.EnumerateArray().Select(t => TimeOnly.Parse(t.GetString()!)).ToList();
-            if (root.TryGetProperty("startDate", out var sd2) && DateOnly.TryParse(sd2.GetString(), out var d3)) med.StartDate = d3;
-            if (root.TryGetProperty("endDate", out var ed2) && DateOnly.TryParse(ed2.GetString(), out var d4)) med.EndDate = d4;
-            if (root.TryGetProperty("notes", out var nt2)) med.Notes = nt2.GetString();
-            med.UpdatedAt = DateTime.UtcNow;
-            await db.SaveChangesAsync(ct);
+            using var json = JsonDocument.Parse(await ReadBodyAsync(request, ct));
+            var updated = await medications.UpdateAsync(userId, id, ReadPatchRequest(json.RootElement), ct);
+            if (!updated) return Results.Ok(new { code = 40004, message = "不存在" });
+
             return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
         });
 
-        group.MapDelete("/{id:guid}", async (Guid id, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapDelete("/{id:guid}", async (Guid id, HttpContext http, IMedicationService medications, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var med = await db.Medications.FirstOrDefaultAsync(m => m.Id == id && m.UserId == userId, ct);
-            if (med != null) { db.Medications.Remove(med); await db.SaveChangesAsync(ct); }
+            await medications.DeleteAsync(userId, id, ct);
             return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
         });
 
-        group.MapPost("/{id:guid}/confirm", async (Guid id, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapPost("/{id:guid}/confirm", async (Guid id, HttpContext http, IMedicationService medications, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var beijingToday = DateTime.UtcNow.AddHours(8).Date;
-            var todayStartUtc = beijingToday.AddHours(-8);
-            var todayEndUtc = todayStartUtc.AddDays(1);
-            var existing = await db.MedicationLogs.FirstOrDefaultAsync(l => l.MedicationId == id && l.CreatedAt >= todayStartUtc && l.CreatedAt < todayEndUtc && l.Status == MedicationLogStatus.Taken, ct);
-            if (existing != null) {
-                db.MedicationLogs.Remove(existing);
-                await db.SaveChangesAsync(ct);
-                return Results.Ok(new { code = 0, data = new { taken = false }, message = (string?)null });
-            }
-            var log = new MedicationLog
-            {
-                Id = Guid.NewGuid(), MedicationId = id, UserId = userId,
-                Status = MedicationLogStatus.Taken, ScheduledTime = TimeOnly.FromDateTime(DateTime.UtcNow.AddHours(8)), ConfirmedAt = DateTime.UtcNow,
-            };
-            db.MedicationLogs.Add(log);
-            await db.SaveChangesAsync(ct);
-            return Results.Ok(new { code = 0, data = new { taken = true }, message = (string?)null });
+            var taken = await medications.ToggleTodayTakenAsync(userId, id, ct);
+            if (taken == null) return Results.Ok(new { code = 404, message = "药品不存在" });
+
+            return Results.Ok(new { code = 0, data = new { taken }, message = (string?)null });
         });
 
-        group.MapGet("/reminders", async (HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapGet("/reminders", async (HttpContext http, IMedicationService medications, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var beijingNow = DateTime.UtcNow.AddHours(8);
-            var now = TimeOnly.FromDateTime(beijingNow);
-            var today = DateOnly.FromDateTime(beijingNow);
-            var todayUtc = DateTime.SpecifyKind(beijingNow.Date, DateTimeKind.Utc);
-
-            // 只查活跃且在有效期内的药
-            var meds = await db.Medications
-                .Where(m => m.UserId == userId && m.IsActive && m.TimeOfDay != null
-                    && m.StartDate <= today && (m.EndDate == null || m.EndDate >= today))
-                .ToListAsync(ct);
-
-            // 查询今天所有服药记录
-            var logs = await db.MedicationLogs
-                .Where(l => l.UserId == userId && l.ConfirmedAt >= todayUtc)
-                .ToListAsync(ct);
-
-            // 按次生成提醒
-            var reminders = new List<object>();
-            foreach (var m in meds)
-            {
-                // 处理隔天/每周的逻辑
-                var dosesToday = GetDosesForToday(m, today);
-                if (!dosesToday) continue;
-
-                foreach (var t in m.TimeOfDay!)
-                {
-                    var scheduledTime = t;
-                    var doseTimeBeijing = today.ToDateTime(scheduledTime);
-
-                    // 查该药该时间是否已打卡
-                    var alreadyLogged = logs.Any(l =>
-                        l.MedicationId == m.Id && l.ScheduledTime == scheduledTime);
-
-                    string status;
-                    if (alreadyLogged)
-                    {
-                        var log = logs.First(l => l.MedicationId == m.Id && l.ScheduledTime == scheduledTime);
-                        status = log.Status == MedicationLogStatus.Taken ? "taken" : "skipped";
-                    }
-                    else if (scheduledTime <= now.AddMinutes(-30))
-                    {
-                        status = "overdue"; // 过了30分钟还没吃
-                    }
-                    else if (scheduledTime <= now.AddHours(3))
-                    {
-                        status = "upcoming"; // 未来3小时内
-                    }
-                    else
-                    {
-                        continue; // 太远，不显示
-                    }
-
-                    reminders.Add(new
-                    {
-                        m.Id, m.Name, m.Dosage,
-                        scheduledTime = scheduledTime.ToString("HH:mm"),
-                        status,
-                    });
-                }
-            }
-
-            // overdue 在前，upcoming 在后，taken 在最后
-            reminders = reminders.OrderBy(r =>
-                ((dynamic)r).status == "overdue" ? 0 :
-                ((dynamic)r).status == "upcoming" ? 1 : 2
-            ).ToList();
-
+            var reminders = await medications.GetRemindersAsync(userId, ct);
             return Results.Ok(new { code = 0, data = reminders, message = (string?)null });
         });
 
