feat: 二级页面色彩刷新 + 用药/通知/设备重构 + 后端健康档案/通知管线增强 + 大量测试

## 后端
- 健康档案: 新增手术状态字段 + EF 迁移; HealthArchiveService 新增查询方法
- 健康记录: HealthRecordService 新增批量/统计方法; 契约扩展
- 用药: 新增 MedicationScheduleStatus 枚举; MedicationService 排班逻辑调整
- 通知: EfUserNotificationPipeline 重构; 新增 EfReminderCatchUpService; 通知管线支持更多场景
- 用户: UserService 账号删除逻辑; 新增 local_account_file_cleanup; EfUserRepository 扩展
- AI: medication_agent_handler 微调; prompt_manager 优化; AiConversationService 上下文处理
- Endpoint: doctor/medication/exercise/health/notification/user 等多接口调整
- BackgroundService: health_record_reminder_service 重构, 提醒补漏逻辑
- 测试: 新增 account_deletion/doctor_endpoint/medication_schedule/medication_update/prompt_manager 测试

## 前端
- UI 系统: app_theme 大幅重构; app_colors/app_design_tokens/app_module_visuals 调整; 二级页面色彩刷新
- 主页: home_page 背景渐变 + 消息列表提取 _HomeMessages + 通知检查逻辑; chat_messages_view 全面重构
- 用药: medication_list/edit/checkin 三页重构, 新增 medication_ui_logic 抽取
- 通知: notification_prefs_page 重构, 新增 notification_prefs_logic; notification_center 优化
- 设备: device_management 重构, 新增 device_sync_ui_logic; device_scan 优化
- 趋势图: trend_page 大幅重构
- 登录: login_page 重构
- 个人资料: 新增 profile_edit_page; profile_page 优化
- 运动: 新增 exercise/ 目录 + care_plan_ui_logic
- 其他: remaining_pages/report_pages/health_drawer/admin/doctor 等多页面调整
- 组件: common_widgets/app_empty_state/app_error_state/app_future_view/app_toast/ai_content 优化
- Provider: chat_provider/consultation_provider/data_providers/auth_provider 调整
- AndroidManifest: 移除多余权限
- 测试: 新增 ai_content/care_plan/home_message/login_flow/medication_checkin/medication_ui/notification_prefs/profile_device/secondary_page/swipe_delete 等大量测试

## 文档
- 新增 ui-design-system.md 设计系统文档
- 新增 secondary-page-color-refresh 计划 + specs 目录

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

@@ -35,7 +35,7 @@ public interface IAiConversationService
     Task<IReadOnlyList<AiConversationDto>> ListAsync(Guid userId, CancellationToken ct);
     Task<IReadOnlyList<AiConversationMessageDto>> GetMessagesAsync(Guid userId, Guid conversationId, CancellationToken ct);
     Task UpdateSummaryAsync(Guid conversationId, string summary, CancellationToken ct);
-    Task DeleteAsync(Guid userId, Guid conversationId, CancellationToken ct);
+    Task<bool> DeleteAsync(Guid userId, Guid conversationId, CancellationToken ct);
     Task<int> DeleteAllAsync(Guid userId, CancellationToken ct);
 }
 

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

@@ -5,7 +5,7 @@ namespace Health.Application.AI;
 
 public sealed class AiConversationService(IAiConversationRepository conversations) : IAiConversationService
 {
-    private const int HistoryConversationLimit = 7;
+    private const int HistoryConversationLimit = 30;
     private readonly IAiConversationRepository _conversations = conversations;
 
     public async Task<OpenConversationResult> OpenAsync(
@@ -83,13 +83,14 @@ public sealed class AiConversationService(IAiConversationRepository conversation
         await _conversations.SaveChangesAsync(ct);
     }
 
-    public async Task DeleteAsync(Guid userId, Guid conversationId, CancellationToken ct)
+    public async Task<bool> DeleteAsync(Guid userId, Guid conversationId, CancellationToken ct)
     {
         var conversation = await _conversations.GetOwnedAsync(userId, conversationId, ct);
-        if (conversation == null) return;
+        if (conversation == null) return false;
 
         _conversations.Delete(conversation);
         await _conversations.SaveChangesAsync(ct);
+        return true;
     }
 
     public async Task<int> DeleteAllAsync(Guid userId, CancellationToken ct)

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

@@ -24,7 +24,9 @@ public sealed class PatientContextService(
         if (archive != null)
         {
             if (!string.IsNullOrEmpty(archive.Diagnosis)) sb.AppendLine($"诊断: {archive.Diagnosis}");
-            if (archive.Surgeries.Count > 0)
+            if (archive.SurgeryHistoryStatus == "无")
+                sb.AppendLine("手术史: 无");
+            else if (archive.Surgeries.Count > 0)
                 sb.AppendLine($"手术: {string.Join("；", archive.Surgeries.Select(s => $"{s.Type} ({s.Date})"))}");
             else if (!string.IsNullOrEmpty(archive.SurgeryType))
                 sb.AppendLine($"手术: {archive.SurgeryType} ({archive.SurgeryDate})");

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

@@ -22,6 +22,7 @@ public sealed record HealthArchiveDto(
     IReadOnlyList<string> DietRestrictions,
     IReadOnlyList<string> ChronicDiseases,
     string? FamilyHistory,
+    string? SurgeryHistoryStatus,
     DateTime UpdatedAt);
 
 public sealed record HealthArchiveUpdateRequest(
@@ -32,7 +33,8 @@ public sealed record HealthArchiveUpdateRequest(
     IReadOnlyList<string>? DietRestrictions,
     IReadOnlyList<string>? ChronicDiseases,
     string? FamilyHistory,
-    IReadOnlyList<HealthArchiveSurgeryInput>? Surgeries = null);
+    IReadOnlyList<HealthArchiveSurgeryInput>? Surgeries = null,
+    string? SurgeryHistoryStatus = null);
 
 public interface IHealthArchiveService
 {

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

@@ -1,5 +1,7 @@
 using Health.Domain.Entities;
 
+using System.ComponentModel.DataAnnotations;
+
 namespace Health.Application.HealthArchives;
 
 public sealed class HealthArchiveService(IHealthArchiveRepository archives) : IHealthArchiveService
@@ -14,6 +16,7 @@ public sealed class HealthArchiveService(IHealthArchiveRepository archives) : IH
 
     public async Task<HealthArchiveDto> UpdateAsync(Guid userId, HealthArchiveUpdateRequest request, CancellationToken ct)
     {
+        Validate(request);
         var archive = await GetOrCreateEntityAsync(userId, ct);
         Apply(archive, request);
         archive.UpdatedAt = DateTime.UtcNow;
@@ -110,6 +113,14 @@ public sealed class HealthArchiveService(IHealthArchiveRepository archives) : IH
         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;
+        if (request.SurgeryHistoryStatus != null)
+            archive.SurgeryHistoryStatus = request.SurgeryHistoryStatus;
+    }
+
+    private static void Validate(HealthArchiveUpdateRequest request)
+    {
+        if (request.SurgeryHistoryStatus is not null and not ("无" or "有"))
+            throw new ValidationException("手术史状态格式不正确");
     }
 
     private static object ToAiResult(HealthArchiveDto archive) => new
@@ -123,6 +134,7 @@ public sealed class HealthArchiveService(IHealthArchiveRepository archives) : IH
         archive.DietRestrictions,
         archive.ChronicDiseases,
         archive.FamilyHistory,
+        archive.SurgeryHistoryStatus,
     };
 
     private static HealthArchiveDto ToDto(HealthArchive archive) => new(
@@ -136,6 +148,7 @@ public sealed class HealthArchiveService(IHealthArchiveRepository archives) : IH
         archive.DietRestrictions,
         archive.ChronicDiseases,
         archive.FamilyHistory,
+        archive.SurgeryHistoryStatus,
         archive.UpdatedAt);
 
     private static IReadOnlyList<HealthArchiveSurgeryDto> GetSurgeries(HealthArchive archive)

