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);
+}