-        // 按次打卡
-        group.MapPost("/{id:guid}/confirm-dose", async (Guid id, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapPost("/{id:guid}/confirm-dose", async (Guid id, HttpContext http, IMedicationService medications, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var med = await db.Medications.FirstOrDefaultAsync(m => m.Id == id && m.UserId == userId, ct);
-            if (med == null) return Results.Ok(new { code = 404, message = "药品不存在" });
-
-            using var reader = new System.IO.StreamReader(http.Request.Body);
-            var body = await reader.ReadToEndAsync(ct);
-            var json = System.Text.Json.JsonDocument.Parse(body);
+            using var json = JsonDocument.Parse(await ReadBodyAsync(http.Request, ct));
             var timeStr = json.RootElement.GetProperty("scheduledTime").GetString()!;
             var statusStr = json.RootElement.TryGetProperty("status", out var st) ? st.GetString() : "taken";
             var scheduledTime = TimeOnly.Parse(timeStr);
             var status = statusStr == "taken" ? MedicationLogStatus.Taken : MedicationLogStatus.Skipped;
 
-            // 防止重复打卡
-            var todayUtc = DateTime.SpecifyKind(DateTime.UtcNow.AddHours(8).Date, DateTimeKind.Utc);
-            var existing = await db.MedicationLogs.AnyAsync(l =>
-                l.MedicationId == id && l.UserId == userId
-                && l.ScheduledTime == scheduledTime && l.ConfirmedAt >= todayUtc, ct);
-            if (existing) return Results.Ok(new { code = 0, data = new { success = false, message = "已打卡" }, message = (string?)null });
+            var result = await medications.ConfirmDoseAsync(userId, id, scheduledTime, status, ct);
+            if (result == null) return Results.Ok(new { code = 404, message = "药品不存在" });
+            if (result == false) return Results.Ok(new { code = 0, data = new { success = false, message = "已打卡" }, message = (string?)null });
 
-            db.MedicationLogs.Add(new MedicationLog
-            {
-                Id = Guid.NewGuid(), MedicationId = id, UserId = userId,
-                Status = status, ScheduledTime = scheduledTime, ConfirmedAt = DateTime.UtcNow,
-            });
-            await db.SaveChangesAsync(ct);
             return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
         });
 
-        // 取消打卡（删掉对应 log）
-        group.MapDelete("/{id:guid}/confirm-dose/{time}", async (Guid id, string time, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapDelete("/{id:guid}/confirm-dose/{time}", async (Guid id, string time, HttpContext http, IMedicationService medications, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var scheduledTime = TimeOnly.Parse(time);
-            var todayUtc = DateTime.SpecifyKind(DateTime.UtcNow.AddHours(8).Date, DateTimeKind.Utc);
-            var log = await db.MedicationLogs
-                .Where(l => l.MedicationId == id && l.UserId == userId
-                    && l.ScheduledTime == scheduledTime && l.ConfirmedAt >= todayUtc)
-                .FirstOrDefaultAsync(ct);
-            if (log != null) { db.MedicationLogs.Remove(log); await db.SaveChangesAsync(ct); }
+            await medications.CancelDoseAsync(userId, id, TimeOnly.Parse(time), ct);
             return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
         });
     }
 
-    /// <summary>
-    /// 判断今天是否该吃药（处理隔天/每周频率）
-    /// </summary>
-    private static bool GetDosesForToday(Medication m, DateOnly today)
+    private static MedicationUpsertRequest ReadCreateRequest(JsonElement root)
     {
-        if (m.Frequency == MedicationFrequency.Daily) return true;
-        if (m.Frequency == MedicationFrequency.TwiceDaily) return true;
-        if (m.Frequency == MedicationFrequency.ThreeTimesDaily) return true;
-        if (m.Frequency == MedicationFrequency.AsNeeded) return true;
+        var frequency = Enum.TryParse<MedicationFrequency>(
+            root.TryGetProperty("frequency", out var f) ? f.GetString() : "Daily",
+            out var freq)
+            ? freq
+            : MedicationFrequency.Daily;
+        var source = Enum.TryParse<MedicationSource>(
+            root.TryGetProperty("source", out var s) ? s.GetString() : "Manual",
+            out var src)
+            ? src
+            : MedicationSource.Manual;
 
-        var startDate = m.StartDate ?? today;
-        if (m.Frequency == MedicationFrequency.EveryOtherDay)
-        {
-            var daysSinceStart = today.DayNumber - startDate.DayNumber;
-            return daysSinceStart % 2 == 0;
-        }
-        if (m.Frequency == MedicationFrequency.Weekly)
-        {
-            return today.DayOfWeek == startDate.DayOfWeek;
-        }
-        return true;
+        return new MedicationUpsertRequest(
+            root.GetProperty("name").GetString()!,
+            root.TryGetProperty("dosage", out var dg) ? dg.GetString() : null,
+            frequency,
+            ReadTimes(root, "timeOfDay"),
+            root.TryGetProperty("startDate", out var sd) && DateOnly.TryParse(sd.GetString(), out var startDate) ? startDate : null,
+            root.TryGetProperty("endDate", out var ed) && DateOnly.TryParse(ed.GetString(), out var endDate) ? endDate : null,
+            source,
+            root.TryGetProperty("notes", out var nt) ? nt.GetString() : null);
     }
 