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

@@ -27,6 +27,7 @@ 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<IReadOnlyList<Guid>> CreateManyAsync(Guid userId, IReadOnlyList<HealthRecordUpsertRequest> requests, 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);

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

@@ -49,6 +49,44 @@ public sealed class HealthRecordService(
         return record.Id;
     }
 
+    public async Task<IReadOnlyList<Guid>> CreateManyAsync(
+        Guid userId,
+        IReadOnlyList<HealthRecordUpsertRequest> requests,
+        CancellationToken ct)
+    {
+        if (requests.Count == 0)
+            throw new ArgumentException("至少需要一条健康记录", nameof(requests));
+
+        foreach (var request in requests)
+            HealthRecordRules.Validate(request);
+
+        var now = DateTime.UtcNow;
+        var records = requests.Select(request => 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 ?? now,
+            CreatedAt = now,
+            IsAbnormal = HealthRecordRules.CheckAbnormal(request),
+        }).ToList();
+
+        foreach (var record in records)
+            await _records.AddAsync(record, ct);
+
+        await _records.SaveChangesAsync(ct);
+
+        foreach (var record in records)
+            await EnqueueAbnormalNotificationAsync(record, ct);
+
+        return records.Select(record => record.Id).ToList();
+    }
+
     public async Task<bool> UpdateAsync(Guid userId, Guid id, HealthRecordUpsertRequest request, CancellationToken ct)
     {
         var record = await _records.GetOwnedAsync(userId, id, ct);

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

@@ -20,7 +20,8 @@ public sealed record MedicationPatchRequest(
     IReadOnlyList<TimeOnly>? TimeOfDay,
     DateOnly? StartDate,
     DateOnly? EndDate,
-    string? Notes);
+    string? Notes,
+    bool ClearEndDate = false);
 
 public sealed record MedicationDto(
     Guid Id,

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

@@ -0,0 +1,18 @@
+using Health.Domain.Enums;
+
+namespace Health.Application.Medications;
+
+public static class MedicationScheduleStatus
+{
+    public static string Resolve(
+        TimeOnly scheduledTime,
+        TimeOnly currentTime,
+        MedicationLogStatus? logStatus)
+    {
+        if (logStatus.HasValue)
+            return logStatus == MedicationLogStatus.Taken ? "taken" : "skipped";
+        if (scheduledTime <= currentTime.AddMinutes(-30)) return "overdue";
+        if (scheduledTime <= currentTime.AddHours(3)) return "upcoming";
+        return "scheduled";
+    }
+}

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

@@ -54,7 +54,8 @@ public sealed class MedicationService(IMedicationRepository medications) : IMedi
         if (request.Frequency.HasValue) med.Frequency = request.Frequency.Value;
         if (request.TimeOfDay != null) med.TimeOfDay = NormalizeTimes(request.TimeOfDay);
         if (request.StartDate.HasValue) med.StartDate = request.StartDate.Value;
-        if (request.EndDate.HasValue) med.EndDate = request.EndDate.Value;
+        if (request.ClearEndDate) med.EndDate = null;
+        else if (request.EndDate.HasValue) med.EndDate = request.EndDate.Value;
         ValidateDateRange(med.StartDate, med.EndDate);
         if (request.Notes != null) med.Notes = request.Notes;
         med.UpdatedAt = DateTime.UtcNow;
@@ -130,15 +131,10 @@ public sealed class MedicationService(IMedicationRepository medications) : IMedi
             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;
+                var status = MedicationScheduleStatus.Resolve(
+                    scheduledTime,
+                    now,
+                    log?.Status);
 
                 reminders.Add(new MedicationReminderDto(med.Id, med.Name, med.Dosage, scheduledTime.ToString("HH:mm"), status));
             }

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

@@ -58,3 +58,10 @@ public interface INotificationOutboxProcessor
     Task RecoverStaleAsync(CancellationToken ct);
     Task<bool> ProcessNextAsync(CancellationToken ct);
 }
+
+public sealed record ReminderCatchUpResult(int CreatedCount);
+
+public interface IReminderCatchUpService
+{
+    Task<ReminderCatchUpResult> CheckDueAsync(Guid userId, DateTime utcNow, CancellationToken ct);
+}

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

@@ -16,6 +16,10 @@ public sealed record UserProfileUpdateRequest(
     string? Gender,
     DateOnly? BirthDate);
 
+public sealed record AccountFileReferences(
+    IReadOnlyList<string> FileUrls,
+    IReadOnlyList<string> ConversationMetadataJson);
+
 public interface IUserService
 {
     Task<UserProfileDto?> GetProfileAsync(Guid userId, CancellationToken ct);
@@ -26,6 +30,12 @@ public interface IUserService
 public interface IUserRepository
 {
     Task<User?> GetAsync(Guid userId, CancellationToken ct);
+    Task<AccountFileReferences> GetAccountFileReferencesAsync(Guid userId, CancellationToken ct);
     Task SaveChangesAsync(CancellationToken ct);
     Task DeleteAccountDataAsync(Guid userId, CancellationToken ct);
 }
+
+public interface IAccountFileCleanup
+{
+    Task DeleteAsync(Guid userId, AccountFileReferences references, CancellationToken ct);
+}

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

@@ -1,8 +1,11 @@
 namespace Health.Application.Users;
 
-public sealed class UserService(IUserRepository users) : IUserService
+public sealed class UserService(
+    IUserRepository users,
+    IAccountFileCleanup fileCleanup) : IUserService
 {
     private readonly IUserRepository _users = users;
+    private readonly IAccountFileCleanup _fileCleanup = fileCleanup;
 
     public async Task<UserProfileDto?> GetProfileAsync(Guid userId, CancellationToken ct)
     {
@@ -30,6 +33,10 @@ public sealed class UserService(IUserRepository users) : IUserService
         return true;
     }
 
-    public Task DeleteAccountAsync(Guid userId, CancellationToken ct) =>
-        _users.DeleteAccountDataAsync(userId, ct);
+    public async Task DeleteAccountAsync(Guid userId, CancellationToken ct)
+    {
+        var references = await _users.GetAccountFileReferencesAsync(userId, ct);
+        await _fileCleanup.DeleteAsync(userId, references, ct);
+        await _users.DeleteAccountDataAsync(userId, ct);
+    }
 }

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

@@ -35,6 +35,7 @@ public sealed class HealthArchive
     public List<string> DietRestrictions { get; set; } = [];    // 饮食限制
     public List<string> ChronicDiseases { get; set; } = [];     // 慢病史
     public string? FamilyHistory { get; set; }       // 家族病史
+    public string? SurgeryHistoryStatus { get; set; } // 无/有，区分未填写与无手术史
     public DateTime UpdatedAt { get; set; } = DateTime.UtcNow;
 
     public User User { get; set; } = null!;

