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/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",
+        _ => "—"
+    };
+}