-    private static bool InTimeWindow(TimeOnly t, TimeOnly start, TimeOnly end) =>
-        end > start ? (t >= start && t <= end) : (t >= start || t <= end); // 处理跨午夜
+    private static MedicationPatchRequest ReadPatchRequest(JsonElement root)
+    {
+        MedicationFrequency? frequency = null;
+        if (root.TryGetProperty("frequency", out var f) && Enum.TryParse<MedicationFrequency>(f.GetString(), out var freq))
+            frequency = freq;
+
+        return new MedicationPatchRequest(
+            root.TryGetProperty("name", out var n) ? n.GetString() : null,
+            root.TryGetProperty("dosage", out var dg) ? dg.GetString() : null,
+            frequency,
+            root.TryGetProperty("timeOfDay", out _) ? ReadTimes(root, "timeOfDay") : null,
+            root.TryGetProperty("startDate", out var sd) && DateOnly.TryParse(sd.GetString(), out var startDate) ? startDate : null,
+            root.TryGetProperty("endDate", out var ed) && DateOnly.TryParse(ed.GetString(), out var endDate) ? endDate : null,
+            root.TryGetProperty("notes", out var nt) ? nt.GetString() : null);
+    }
+
+    private static List<TimeOnly> ReadTimes(JsonElement root, string propertyName)
+    {
+        if (!root.TryGetProperty(propertyName, out var tod) || tod.ValueKind != JsonValueKind.Array)
+            return [];
+
+        return tod.EnumerateArray()
+            .Select(t => TimeOnly.TryParse(t.GetString(), out var parsed) ? parsed : (TimeOnly?)null)
+            .Where(t => t.HasValue)
+            .Select(t => t!.Value)
+            .ToList();
+    }
+
+    private static async Task<string> ReadBodyAsync(HttpRequest request, CancellationToken ct)
+    {
+        request.EnableBuffering();
+        using var reader = new StreamReader(request.Body, leaveOpen: true);
+        var body = await reader.ReadToEndAsync(ct);
+        request.Body.Position = 0;
+        return string.IsNullOrWhiteSpace(body) ? "{}" : body;
+    }
 
     private static Guid GetUserId(HttpContext http) =>
         Guid.TryParse(http.User.FindFirst(System.Security.Claims.ClaimTypes.NameIdentifier)?.Value, out var id) ? id : Guid.Empty;
 }
-

backend/src/Health.WebApi/Endpoints/notification_endpoints.cs

@@ -0,0 +1,31 @@
+using System.Security.Claims;
+using Health.Application.Notifications;
+
+namespace Health.WebApi.Endpoints;
+
+public static class NotificationEndpoints
+{
+    public static void MapNotificationEndpoints(this WebApplication app)
+    {
+        var group = app.MapGroup("/api/notifications").RequireAuthorization();
+
+        group.MapGet("/pending", async (HttpContext http, IInAppNotificationService notifications, CancellationToken ct) =>
+        {
+            var userId = GetUserId(http);
+            if (userId == Guid.Empty) return Results.Unauthorized();
+            var result = await notifications.GetPendingAsync(userId, ct);
+            return Results.Ok(new { code = 0, data = result, message = (string?)null });
+        });
+
+        group.MapPost("/{id:guid}/acknowledge", async (Guid id, HttpContext http, IInAppNotificationService notifications, CancellationToken ct) =>
+        {
+            var userId = GetUserId(http);
+            if (userId == Guid.Empty) return Results.Unauthorized();
+            var acknowledged = await notifications.AcknowledgeAsync(userId, id, ct);
+            return Results.Ok(new { code = 0, data = new { acknowledged }, message = (string?)null });
+        });
+    }
+
+    private static Guid GetUserId(HttpContext http) =>
+        Guid.TryParse(http.User.FindFirst(ClaimTypes.NameIdentifier)?.Value, out var id) ? id : Guid.Empty;
+}

backend/src/Health.WebApi/Endpoints/report_endpoints.cs

@@ -1,4 +1,4 @@
-using Health.Infrastructure.AI;
+using Health.Application.Reports;
 
 namespace Health.WebApi.Endpoints;
 
@@ -8,294 +8,62 @@ public static class ReportEndpoints
     {
         var group = app.MapGroup("/api/reports").RequireAuthorization();
 
-        // 列表
-        group.MapGet("/", async (HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapGet("/", async (HttpContext http, IReportService reports, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var reports = await db.Reports.Where(r => r.UserId == userId).OrderByDescending(r => r.CreatedAt).ToListAsync(ct);
-            return Results.Ok(new { code = 0, data = reports, message = (string?)null });
+            var data = await reports.GetReportsAsync(userId, ct);
+            return Results.Ok(new { code = 0, data, message = (string?)null });
         });
 
-        // 删除
-        group.MapDelete("/{id:guid}", async (Guid id, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapGet("/{id:guid}", async (Guid id, HttpContext http, IReportService reports, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            var report = await db.Reports.FirstOrDefaultAsync(r => r.Id == id && r.UserId == userId, ct);
-            if (report == null) return Results.Ok(new { code = 40004, message = "不存在" });
-            // 删除本地文件
-            if (!string.IsNullOrEmpty(report.FileUrl))
-            {
-                var filePath = Path.Combine(Directory.GetCurrentDirectory(), report.FileUrl.TrimStart('/'));
-                if (File.Exists(filePath)) File.Delete(filePath);
-            }
-            db.Reports.Remove(report);
-            await db.SaveChangesAsync(ct);
-            return Results.Ok(new { code = 0, message = "已删除" });
+            var report = await reports.GetReportAsync(userId, id, ct);
+            return report == null
+                ? Results.Ok(new { code = 40004, data = (object?)null, message = "不存在" })
+                : Results.Ok(new { code = 0, data = report, message = (string?)null });
         });
 