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

@@ -43,7 +43,7 @@ public static class MedicationAgentHandler
         return toolName switch
         {
             "manage_medication" => await ExecuteManageMedication(medications, userId, args, ct),
-            _ => new { success = false, message = $"鏈煡宸ュ叿: {toolName}" }
+            _ => new { success = false, message = $"未知工具: {toolName}" }
         };
     }
 

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

@@ -157,9 +157,9 @@ public sealed class PromptManager
         """;
 
     private const string UnifiedPrompt = """
-        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。
+        你是患者端统一 AI 健康助手“小脉”。无论用户是否点击顶部功能入口，你都要理解其真实意图，并完成当前可用的健康解释、数据记录、用药管理、运动管理和预问诊辅助。
 
-        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。
+        核心原则：先识别用户想做什么，再决定调用工具或继续对话。不能只在文字中声称“已录入”“已保存”或“请点击确认”，实际却没有调用写入工具并生成确认卡片。
 
         领域判断与可用工具：
         1. 健康数据（血压/心率/血糖/血氧/体重）→ 调用 record_health_data
@@ -182,10 +182,18 @@ public sealed class PromptManager
 
         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→直接生成待确认命令，不要追问
+        - 先判断用户是在咨询数值，还是希望记录数据，不能仅凭消息中出现指标和数值就自动录入
+        - 明确提问时先回答问题，不调用 record_health_data。例如“血氧98%是不是太高了”是在咨询，应解释正常范围，不生成录入确认卡片；除非用户同时明确要求记录
+        - 明确要求“记录、录入、保存、记一下”时调用 record_health_data。例如“帮我记录血压116/89”必须生成待确认命令
+        - 只有指标和数值、没有明显疑问或记录用语时，结合当前对话上下文判断；仍无法确定意图时，先简短询问用户是想了解数值还是保存记录
+        - 指标或数值缺失时只追问缺失部分，不猜测数值
+        - 多个明确指标要逐项调用 record_health_data，不能遗漏
         - 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
+        - 没有真实调用写入工具时，禁止告诉用户“点击确认按钮”或暗示已经出现确认卡片
+        - 用户描述症状或身体不适时进入预问诊：每轮只追问一个最关键问题，连续追问症状部位、开始时间、程度、诱因和伴随表现；信息足够后给出可能相关方向、严重程度以及观察/门诊/尽快就医/急诊建议，不作正式确诊
+        - 预问诊通常追问 2-5 轮；发现危险信号时立即停止普通追问并优先给出就医提醒
         - 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
+        - 回复语气温和、清楚、专业，避免假装医生或作确定诊断
         """;
 }

backend/src/Health.Infrastructure/Data/Migrations/20260713132830_AddHealthArchiveSurgeryStatus.cs

@@ -0,0 +1,29 @@
+using Microsoft.EntityFrameworkCore.Migrations;
+
+#nullable disable
+
+namespace Health.Infrastructure.Data.Migrations
+{
+    /// <inheritdoc />
+    public partial class AddHealthArchiveSurgeryStatus : Migration
+    {
+        /// <inheritdoc />
+        protected override void Up(MigrationBuilder migrationBuilder)
+        {
+            migrationBuilder.AddColumn<string>(
+                name: "SurgeryHistoryStatus",
+                table: "HealthArchives",
+                type: "character varying(8)",
+                maxLength: 8,
+                nullable: true);
+        }
+
+        /// <inheritdoc />
+        protected override void Down(MigrationBuilder migrationBuilder)
+        {
+            migrationBuilder.DropColumn(
+                name: "SurgeryHistoryStatus",
+                table: "HealthArchives");
+        }
+    }
+}

backend/src/Health.Infrastructure/Data/Migrations/AppDbContextModelSnapshot.cs

@@ -486,6 +486,10 @@ namespace Health.Infrastructure.Data.Migrations
                     b.Property<DateOnly?>("SurgeryDate")
                         .HasColumnType("date");
 
+                    b.Property<string>("SurgeryHistoryStatus")
+                        .HasMaxLength(8)
+                        .HasColumnType("character varying(8)");
+
                     b.Property<string>("SurgeryType")
                         .HasColumnType("text");
 

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

@@ -170,6 +170,7 @@ public sealed class AppDbContext(DbContextOptions<AppDbContext> options) : DbCon
         builder.Entity<HealthArchive>(e =>
         {
             e.HasIndex(a => a.UserId).IsUnique();
+            e.Property(a => a.SurgeryHistoryStatus).HasMaxLength(8);
         });
 
         builder.Entity<HealthArchiveSurgery>(e =>

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

@@ -0,0 +1,284 @@
+using Health.Application.Notifications;
+using Health.Domain.Entities;
+using Health.Domain.Enums;
+
+namespace Health.Infrastructure.Notifications;
+
+public sealed class EfReminderCatchUpService(AppDbContext db) : IReminderCatchUpService
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<ReminderCatchUpResult> CheckDueAsync(Guid userId, DateTime utcNow, CancellationToken ct)
+    {
+        var pref = await GetPreferenceAsync(userId, ct);
+        if (!pref.PushEnabled) return new ReminderCatchUpResult(0);
+
+        var beijingNow = utcNow.AddHours(8);
+        var today = DateOnly.FromDateTime(beijingNow);
+        var todayStartUtc = beijingNow.Date.AddHours(-8);
+        var todayEndUtc = todayStartUtc.AddDays(1);
+        var created = 0;
+
+        created += await CreateHealthRecordReminderAsync(userId, pref, beijingNow, todayStartUtc, todayEndUtc, ct);
+        created += await CreateMedicationRemindersAsync(userId, pref, beijingNow, today, todayStartUtc, todayEndUtc, ct);
+        created += await CreateExerciseRemindersAsync(userId, pref, beijingNow, today, ct);
+        created += await CreateFollowUpRemindersAsync(userId, pref, beijingNow, ct);
+
+        if (created > 0)
+            await _db.SaveChangesAsync(ct);
+
+        return new ReminderCatchUpResult(created);
+    }
+
+    private async Task<NotificationPreference> GetPreferenceAsync(Guid userId, CancellationToken ct)
+    {
+        var pref = await _db.NotificationPreferences.FirstOrDefaultAsync(x => x.UserId == userId, ct);
+        if (pref != null) return pref;
+
+        pref = new NotificationPreference { Id = Guid.NewGuid(), UserId = userId };
+        await _db.NotificationPreferences.AddAsync(pref, ct);
+        return pref;
+    }
+
+    private async Task<int> CreateHealthRecordReminderAsync(
+        Guid userId,
+        NotificationPreference pref,
+        DateTime beijingNow,
+        DateTime todayStartUtc,
+        DateTime todayEndUtc,
+        CancellationToken ct)
+    {
+        if (!pref.HealthRecordReminder || IsInDnd(pref, beijingNow)) return 0;
+        var window = HealthRecordWindow(beijingNow);
+        if (window == null) return 0;
+
+        var recordedTypes = await _db.HealthRecords.AsNoTracking()
+            .Where(r => r.UserId == userId && r.RecordedAt >= todayStartUtc && r.RecordedAt < todayEndUtc)
+            .Select(r => r.MetricType)
+            .Distinct()
+            .ToListAsync(ct);
+
+        var missing = EnabledHealthMetrics(pref)
+            .Where(x => !recordedTypes.Contains(x.Type))
+            .ToList();
+        if (missing.Count == 0) return 0;
+
+        var date = DateOnly.FromDateTime(beijingNow);
+        var sourceId = StableGuid($"health_record|{userId:N}|{date:yyyyMMdd}|{window}");
+        return await AddNotificationIfMissingAsync(
+            userId,
+            sourceId,
+            "health_record_reminder",
+            window == "evening" ? "今日健康指标还未完成" : "记得录入今日健康指标",
+            $"建议录入：{string.Join("、", missing.Select(x => x.Label))}",
+            "info",
+            "health",
+            null,
+            ct);
+    }
+
+    private async Task<int> CreateMedicationRemindersAsync(
+        Guid userId,
+        NotificationPreference pref,
+        DateTime beijingNow,
+        DateOnly today,
+        DateTime todayStartUtc,
+        DateTime todayEndUtc,
+        CancellationToken ct)
+    {
+        if (!pref.MedicationReminder || IsInDnd(pref, beijingNow)) return 0;
+        var now = TimeOnly.FromDateTime(beijingNow);
+        var earliest = now.AddHours(-4);
+        var medications = await _db.Medications.AsNoTracking()
+            .Where(m => m.UserId == userId && m.IsActive)
+            .ToListAsync(ct);
+        var created = 0;
+
+        foreach (var medication in medications.Where(m => IsMedicationActiveOn(m, today) && ShouldDoseToday(m, today)))
+        {
+            foreach (var scheduledTime in medication.TimeOfDay.Where(t => IsInTimeWindow(t, earliest, now)))
+            {
+                var logged = await _db.MedicationLogs.AsNoTracking().AnyAsync(l =>
+                    l.UserId == userId &&
+                    l.MedicationId == medication.Id &&
+                    l.ScheduledTime == scheduledTime &&
+                    l.CreatedAt >= todayStartUtc &&
+                    l.CreatedAt < todayEndUtc, ct);
+                if (logged) continue;
+
+                var sourceId = StableGuid($"medication|{userId:N}|{medication.Id:N}|{today:yyyyMMdd}|{scheduledTime:HHmm}");
+                var details = string.Join(" ", new[] { medication.Dosage, scheduledTime.ToString("HH:mm") }
+                    .Where(x => !string.IsNullOrWhiteSpace(x)));
+                created += await AddNotificationIfMissingAsync(
+                    userId,
+                    sourceId,
+                    "MedicationReminder",
+                    "用药时间到了",
+                    $"请按计划服用{medication.Name}{(details.Length > 0 ? $"（{details}）" : "")}，服用后记得打卡。",
+                    "info",
+                    "medication",
+                    medication.Id.ToString(),
+                    ct);
+            }
+        }
+
+        return created;
+    }
+
+    private async Task<int> CreateExerciseRemindersAsync(
+        Guid userId,
+        NotificationPreference pref,
+        DateTime beijingNow,
+        DateOnly today,
+        CancellationToken ct)
+    {
+        if (IsInDnd(pref, beijingNow)) return 0;
+        var now = TimeOnly.FromDateTime(beijingNow);
+        var dueItems = await _db.ExercisePlanItems.AsNoTracking()
+            .Include(x => x.Plan)
+            .Where(x => x.Plan.UserId == userId &&
+                x.ScheduledDate == today &&
+                !x.IsCompleted &&
+                !x.IsRestDay &&
+                x.Plan.ReminderTime <= now)
+            .ToListAsync(ct);
+        var created = 0;
+
+        foreach (var item in dueItems)
+        {
+            var sourceId = StableGuid($"exercise|{userId:N}|{item.Id:N}|{today:yyyyMMdd}");
+            created += await AddNotificationIfMissingAsync(
+                userId,
+                sourceId,
+                "ExerciseReminder",
+                "今日运动计划",
+                $"今天安排了{item.ExerciseType} {item.DurationMinutes} 分钟，完成后记得打卡。",
+                "info",
+                "exercise",
+                item.PlanId.ToString(),
+                ct);
+        }
+
+        return created;
+    }
+
+    private async Task<int> CreateFollowUpRemindersAsync(
+        Guid userId,
+        NotificationPreference pref,
+        DateTime beijingNow,
+        CancellationToken ct)
+    {
+        if (!pref.FollowUpReminder || IsInDnd(pref, beijingNow)) return 0;
+        var nowUtc = beijingNow.AddHours(-8);
+        var upcomingEndUtc = nowUtc.AddHours(24);
+        var followUps = await _db.FollowUps.AsNoTracking()
+            .Where(x => x.UserId == userId && x.ScheduledAt >= nowUtc && x.ScheduledAt <= upcomingEndUtc)
+            .ToListAsync(ct);
+        var created = 0;
+
+        foreach (var followUp in followUps)
+        {
+            var sourceId = StableGuid($"followup|{userId:N}|{followUp.Id:N}|24h");
+            created += await AddNotificationIfMissingAsync(
+                userId,
+                sourceId,
+                "follow_up_reminder",
+                "复查提醒",
+                $"{followUp.Title} 即将到期，请提前安排时间。",
+                "info",
+                "followup",
+                followUp.Id.ToString(),
+                ct);
+        }
+
+        return created;
+    }
+
+    private async Task<int> AddNotificationIfMissingAsync(
+        Guid userId,
+        Guid sourceId,
+        string type,
+        string title,
+        string message,
+        string severity,
+        string? actionType,
+        string? actionTargetId,
+        CancellationToken ct)
+    {
+        if (await _db.UserNotifications.AsNoTracking().AnyAsync(x => x.SourceId == sourceId, ct))
+            return 0;
+
+        await _db.UserNotifications.AddAsync(new UserNotification
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            SourceId = sourceId,
+            Type = type,
+            Title = title,
+            Message = message,
+            Severity = severity,
+            ActionType = actionType,
+            ActionTargetId = actionTargetId,
+            CreatedAt = DateTime.UtcNow,
+        }, ct);
+        return 1;
+    }
+
+    private static string? HealthRecordWindow(DateTime beijingNow)
+    {
+        var minutes = beijingNow.Hour * 60 + beijingNow.Minute;
+        if (minutes is >= 7 * 60 and <= 10 * 60 + 30) return "morning";
+        if (minutes is >= 11 * 60 + 30 and <= 14 * 60) return "noon";
+        if (minutes is >= 18 * 60 and <= 21 * 60 + 30) return "evening";
+        return null;
+    }
+
+    private static IReadOnlyList<(HealthMetricType Type, string Label)> EnabledHealthMetrics(NotificationPreference pref)
+    {
+        var result = new List<(HealthMetricType, string)>();
+        if (pref.HealthRecordReminderBloodPressure) result.Add((HealthMetricType.BloodPressure, "血压"));
+        if (pref.HealthRecordReminderHeartRate) result.Add((HealthMetricType.HeartRate, "心率"));
+        if (pref.HealthRecordReminderGlucose) result.Add((HealthMetricType.Glucose, "血糖"));
+        if (pref.HealthRecordReminderSpO2) result.Add((HealthMetricType.SpO2, "血氧"));
+        if (pref.HealthRecordReminderWeight) result.Add((HealthMetricType.Weight, "体重"));
+        return result;
+    }
+
+    private static bool IsInDnd(NotificationPreference pref, DateTime beijingNow)
+    {
+        if (!pref.DndEnabled) return false;
+        var minuteOfDay = beijingNow.Hour * 60 + beijingNow.Minute;
+        return pref.DndStartMinutes <= pref.DndEndMinutes
+            ? minuteOfDay >= pref.DndStartMinutes && minuteOfDay < pref.DndEndMinutes
+            : minuteOfDay >= pref.DndStartMinutes || minuteOfDay < pref.DndEndMinutes;
+    }
+
+    private static bool IsMedicationActiveOn(Medication medication, DateOnly date) =>
+        (medication.StartDate == null || medication.StartDate <= date) &&
+        (medication.EndDate == null || medication.EndDate >= date);
+
+    private static bool ShouldDoseToday(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;
+    }
+
+    private static bool IsInTimeWindow(TimeOnly value, TimeOnly start, TimeOnly end) =>
+        end >= start ? value >= start && value <= end : value >= start || value <= end;
+
+    private static Guid StableGuid(string key)
+    {
+        var bytes = System.Security.Cryptography.MD5.HashData(System.Text.Encoding.UTF8.GetBytes(key));
+        return new Guid(bytes);
+    }
+}