-        // 详情
-        group.MapGet("/{id:guid}", async (Guid id, HttpContext http, AppDbContext db, CancellationToken ct) =>
-        {
-            var userId = GetUserId(http);
-            var report = await db.Reports.FirstOrDefaultAsync(r => r.Id == id && r.UserId == userId, ct);
-            return report == null ? Results.Ok(new { code = 40004, message = "不存在" }) : Results.Ok(new { code = 0, data = report, message = (string?)null });
-        });
-
-        // 上传 + AI 预解读（VLM 提取指标 → LLM 生成摘要）
-        group.MapPost("/", async (HttpContext http, AppDbContext db, IServiceScopeFactory scopeFactory, CancellationToken ct) =>
+        group.MapPost("/", async (HttpContext http, IReportService reports, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
 
-            // 读 multipart form
             if (!http.Request.HasFormContentType)
-                return Results.Ok(new { code = 400, message = "需要 multipart/form-data" });
+                return Results.Ok(new { code = 400, data = (object?)null, message = "需要 multipart/form-data" });
 
             var form = await http.Request.ReadFormAsync(ct);
             var file = form.Files.GetFile("file");
-            if (file == null || file.Length == 0)
-                return Results.Ok(new { code = 400, message = "未上传文件" });
+            if (file == null)
+                return Results.Ok(new { code = 400, data = (object?)null, message = "未上传文件" });
 
-            // 保存文件
-            var uploadsDir = Path.Combine(Directory.GetCurrentDirectory(), "uploads", "reports");
-            Directory.CreateDirectory(uploadsDir);
-            var fileName = $"{Guid.NewGuid()}{Path.GetExtension(file.FileName)}";
-            var filePath = Path.Combine(uploadsDir, fileName);
-            await using (var stream = new FileStream(filePath, FileMode.Create))
-                await file.CopyToAsync(stream, ct);
+            await using var stream = file.OpenReadStream();
+            var result = await reports.UploadReportAsync(
+                userId,
+                new ReportUploadFile(file.FileName, file.Length, stream),
+                ct);
 
-            var fileUrl = $"/uploads/reports/{fileName}";
-            var isPdf = Path.GetExtension(fileName).ToLowerInvariant() == ".pdf";
+            return Results.Ok(new { code = result.Code, data = result.Report, message = result.Message });
+        });
 
-            // 创建报告记录
-            var report = new Report
-            {
-                Id = Guid.NewGuid(), UserId = userId,
-                FileUrl = fileUrl,
-                FileType = isPdf ? ReportFileType.Pdf : ReportFileType.Image,
-                Category = ReportCategory.Other,
-                Status = ReportStatus.PendingDoctor,
-                CreatedAt = DateTime.UtcNow,
-            };
-            db.Reports.Add(report);
-            await db.SaveChangesAsync(ct);
+        group.MapPost("/{id:guid}/reanalyze", async (Guid id, HttpContext http, IReportService reports, CancellationToken ct) =>
+        {
+            var userId = GetUserId(http);
+            var ok = await reports.ReanalyzeReportAsync(userId, id, ct);
+            return ok
+                ? Results.Ok(new { code = 0, data = new { success = true }, message = "已重新提交 AI 分析" })
+                : Results.Ok(new { code = 40004, data = (object?)null, message = "报告不存在或原始文件丢失" });
+        });
 
-            // 异步 AI 分析（用独立 scope，不依赖请求生命周期）
-            var reportId = report.Id;
-            _ = Task.Run(async () =>
-            {
-                try
-                {
-                    using var scope = scopeFactory.CreateScope();
-                    var taskDb = scope.ServiceProvider.GetRequiredService<AppDbContext>();
-                    var taskVision = scope.ServiceProvider.GetRequiredService<VisionClient>();
-                    var taskLlm = scope.ServiceProvider.GetRequiredService<DeepSeekClient>();
-                    await AnalyzeReportWithAI(reportId, filePath, taskVision, taskLlm, taskDb);
-                }
-                catch (Exception ex)
-                {
-                    Console.WriteLine($"[Report] AI 分析失败: {ex.Message}");
-                    // 回退：写入 fallback 数据
-                    try
-                    {
-                        using var fbScope = scopeFactory.CreateScope();
-                        var fbDb = fbScope.ServiceProvider.GetRequiredService<AppDbContext>();
-                        var fbReport = await fbDb.Reports.FirstOrDefaultAsync(r => r.Id == reportId);
-                        if (fbReport != null)
-                        {
-                            fbReport.AiSummary = GenerateFallbackSummary(fbReport.Category);
-                            fbReport.AiIndicators = GenerateFallbackIndicators(fbReport.Category);
-                            await fbDb.SaveChangesAsync();
-                        }
-                    }
-                    catch { }
-                }
-            }, CancellationToken.None);
-
-            return Results.Ok(new { code = 0, data = new { report.Id, report.Status, report.FileUrl }, message = "报告已上传，AI 正在分析中" });
+        group.MapDelete("/{id:guid}", async (Guid id, HttpContext http, IReportService reports, CancellationToken ct) =>
+        {
+            var userId = GetUserId(http);
+            var ok = await reports.DeleteReportAsync(userId, id, ct);
+            return ok
+                ? Results.Ok(new { code = 0, data = new { success = true }, message = "已删除" })
+                : Results.Ok(new { code = 40004, data = (object?)null, message = "不存在" });
         });
     }
 