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

@@ -15,6 +15,12 @@ public sealed class EfUserNotificationProducer(AppDbContext db) : IUserNotificat
         NotificationMessage message,
         CancellationToken ct)
     {
+        var pushEnabled = await _db.NotificationPreferences.AsNoTracking()
+            .Where(x => x.UserId == userId)
+            .Select(x => (bool?)x.PushEnabled)
+            .FirstOrDefaultAsync(ct);
+        if (pushEnabled is false) return false;
+
         if (await _db.NotificationOutbox.AsNoTracking().AnyAsync(x => x.SourceTaskId == sourceId, ct))
             return false;
 
@@ -67,7 +73,7 @@ public sealed class EfNotificationOutboxProcessor(AppDbContext db) : INotificati
                 x.UpdatedAt < now.AddMinutes(-5) && x.Attempts >= MaxAttempts)
             .ExecuteUpdateAsync(setters => setters
                 .SetProperty(x => x.Status, "Failed")
-                .SetProperty(x => x.LastError, "通知任务执行超时且已达到最大重试次数")
+                .SetProperty(x => x.LastError, "Notification task timed out and reached max retry count")
                 .SetProperty(x => x.UpdatedAt, now), ct);
     }
 
@@ -81,61 +87,55 @@ public sealed class EfNotificationOutboxProcessor(AppDbContext db) : INotificati
             .FirstOrDefaultAsync(ct);
         if (candidate == null) return false;
 
-        var claimed = await _db.NotificationOutbox
-            .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 true;
+        var task = await _db.NotificationOutbox
+            .FirstOrDefaultAsync(x => x.Id == candidate.Id && x.Status == "Pending", ct);
+        if (task == null) return true;
+
+        task.Status = "Processing";
+        task.Attempts += 1;
+        task.UpdatedAt = now;
+        await _db.SaveChangesAsync(ct);
 
         try
         {
-            var message = JsonSerializer.Deserialize<NotificationMessage>(candidate.Payload)
-                ?? throw new InvalidOperationException("通知消息内容为空");
+            var message = JsonSerializer.Deserialize<NotificationMessage>(task.Payload)
+                ?? throw new InvalidOperationException("Notification payload is empty");
 
             var preference = await _db.NotificationPreferences.AsNoTracking()
-                .FirstOrDefaultAsync(x => x.UserId == candidate.UserId, ct);
+                .FirstOrDefaultAsync(x => x.UserId == task.UserId, ct);
             var deliver = preference == null || ShouldDeliver(preference, message.Type, DateTime.UtcNow.AddHours(8));
 
             if (deliver && !await _db.UserNotifications.AsNoTracking()
-                    .AnyAsync(x => x.SourceId == candidate.SourceTaskId, ct))
+                    .AnyAsync(x => x.SourceId == task.SourceTaskId, ct))
             {
                 await _db.UserNotifications.AddAsync(new UserNotification
                 {
                     Id = Guid.NewGuid(),
-                    UserId = candidate.UserId,
-                    SourceId = candidate.SourceTaskId,
+                    UserId = task.UserId,
+                    SourceId = task.SourceTaskId,
                     Type = message.Type,
                     Title = message.Title,
                     Message = message.Message,
                     Severity = message.Severity,
                     ActionType = message.ActionType,
                     ActionTargetId = message.ActionTargetId,
-                    CreatedAt = candidate.CreatedAt,
+                    CreatedAt = task.CreatedAt,
                 }, ct);
-                // Persist the inbox item first. If completion fails, stale-task
-                // recovery can safely retry because SourceId is idempotent.
                 await _db.SaveChangesAsync(ct);
             }
 
-            await _db.NotificationOutbox.Where(x => x.Id == candidate.Id)
-                .ExecuteUpdateAsync(setters => setters
-                    .SetProperty(x => x.Status, "Completed")
-                    .SetProperty(x => x.LastError, (string?)null)
-                    .SetProperty(x => x.UpdatedAt, DateTime.UtcNow), ct);
+            task.Status = "Completed";
+            task.LastError = null;
+            task.UpdatedAt = DateTime.UtcNow;
+            await _db.SaveChangesAsync(ct);
         }
         catch (Exception ex)
         {
-            var attempts = candidate.Attempts + 1;
-            await _db.NotificationOutbox.Where(x => x.Id == candidate.Id)
-                .ExecuteUpdateAsync(setters => setters
-                    .SetProperty(x => x.Status, attempts >= MaxAttempts ? "Failed" : "Pending")
-                    .SetProperty(x => x.AvailableAt,
-                        DateTime.UtcNow.AddSeconds(Math.Pow(2, attempts) * 5))
-                    .SetProperty(x => x.LastError,
-                        ex.Message.Length > 2000 ? ex.Message[..2000] : ex.Message)
-                    .SetProperty(x => x.UpdatedAt, DateTime.UtcNow), ct);
+            task.Status = task.Attempts >= MaxAttempts ? "Failed" : "Pending";
+            task.AvailableAt = DateTime.UtcNow.AddSeconds(Math.Pow(2, task.Attempts) * 5);
+            task.LastError = ex.Message.Length > 2000 ? ex.Message[..2000] : ex.Message;
+            task.UpdatedAt = DateTime.UtcNow;
+            await _db.SaveChangesAsync(ct);
         }
 
         return true;
@@ -151,14 +151,25 @@ public sealed class EfNotificationOutboxProcessor(AppDbContext db) : INotificati
             : minuteOfDay >= preference.DndStartMinutes || minuteOfDay < preference.DndEndMinutes);
         if (inDnd) return false;
 
-        return type switch
+        return NormalizeType(type) switch
         {
             "medication_reminder" => preference.MedicationReminder,
+            "exercise_reminder" => true,
             "follow_up_reminder" => preference.FollowUpReminder,
             "doctor_reply" => preference.DoctorReply,
             "abnormal_alert" => preference.AbnormalAlert,
             "health_record_reminder" => preference.HealthRecordReminder,
+            "health_metric_alert" => preference.AbnormalAlert,
             _ => true,
         };
     }
+
+    private static string NormalizeType(string type) => type switch
+    {
+        "MedicationReminder" => "medication_reminder",
+        "ExerciseReminder" => "exercise_reminder",
+        "HealthMetricAlert" => "health_metric_alert",
+        "FollowUpReminder" => "follow_up_reminder",
+        _ => type.ToLowerInvariant(),
+    };
 }

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

@@ -9,6 +9,44 @@ public sealed class EfUserRepository(AppDbContext db) : IUserRepository
     public Task<User?> GetAsync(Guid userId, CancellationToken ct) =>
         _db.Users.FirstOrDefaultAsync(u => u.Id == userId, ct);
 
+    public async Task<AccountFileReferences> GetAccountFileReferencesAsync(Guid userId, CancellationToken ct)
+    {
+        var fileUrls = new List<string>();
+
+        var userAvatar = await _db.Users
+            .Where(u => u.Id == userId)
+            .Select(u => u.AvatarUrl)
+            .FirstOrDefaultAsync(ct);
+        AddIfPresent(fileUrls, userAvatar);
+
+        var doctorProfile = await _db.DoctorProfiles
+            .Where(p => p.UserId == userId)
+            .Select(p => new { p.DoctorId, p.AvatarUrl })
+            .FirstOrDefaultAsync(ct);
+        AddIfPresent(fileUrls, doctorProfile?.AvatarUrl);
+
+        if (doctorProfile?.DoctorId != null)
+        {
+            var doctorAvatar = await _db.Doctors
+                .Where(d => d.Id == doctorProfile.DoctorId)
+                .Select(d => d.AvatarUrl)
+                .FirstOrDefaultAsync(ct);
+            AddIfPresent(fileUrls, doctorAvatar);
+        }
+
+        fileUrls.AddRange(await _db.Reports
+            .Where(r => r.UserId == userId && r.FileUrl != "")
+            .Select(r => r.FileUrl)
+            .ToListAsync(ct));
+
+        var metadata = await _db.ConversationMessages
+            .Where(m => m.Conversation!.UserId == userId && m.MetadataJson != null && m.MetadataJson != "")
+            .Select(m => m.MetadataJson!)
+            .ToListAsync(ct);
+
+        return new AccountFileReferences(fileUrls.Distinct().ToList(), metadata);
+    }
+
     public Task SaveChangesAsync(CancellationToken ct) =>
         _db.SaveChangesAsync(ct);
 
@@ -50,4 +88,9 @@ public sealed class EfUserRepository(AppDbContext db) : IUserRepository
 
         await transaction.CommitAsync(ct);
     }
+
+    private static void AddIfPresent(List<string> values, string? value)
+    {
+        if (!string.IsNullOrWhiteSpace(value)) values.Add(value);
+    }
 }

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

@@ -0,0 +1,83 @@
+using System.Text.Json;
+using Health.Application.Users;
+
+namespace Health.Infrastructure.Users;
+
+public sealed class LocalAccountFileCleanup(string uploadsRoot) : IAccountFileCleanup
+{
+    private readonly string _uploadsRoot = Path.GetFullPath(uploadsRoot);
+
+    public Task DeleteAsync(Guid userId, AccountFileReferences references, CancellationToken ct)
+    {
+        var fileUrls = new HashSet<string>(references.FileUrls, StringComparer.OrdinalIgnoreCase);
+        foreach (var metadataJson in references.ConversationMetadataJson)
+            AddMetadataUrls(fileUrls, metadataJson);
+
+        foreach (var fileUrl in fileUrls)
+        {
+            ct.ThrowIfCancellationRequested();
+            var localPath = ResolveLocalPath(fileUrl);
+            if (localPath != null && File.Exists(localPath)) File.Delete(localPath);
+        }
+
+        ct.ThrowIfCancellationRequested();
+        var userDirectory = Path.Combine(_uploadsRoot, "users", userId.ToString("N"));
+        if (Directory.Exists(userDirectory)) Directory.Delete(userDirectory, recursive: true);
+
+        return Task.CompletedTask;
+    }
+
+    private static void AddMetadataUrls(HashSet<string> fileUrls, string metadataJson)
+    {
+        try
+        {
+            using var document = JsonDocument.Parse(metadataJson);
+            AddStringProperty(document.RootElement, "imageUrl", fileUrls);
+            AddStringProperty(document.RootElement, "pdfUrl", fileUrls);
+        }
+        catch (JsonException)
+        {
+            // 旧消息元数据可能不是合法 JSON；不影响其余账号数据注销。
+        }
+    }
+
+    private static void AddStringProperty(JsonElement root, string propertyName, HashSet<string> fileUrls)
+    {
+        if (root.ValueKind != JsonValueKind.Object ||
+            !root.TryGetProperty(propertyName, out var property) ||
+            property.ValueKind != JsonValueKind.String)
+            return;
+
+        var value = property.GetString();
+        if (!string.IsNullOrWhiteSpace(value)) fileUrls.Add(value);
+    }
+
+    private string? ResolveLocalPath(string fileUrl)
+    {
+        var urlPath = fileUrl;
+        if (Uri.TryCreate(fileUrl, UriKind.Absolute, out var absoluteUri))
+            urlPath = absoluteUri.AbsolutePath;
+
+        var uploadsIndex = urlPath.IndexOf("/uploads/", StringComparison.OrdinalIgnoreCase);
+        if (uploadsIndex < 0) return null;
+
+        string relativePath;
+        try
+        {
+            relativePath = Uri.UnescapeDataString(urlPath[(uploadsIndex + "/uploads/".Length)..]);
+        }
+        catch (UriFormatException)
+        {
+            return null;
+        }
+
+        var queryIndex = relativePath.IndexOfAny(['?', '#']);
+        if (queryIndex >= 0) relativePath = relativePath[..queryIndex];
+        relativePath = relativePath.Replace('/', Path.DirectorySeparatorChar);
+
+        var fullPath = Path.GetFullPath(Path.Combine(_uploadsRoot, relativePath));
+        var rootPrefix = _uploadsRoot.TrimEnd(Path.DirectorySeparatorChar, Path.AltDirectorySeparatorChar)
+            + Path.DirectorySeparatorChar;
+        return fullPath.StartsWith(rootPrefix, StringComparison.OrdinalIgnoreCase) ? fullPath : null;
+    }
+}

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

@@ -1,112 +1,66 @@
 using Health.Application.Notifications;
-using Health.Domain.Enums;
 
 namespace Health.WebApi.BackgroundServices;
 