-    /// <summary>
-    /// VLM 识别 + LLM 解读
-    /// </summary>
-    private static async Task AnalyzeReportWithAI(
-        Guid reportId, string filePath,
-        VisionClient vision, DeepSeekClient llm, AppDbContext db)
-    {
-        var report = await db.Reports.FirstOrDefaultAsync(r => r.Id == reportId);
-        if (report == null) return;
-
-        try
-        {
-            // ===== Step 1: 使用 VLM 识别报告图片，提取指标 =====
-            var vlmPrompt = """
-                你是一名医学检验报告分析专家。请仔细识别这份医学报告。
-
-                第一步：判断这到底是不是一份医学检验报告。
-                如果不是（比如是自拍、风景照、食物、文件等），直接返回：
-                {"isReport": false, "reason": "这不是医学报告，原因：..."}
-
-                如果是医学报告，提取所有检测指标，返回严格JSON格式（不要markdown包裹）：
-                {
-                  "isReport": true,
-                  "reportType": "BloodTest/Biochemistry/Ecg/Ultrasound/Discharge/Other",
-                  "indicators": [
-                    {"name": "指标名称", "value": "数值", "unit": "单位", "referenceRange": "参考范围", "status": "normal/high/low"}
-                  ]
-                }
-
-                注意：
-                - status 判断：数值在参考范围内=normal，超出上限=high，低于下限=low
-                - 如果参考范围不明确，根据常见医学标准判断
-                """;
-
-            var vlmContent = "";
-            try
-            {
-                var isPdf = Path.GetExtension(filePath).ToLowerInvariant() == ".pdf";
-                var imageUrl = isPdf ? null : await GetLocalImageUrl(filePath);
-                var vlmResponse = await vision.VisionAsync(
-                    vlmPrompt,
-                    imageUrl != null ? [imageUrl] : [],
-                    userText: "请分析这份医学报告",
-                    maxTokens: 2048);
-
-                vlmContent = vlmResponse.Choices?.FirstOrDefault()?.Message?.Content ?? "";
-                Console.WriteLine($"[Report] VLM 返回: {vlmContent?[..Math.Min(vlmContent.Length, 200)]}");
-            }
-            catch (Exception ex)
-            {
-                Console.WriteLine($"[Report] VLM 调用失败: {ex.Message}");
-                // VLM 不可用时回退到 mock 数据
-                vlmContent = GenerateFallbackIndicators(report.Category);
-            }
-
-            // 解析 VLM 结果
-            var vlmJson = TryParseJson(vlmContent);
-            var isReport = vlmJson?.TryGetProperty("isReport", out var ir) == true && ir.GetBoolean();
-            var reason = vlmJson?.TryGetProperty("reason", out var rsn) == true ? rsn.GetString() : null;
-
-            if (!isReport && !string.IsNullOrEmpty(reason))
-            {
-                report.AiSummary = $"⚠️ 无法分析：{reason}";
-                report.AiIndicators = "[]";
-                report.Status = ReportStatus.PendingDoctor;
-            }
-            else
-            {
-                var indicatorsJson = "[]";
-                var reportType = "Other";
-                if (vlmJson != null)
-                {
-                    reportType = vlmJson.Value.TryGetProperty("reportType", out var rt) ? rt.GetString()! : "Other";
-                    if (vlmJson.Value.TryGetProperty("indicators", out var inds))
-                        indicatorsJson = inds.GetRawText();
-                }
-
-                report.Category = Enum.TryParse<ReportCategory>(reportType, out var cat) ? cat : ReportCategory.Other;
-                report.AiIndicators = indicatorsJson;
-
-                // ===== Step 2: 使用 LLM 生成专业解读摘要 =====
-                try
-                {
-                    var indicators = indicatorsJson;
-                    var llmPrompt = $"""
-                        你是一名心血管内科主任医师。请根据以下检验指标，用通俗易懂的语言写一份报告解读。
-
-                        检测指标：{indicators}
-
-                        要求：
-                        1. 总字数200-300字
-                        2. 先总结整体情况
-                        3. 指出异常指标及其可能原因
-                        4. 给出生活建议
-                        5. 末尾提醒"以上为AI预解读，具体请以医生诊断为准"
-
-                        只返回解读文本，不要JSON格式。
-                        """;
-
-                    var llmMessages = new List<ChatMessage>
-                    {
-                        new() { Role = "system", Content = "你是一名心血管内科主任医师，擅长解读检验报告。" },
-                        new() { Role = "user", Content = llmPrompt }
-                    };
-
-                    var llmResponse = await llm.ChatAsync(llmMessages, maxTokens: 800, temperature: 0.3f);
-                    var summary = llmResponse.Choices?.FirstOrDefault()?.Message?.Content?.Trim() ?? "";
-
-                    if (!string.IsNullOrEmpty(summary))
-                        report.AiSummary = summary;
-                    else
-                        report.AiSummary = GenerateFallbackSummary(report.Category);
-                }
-                catch (Exception ex)
-                {
-                    Console.WriteLine($"[Report] LLM 调用失败: {ex.Message}");
-                    report.AiSummary = GenerateFallbackSummary(report.Category);
-                }
-            }
-
-            await db.SaveChangesAsync();
-            Console.WriteLine($"[Report] AI 分析完成: {reportId}");
-        }
-        catch (Exception ex)
-        {
-            Console.WriteLine($"[Report] 分析异常: {ex.Message}");
-            if (report != null)
-            {
-                report.AiSummary = GenerateFallbackSummary(report.Category);
-                report.AiIndicators = GenerateFallbackIndicators(report.Category);
-                await db.SaveChangesAsync();
-            }
-        }
-
-    }
-
-    private static async Task<string?> GetLocalImageUrl(string filePath)
-    {
-        // 对于本地文件，VLM 需要可访问的 URL
-        // 由于 VLM 调用是服务器端，本地路径可以直接作为 base64 或者 file:// URL
-        // 这里简化：暂不支持 PDF，图片直接用本地路径（千问支持本地路径）
-        if (!File.Exists(filePath)) return null;
-        var bytes = await File.ReadAllBytesAsync(filePath);
-        var base64 = Convert.ToBase64String(bytes);
-        var ext = Path.GetExtension(filePath).ToLowerInvariant().TrimStart('.');
-        var mime = ext switch { "png" => "image/png", "jpg" or "jpeg" => "image/jpeg", "webp" => "image/webp", _ => "image/png" };
-        return $"data:{mime};base64,{base64}";
-    }
-
-    private static JsonElement? TryParseJson(string content)
-    {
-        if (string.IsNullOrWhiteSpace(content)) return null;
-        content = content.Trim();
-        // 去掉可能包裹的 markdown ```json ... ```
-        if (content.StartsWith("```"))
-        {
-            var end = content.IndexOf('\n');
-            if (end > 0) content = content[(end + 1)..];
-            if (content.EndsWith("```"))
-                content = content[..^3];
-        }
-        content = content.Trim();
-        try { return JsonDocument.Parse(content).RootElement; }
-        catch { return null; }
-    }
-
-    private static string GenerateFallbackSummary(ReportCategory category) => category switch
-    {
-        ReportCategory.BloodTest => "血常规显示白细胞计数正常，红细胞及血红蛋白略低于参考范围下限，提示可能存在轻度贫血。血小板计数在正常范围内。建议关注铁蛋白及维生素B12水平，适当补充富含铁质的食物。以上为AI预解读，具体请以医生诊断为准。",
-        ReportCategory.Ecg => "心电图显示窦性心律，心率正常。无明显ST段改变或心律失常。以上为AI预解读，具体请以医生诊断为准。",
-        _ => "检查指标基本在参考范围内。以上为AI预解读，具体请以医生诊断为准。"
-    };
-
-    private static string GenerateFallbackIndicators(ReportCategory category) => category switch
-    {
-        ReportCategory.BloodTest => """[{"name":"白细胞计数","value":"7.5","unit":"×10^9/L","referenceRange":"4.0-10.0","status":"normal"},{"name":"红细胞计数","value":"4.1","unit":"×10^12/L","referenceRange":"4.3-5.8","status":"low"},{"name":"血红蛋白","value":"125","unit":"g/L","referenceRange":"130-175","status":"low"},{"name":"血小板计数","value":"195","unit":"×10^9/L","referenceRange":"100-300","status":"normal"}]""",
-        _ => """[{"name":"检查结果","value":"正常","unit":"","referenceRange":"","status":"normal"}]"""
-    };
-
     private static Guid GetUserId(HttpContext http) =>
         Guid.TryParse(http.User.FindFirst(System.Security.Claims.ClaimTypes.NameIdentifier)?.Value, out var id) ? id : Guid.Empty;
 }
-
-public sealed record CreateReportRequest(string FileUrl, ReportFileType FileType, ReportCategory? Category);