 /// <summary>
-/// 健康录入提醒服务——每天 9:00 / 12:00 扫描所有用户，
-/// 对未录入指标且开关开启的用户推送提醒。
-/// 中国时区 UTC+8。
+/// Produces in-app catch-up reminders for health records.
+/// The actual reminder rules live in IReminderCatchUpService so foreground
+/// app checks and background scans stay consistent.
 /// </summary>
 public sealed class HealthRecordReminderService(
     IServiceScopeFactory scopeFactory,
     ILogger<HealthRecordReminderService> logger) : BackgroundService
 {
-    private readonly IServiceScopeFactory _scopeFactory = scopeFactory;
-    private readonly ILogger<HealthRecordReminderService> _logger = logger;
-
-    // 北京时间 9:00 和 12:00 触发
-    private static readonly int[] ReminderHoursCst = [9, 12];
-
+    private static readonly int[] ReminderHoursCst = [9, 13, 19];
     private DateTime _lastFired = DateTime.MinValue;
 
     protected override async Task ExecuteAsync(CancellationToken stoppingToken)
     {
-        _logger.LogInformation("健康录入提醒服务已启动");
+        logger.LogInformation("Health record in-app reminder service started");
         while (!stoppingToken.IsCancellationRequested)
         {
             try
             {
                 var nowCst = DateTime.UtcNow.AddHours(8);
-                // 当前小时是否在触发列表，且今天该小时还没触发过
-                if (ReminderHoursCst.Contains(nowCst.Hour)
-                    && (_lastFired.Date != nowCst.Date || _lastFired.Hour != nowCst.Hour))
+                if (ReminderHoursCst.Contains(nowCst.Hour) &&
+                    (_lastFired.Date != nowCst.Date || _lastFired.Hour != nowCst.Hour))
                 {
-                    await ScanAndPushAsync(nowCst, stoppingToken);
+                    await CheckUsersAsync(DateTime.UtcNow, stoppingToken);
                     _lastFired = nowCst;
                 }
             }
-            catch (OperationCanceledException) when (stoppingToken.IsCancellationRequested) { break; }
-            catch (Exception ex) { _logger.LogError(ex, "健康录入提醒扫描异常"); }
+            catch (OperationCanceledException) when (stoppingToken.IsCancellationRequested)
+            {
+                break;
+            }
+            catch (Exception ex)
+            {
+                logger.LogError(ex, "Health record in-app reminder scan failed");
+            }
 
             await Task.Delay(TimeSpan.FromMinutes(5), stoppingToken);
         }
     }
 
-    private async Task ScanAndPushAsync(DateTime nowCst, CancellationToken ct)
+    private async Task CheckUsersAsync(DateTime utcNow, CancellationToken ct)
     {
-        using var scope = _scopeFactory.CreateScope();
+        using var scope = scopeFactory.CreateScope();
         var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
-        var producer = scope.ServiceProvider.GetRequiredService<IUserNotificationProducer>();
+        var catchUp = scope.ServiceProvider.GetRequiredService<IReminderCatchUpService>();
 
-        var todayStart = nowCst.Date.AddHours(-8); // 北京 0:00 转 UTC
-        var todayEnd = todayStart.AddDays(1);
-
-        // 取所有启用了健康录入提醒的用户偏好
-        var prefs = await db.NotificationPreferences
-            .Where(p => p.PushEnabled && p.HealthRecordReminder)
+        var userIds = await db.NotificationPreferences.AsNoTracking()
+            .Where(x => x.PushEnabled && x.HealthRecordReminder)
+            .Select(x => x.UserId)
             .ToListAsync(ct);
 
-        foreach (var pref in prefs)
+        var created = 0;
+        foreach (var userId in userIds)
         {
-            var minuteOfDay = nowCst.Hour * 60 + nowCst.Minute;
-            var inDnd = pref.DndEnabled && (pref.DndStartMinutes <= pref.DndEndMinutes
-                ? minuteOfDay >= pref.DndStartMinutes && minuteOfDay < pref.DndEndMinutes
-                : minuteOfDay >= pref.DndStartMinutes || minuteOfDay < pref.DndEndMinutes);
-            if (inDnd) continue;
-            // 该用户当天已录入的指标
-            var recordedTypes = await db.HealthRecords
-                .Where(r => r.UserId == pref.UserId && r.RecordedAt >= todayStart && r.RecordedAt < todayEnd)
-                .Select(r => r.MetricType)
-                .Distinct()
-                .ToListAsync(ct);
-
-            // 哪些指标启用开关但当天没录入
-            var missing = new List<(HealthMetricType type, bool enabled, string label)>
-            {
-                (HealthMetricType.BloodPressure, pref.HealthRecordReminderBloodPressure, "血压"),
-                (HealthMetricType.HeartRate, pref.HealthRecordReminderHeartRate, "心率"),
-                (HealthMetricType.Glucose, pref.HealthRecordReminderGlucose, "血糖"),
-                (HealthMetricType.SpO2, pref.HealthRecordReminderSpO2, "血氧"),
-                (HealthMetricType.Weight, pref.HealthRecordReminderWeight, "体重"),
-            };
-
-            var missingLabels = missing
-                .Where(m => m.enabled && !recordedTypes.Contains(m.type))
-                .Select(m => m.label)
-                .ToList();
-
-            if (missingLabels.Count == 0) continue;
-
-            // 每天每个时段每个用户只推一次——SourceTaskId 用 userId + 日期 + 小时
-            var sourceId = MakeSourceId(pref.UserId, nowCst);
-            var summary = string.Join("、", missingLabels);
-
-            await producer.EnqueueAsync(pref.UserId, sourceId, new NotificationMessage(
-                Type: "health_record_reminder",
-                Title: nowCst.Hour < 12 ? "早安，记得录入今日健康数据" : "下午好，今日健康数据还未录入",
-                Message: $"建议录入：{summary}",
-                Severity: "info",
-                ActionType: "health",
-                ActionTargetId: null), ct);
+            var result = await catchUp.CheckDueAsync(userId, utcNow, ct);
+            created += result.CreatedCount;
         }
-    }
 
-    private static Guid MakeSourceId(Guid userId, DateTime nowCst)
-    {
-        // 通过哈希构造稳定的 Guid，保证同一用户同一时段不重复
-        var key = $"hrr|{userId:N}|{nowCst:yyyyMMddHH}";
-        var bytes = System.Security.Cryptography.MD5.HashData(System.Text.Encoding.UTF8.GetBytes(key));
-        return new Guid(bytes);
+        if (created > 0)
+            logger.LogInformation("Created {Count} in-app catch-up reminders", created);
     }
 }

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

@@ -321,8 +321,12 @@ public static class AiChatEndpoints
             var userId = GetUserId(http);
             if (userId == null) return Results.Json(new { code = 40002 }, statusCode: 401);
 
-            await conversations.DeleteAsync(userId.Value, id, ct);
-            return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
+            var deleted = await conversations.DeleteAsync(userId.Value, id, ct);
+            return deleted
+                ? Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null })
+                : Results.Json(
+                    new { code = 40401, data = (object?)null, message = "对话不存在" },
+                    statusCode: StatusCodes.Status404NotFound);
         });
 
         // 一键清空当前用户的全部对话

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

@@ -29,6 +29,20 @@ public static class DoctorEndpoints
         return profile?.DoctorId;
     }
 
+    public static (DateTime StartUtc, DateTime EndUtc) GetBeijingDayRange(DateTime utcNow)
+    {
+        var beijingNow = utcNow.ToUniversalTime().AddHours(8);
+        var startUtc = new DateTime(
+            beijingNow.Year,
+            beijingNow.Month,
+            beijingNow.Day,
+            0,
+            0,
+            0,
+            DateTimeKind.Utc).AddHours(-8);
+        return (startUtc, startUtc.AddDays(1));
+    }
+
     public static void MapDoctorEndpoints(this WebApplication app)
     {
         var group = app.MapGroup("/api/doctor").RequireAuthorization();
@@ -56,8 +70,7 @@ public static class DoctorEndpoints
             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 (todayStart, todayEnd) = GetBeijingDayRange(DateTime.UtcNow);
             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
@@ -190,7 +203,8 @@ public static class DoctorEndpoints
                         user.HealthArchive.Allergies,
                         user.HealthArchive.DietRestrictions,
                         user.HealthArchive.ChronicDiseases,
-                        user.HealthArchive.FamilyHistory
+                        user.HealthArchive.FamilyHistory,
+                        user.HealthArchive.SurgeryHistoryStatus
                     },
                     latestRecords,
                     trendRecords,