backend/src/Health.WebApi/Endpoints/user_endpoints.cs

@@ -1,105 +1,58 @@
+using Health.Application.HealthArchives;
+using Health.Application.Users;
+
 namespace Health.WebApi.Endpoints;
 
-/// <summary>
-/// 用户与健康档案 API 端点
-/// </summary>
 public static class UserEndpoints
 {
     public static void MapUserEndpoints(this WebApplication app)
     {
         var group = app.MapGroup("/api/user").RequireAuthorization();
 
-        // 获取个人信息
-        group.MapGet("/profile", async (HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapGet("/profile", async (HttpContext http, IUserService users, CancellationToken ct) =>
         {
-            var userId = GetUserId(http);
-            var user = await db.Users.Select(u => new
-            {
-                u.Id, u.Phone, u.Role, u.Name, u.Gender, BirthDate = u.BirthDate != null ? u.BirthDate.Value.ToString("yyyy-MM-dd") : null, u.AvatarUrl
-            }).FirstOrDefaultAsync(u => u.Id == userId, ct);
-
-            return Results.Ok(new { code = 0, data = user, message = (string?)null });
+            var profile = await users.GetProfileAsync(GetUserId(http), ct);
+            return Results.Ok(new { code = 0, data = profile, message = (string?)null });
         });
 
-        // 修改资料
-        group.MapPut("/profile", async (UpdateProfileRequest req, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapPut("/profile", async (UpdateProfileRequest req, HttpContext http, IUserService users, CancellationToken ct) =>
         {
-            var userId = GetUserId(http);
-            var user = await db.Users.FindAsync([userId], ct);
-            if (user == null) return Results.Ok(new { code = 40004, message = "用户不存在" });
-
-            user.Name = req.Name ?? user.Name;
-            user.Gender = req.Gender ?? user.Gender;
-            if (DateOnly.TryParse(req.BirthDate, out var bd)) user.BirthDate = bd;
-            user.UpdatedAt = DateTime.UtcNow;
-            await db.SaveChangesAsync(ct);
+            var birthDate = DateOnly.TryParse(req.BirthDate, out var parsed) ? parsed : (DateOnly?)null;
+            var updated = await users.UpdateProfileAsync(
+                GetUserId(http),
+                new UserProfileUpdateRequest(req.Name, req.Gender, birthDate),
+                ct);
+            if (!updated) return Results.Ok(new { code = 40004, message = "用户不存在" });
 
             return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
         });
 
-        // 获取健康档案
-        group.MapGet("/health-archive", async (HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapGet("/health-archive", async (HttpContext http, IHealthArchiveService archives, CancellationToken ct) =>
         {
-            var userId = GetUserId(http);
-            var archive = await db.HealthArchives.FirstOrDefaultAsync(a => a.UserId == userId, ct);
+            var archive = await archives.GetAsync(GetUserId(http), ct);
             return Results.Ok(new { code = 0, data = archive, message = (string?)null });
         });
 
-        // 更新健康档案
-        group.MapPut("/health-archive", async (UpdateArchiveRequest req, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapPut("/health-archive", async (UpdateArchiveRequest req, HttpContext http, IHealthArchiveService archives, CancellationToken ct) =>
         {
-            var userId = GetUserId(http);
-            var archive = await db.HealthArchives.FirstOrDefaultAsync(a => a.UserId == userId, ct);
-            if (archive == null)
-            {
-                archive = new HealthArchive { Id = Guid.NewGuid(), UserId = userId };
-                db.HealthArchives.Add(archive);
-            }
-
-            archive.Diagnosis = req.Diagnosis ?? archive.Diagnosis;
-            archive.SurgeryType = req.SurgeryType ?? archive.SurgeryType;
-            if (DateOnly.TryParse(req.SurgeryDate, out var sd)) archive.SurgeryDate = sd;
-            if (req.Allergies != null) archive.Allergies = req.Allergies;
-            if (req.DietRestrictions != null) archive.DietRestrictions = req.DietRestrictions;
-            if (req.ChronicDiseases != null) archive.ChronicDiseases = req.ChronicDiseases;
-            archive.FamilyHistory = req.FamilyHistory ?? archive.FamilyHistory;
-            archive.UpdatedAt = DateTime.UtcNow;
-            await db.SaveChangesAsync(ct);
-
+            var surgeryDate = DateOnly.TryParse(req.SurgeryDate, out var parsed) ? parsed : (DateOnly?)null;
+            await archives.UpdateAsync(
+                GetUserId(http),
+                new HealthArchiveUpdateRequest(
+                    req.Diagnosis,
+                    req.SurgeryType,
+                    surgeryDate,
+                    req.Allergies,
+                    req.DietRestrictions,
+                    req.ChronicDiseases,
+                    req.FamilyHistory),
+                ct);
             return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
         });
 
-        // 注销账号
-        group.MapDelete("/account", async (HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapDelete("/account", async (HttpContext http, IUserService users, CancellationToken ct) =>
         {
-            var userId = GetUserId(http);
-            // 医生：清除Doctor关联
-            var profile = await db.DoctorProfiles.FirstOrDefaultAsync(p => p.UserId == userId, ct);
-            if (profile?.DoctorId != null)
-            {
-                await db.Users.Where(u => u.DoctorId == profile!.DoctorId).ExecuteUpdateAsync(u => u.SetProperty(x => x.DoctorId, (Guid?)null), ct);
-                await db.Doctors.Where(d => d.Id == profile.DoctorId).ExecuteDeleteAsync(ct);
-            }
-            // 删除所有关联数据
-            await db.HealthRecords.Where(r => r.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.MedicationLogs.Where(l => l.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.Medications.Where(m => m.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.DietFoodItems.Where(i => i.DietRecord!.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.DietRecords.Where(d => d.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.ExercisePlanItems.Where(i => i.Plan!.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.ExercisePlans.Where(p => p.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.Reports.Where(r => r.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.ConversationMessages.Where(m => m.Conversation!.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.Conversations.Where(c => c.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.ConsultationMessages.Where(m => m.Consultation!.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.Consultations.Where(c => c.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.FollowUps.Where(f => f.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.RefreshTokens.Where(t => t.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.DeviceTokens.Where(t => t.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.NotificationPreferences.Where(p => p.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.HealthArchives.Where(a => a.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.DoctorProfiles.Where(p => p.UserId == userId).ExecuteDeleteAsync(ct);
-            await db.Users.Where(u => u.Id == userId).ExecuteDeleteAsync(ct);
+            await users.DeleteAccountAsync(GetUserId(http), ct);
             return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
         });
     }

backend/src/Health.WebApi/Program.cs

@@ -1,13 +1,40 @@
 using System.Text;
+using Health.Application.AI;
+using Health.Application.Admin;
+using Health.Application.Auth;
+using Health.Application.Calendars;
+using Health.Application.Diets;
+using Health.Application.Exercises;
+using Health.Application.HealthArchives;
+using Health.Application.HealthRecords;
+using Health.Application.Medications;
+using Health.Application.Maintenance;
+using Health.Application.Notifications;
+using Health.Application.Reports;
+using Health.Application.Users;
 using Health.Infrastructure.AI;
+using Health.Infrastructure.Admin;
+using Health.Infrastructure.Auth;
+using Health.Infrastructure.Calendars;
 using Health.Infrastructure.Data;
+using Health.Infrastructure.Diets;
+using Health.Infrastructure.Exercises;
+using Health.Infrastructure.HealthArchives;
+using Health.Infrastructure.HealthRecords;
+using Health.Infrastructure.Medications;
+using Health.Infrastructure.Maintenance;
+using Health.Infrastructure.Notifications;
+using Health.Infrastructure.Reports;
 using Health.Infrastructure.Services;
+using Health.Infrastructure.Users;
 using Health.WebApi.BackgroundServices;
 using Health.WebApi.Converters;
 using Health.WebApi.Endpoints;
 using Health.WebApi.Middleware;
+using Microsoft.AspNetCore.DataProtection;
 using Microsoft.AspNetCore.Authentication.JwtBearer;
 using Microsoft.EntityFrameworkCore;
+using Microsoft.Extensions.FileProviders;
 using Microsoft.IdentityModel.Tokens;
 
 // 加载 .env 文件（开发环境）
@@ -28,6 +55,18 @@ if (File.Exists(envPath))
 
 var builder = WebApplication.CreateBuilder(args);
 
+if (builder.Environment.IsDevelopment())
+{
+    builder.Logging.ClearProviders();
+    builder.Logging.AddConsole();
+    builder.Logging.AddDebug();
+    var dataProtectionPath = Path.Combine(Directory.GetCurrentDirectory(), "data-protection-keys");
+    Directory.CreateDirectory(dataProtectionPath);
+    builder.Services.AddDataProtection()
+        .PersistKeysToFileSystem(new DirectoryInfo(dataProtectionPath))
+        .SetApplicationName("HealthManager.Development");
+}
+
 // ---- JSON 配置（枚举字符串、camelCase、UTC时间统一带Z）----
 builder.Services.ConfigureHttpJsonOptions(options =>
 {
@@ -68,6 +107,44 @@ builder.Services.AddAuthorization();
 builder.Services.AddSingleton<JwtProvider>();
 builder.Services.AddSingleton<SmsService>();
 builder.Services.AddSingleton<PromptManager>();
+builder.Services.AddScoped<IAiWriteConfirmationStore, EfAiWriteConfirmationStore>();
+builder.Services.AddScoped<IAiToolExecutionService, AiToolExecutionService>();
+builder.Services.AddScoped<IAdminService, AdminService>();
+builder.Services.AddScoped<IAuthService, AuthService>();
+builder.Services.AddScoped<IAiConversationService, AiConversationService>();
+builder.Services.AddScoped<IAiConversationRepository, EfAiConversationRepository>();
+builder.Services.AddScoped<IPatientContextService, PatientContextService>();
+builder.Services.AddScoped<ICalendarService, CalendarService>();
+builder.Services.AddScoped<ICalendarRepository, EfCalendarRepository>();
+builder.Services.AddScoped<IDietService, DietService>();
+builder.Services.AddScoped<IDietRepository, EfDietRepository>();
+builder.Services.AddScoped<IDietImageAnalysisCoordinator, DietImageAnalysisCoordinator>();
+builder.Services.AddScoped<IDietImageAnalyzer, DietImageAnalyzer>();
+builder.Services.AddScoped<IDietImageAnalysisQueue, DietImageAnalysisQueue>();
+builder.Services.AddScoped<IExerciseService, ExerciseService>();
+builder.Services.AddScoped<IExerciseRepository, EfExerciseRepository>();
+builder.Services.AddScoped<IExerciseReminderProducer, ExerciseReminderProducer>();
+builder.Services.AddScoped<IHealthArchiveService, HealthArchiveService>();
+builder.Services.AddScoped<IHealthArchiveRepository, EfHealthArchiveRepository>();
+builder.Services.AddScoped<IHealthRecordService, HealthRecordService>();
+builder.Services.AddScoped<IHealthRecordRepository, EfHealthRecordRepository>();
+builder.Services.AddScoped<IMedicationService, MedicationService>();
+builder.Services.AddScoped<IMedicationRepository, EfMedicationRepository>();
+builder.Services.AddScoped<IMedicationReminderScanner, MedicationReminderScanner>();
+builder.Services.AddScoped<IMedicationReminderDispatcher, OutboxMedicationReminderDispatcher>();
+builder.Services.AddScoped<IMedicationReminderQueue, MedicationReminderQueue>();
+builder.Services.AddScoped<IMaintenanceService, MaintenanceService>();
+builder.Services.AddScoped<IMaintenanceRepository, EfMaintenanceRepository>();
+builder.Services.AddScoped<IInAppNotificationService, InAppNotificationService>();
+builder.Services.AddScoped<IInAppNotificationRepository, EfInAppNotificationRepository>();
+builder.Services.AddScoped<IReportService, ReportService>();
+builder.Services.AddScoped<IReportRepository, EfReportRepository>();
+builder.Services.AddScoped<IReportFileStorage, LocalReportFileStorage>();
+builder.Services.AddScoped<IReportAnalysisService, ReportAnalysisService>();
+builder.Services.AddScoped<IReportAnalysisQueue, EfReportAnalysisQueue>();
+builder.Services.AddScoped<IUserService, UserService>();
+builder.Services.AddScoped<IUserRepository, EfUserRepository>();
+builder.Services.AddScoped<DatabaseSchemaMigrator>();
 
 // ---- AI 客户端（使用 IHttpClientFactory 区分 LLM 和 VLM）----
 builder.Services.AddHttpClient<DeepSeekClient>(client =>
@@ -85,7 +162,11 @@ builder.Services.AddHttpClient<VisionClient>(client =>
 
 // ---- 后台服务 ----
 builder.Services.AddHostedService<MedicationReminderService>();
+builder.Services.AddHostedService<ExerciseReminderService>();
+builder.Services.AddHostedService<MedicationReminderWorker>();
 builder.Services.AddHostedService<CleanupService>();
+builder.Services.AddHostedService<ReportAnalysisWorker>();
+builder.Services.AddHostedService<DietImageAnalysisWorker>();
 
 // ---- OpenAPI ----
 builder.Services.AddOpenApi();
@@ -110,6 +191,14 @@ app.UseCors();
 app.UseAuthentication();
 app.UseAuthorization();
 
+var uploadsPath = Path.Combine(Directory.GetCurrentDirectory(), "uploads");
+Directory.CreateDirectory(uploadsPath);
+app.UseStaticFiles(new StaticFileOptions
+{
+    FileProvider = new PhysicalFileProvider(uploadsPath),
+    RequestPath = "/uploads"
+});
+
 if (app.Environment.IsDevelopment())
     app.MapOpenApi();
 
@@ -118,6 +207,7 @@ using (var scope = app.Services.CreateScope())
 {
     var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
     await db.Database.EnsureCreatedAsync();
+    await scope.ServiceProvider.GetRequiredService<DatabaseSchemaMigrator>().ApplyAsync();
     await DataSeeder.SeedAsync(db);
     await DevDataSeeder.SeedIfEnabled(db, app.Configuration);
 }
@@ -134,6 +224,7 @@ app.MapUserEndpoints();
 app.MapAiChatEndpoints();
 app.MapFileEndpoints();
 app.MapCalendarEndpoints();
+app.MapNotificationEndpoints();
 app.MapDoctorEndpoints();
 app.MapAdminEndpoints();
 app.MapFollowUpEndpoints();