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

@@ -57,8 +57,10 @@ public static class ExerciseEndpoints
         group.MapDelete("/{id:guid}", async (Guid id, HttpContext http, IExerciseService exercises, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            await exercises.DeleteAsync(userId, id, ct);
-            return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
+            var deleted = await exercises.DeleteAsync(userId, id, ct);
+            return deleted
+                ? Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null })
+                : Results.Ok(new { code = 40004, data = (object?)null, message = "运动计划不存在" });
         });
 
         group.MapPost("/items/{itemId:guid}/checkin", async (Guid itemId, HttpContext http, IExerciseService exercises, CancellationToken ct) =>

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

@@ -12,8 +12,9 @@ public static class FileEndpoints
     {
         var group = app.MapGroup("/api/files").RequireAuthorization();
 
-        group.MapPost("/upload", async (HttpRequest request, CancellationToken ct) =>
+        group.MapPost("/upload", async (HttpContext http, CancellationToken ct) =>
         {
+            var request = http.Request;
             if (!request.HasFormContentType)
                 return Results.Ok(new { code = 40001, data = (object?)null, message = "需要 multipart/form-data" });
 
@@ -23,7 +24,12 @@ public static class FileEndpoints
                 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");
+            var userDirectoryName = GetUserId(http).ToString("N");
+            var uploadsDir = Path.Combine(
+                Directory.GetCurrentDirectory(),
+                "uploads",
+                "users",
+                userDirectoryName);
             Directory.CreateDirectory(uploadsDir);
 
             foreach (var file in files)
@@ -48,7 +54,7 @@ public static class FileEndpoints
                     id = fileId,
                     name = file.FileName,
                     size = file.Length,
-                    url = $"/uploads/{storedName}",
+                    url = $"/uploads/users/{userDirectoryName}/{storedName}",
                     contentType = string.IsNullOrWhiteSpace(file.ContentType) ? "application/octet-stream" : file.ContentType
                 });
             }
@@ -56,4 +62,9 @@ public static class FileEndpoints
             return Results.Ok(new { code = 0, data = results, message = (string?)null });
         });
     }
+
+    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/health_endpoints.cs

@@ -34,6 +34,20 @@ public static class HealthEndpoints
             return Results.Ok(new { code = 0, data = new { id }, message = (string?)null });
         });
 
+        group.MapPost("/batch", async (
+            IReadOnlyList<CreateHealthRecordRequest> requests,
+            HttpContext http,
+            IHealthRecordService healthRecords,
+            CancellationToken ct) =>
+        {
+            var userId = GetUserId(http);
+            var ids = await healthRecords.CreateManyAsync(
+                userId,
+                requests.Select(request => request.ToServiceRequest()).ToList(),
+                ct);
+            return Results.Ok(new { code = 0, data = new { ids }, message = (string?)null });
+        });
+
         group.MapPut("/{id:guid}", async (
             Guid id,
             CreateHealthRecordRequest req,

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

@@ -77,8 +77,10 @@ public static class MedicationEndpoints
         group.MapDelete("/{id:guid}/confirm-dose/{time}", async (Guid id, string time, HttpContext http, IMedicationService medications, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            await medications.CancelDoseAsync(userId, id, TimeOnly.Parse(time), ct);
-            return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
+            var cancelled = await medications.CancelDoseAsync(userId, id, TimeOnly.Parse(time), ct);
+            return cancelled
+                ? Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null })
+                : Results.Ok(new { code = 40004, data = (object?)null, message = "未找到对应的服药打卡记录" });
         });
     }
 
@@ -112,14 +114,19 @@ public static class MedicationEndpoints
         if (root.TryGetProperty("frequency", out var f) && Enum.TryParse<MedicationFrequency>(f.GetString(), out var freq))
             frequency = freq;
 
+        var hasEndDate = root.TryGetProperty("endDate", out var ed);
+        var clearEndDate = hasEndDate &&
+            (ed.ValueKind == JsonValueKind.Null || string.IsNullOrWhiteSpace(ed.GetString()));
+
         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);
+            hasEndDate && !clearEndDate && DateOnly.TryParse(ed.GetString(), out var endDate) ? endDate : null,
+            root.TryGetProperty("notes", out var nt) ? nt.GetString() : null,
+            clearEndDate);
     }
 
     private static List<TimeOnly> ReadTimes(JsonElement root, string propertyName)

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

@@ -19,6 +19,14 @@ public static class NotificationEndpoints
             return Results.Ok(new { code = 0, data = result, message = (string?)null });
         });
 
+        group.MapPost("/check-due", async (HttpContext http, IReminderCatchUpService reminders, CancellationToken ct) =>
+        {
+            var userId = GetUserId(http);
+            if (userId == Guid.Empty) return Results.Unauthorized();
+            var result = await reminders.CheckDueAsync(userId, DateTime.UtcNow, ct);
+            return Results.Ok(new { code = 0, data = result, message = (string?)null });
+        });
+
         group.MapGet("", async (HttpContext http, IInAppNotificationService notifications, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
@@ -104,7 +112,7 @@ public static class NotificationEndpoints
             await db.SaveChangesAsync(ct);
 
             // 保存后立即检查该用户是否需要健康录入提醒，不用等到 9:00/12:00
-            if (body.HealthRecordReminder is true && pref.HealthRecordReminder)
+            if (body.HealthRecordReminder is true && pref.PushEnabled && pref.HealthRecordReminder)
             {
                 var nowCst = DateTime.UtcNow.AddHours(8);
                 var todayStart = nowCst.Date.AddHours(-8);

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

@@ -49,7 +49,8 @@ public static class UserEndpoints
                     req.DietRestrictions,
                     req.ChronicDiseases,
                     req.FamilyHistory,
-                    surgeries),
+                    surgeries,
+                    req.SurgeryHistoryStatus),
                 ct);
             return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
         });
@@ -70,6 +71,7 @@ public sealed record UpdateArchiveRequest(
     string? Diagnosis, string? SurgeryType, string? SurgeryDate,
     List<string>? Allergies, List<string>? DietRestrictions,
     List<string>? ChronicDiseases, string? FamilyHistory,
-    List<UpdateArchiveSurgeryRequest>? Surgeries);
+    List<UpdateArchiveSurgeryRequest>? Surgeries,
+    string? SurgeryHistoryStatus);
 
 public sealed record UpdateArchiveSurgeryRequest(string Type, string? Date);

backend/src/Health.WebApi/Program.cs

@@ -142,6 +142,7 @@ builder.Services.AddScoped<IInAppNotificationService, InAppNotificationService>(
 builder.Services.AddScoped<IInAppNotificationRepository, EfInAppNotificationRepository>();
 builder.Services.AddScoped<IUserNotificationProducer, EfUserNotificationProducer>();
 builder.Services.AddScoped<INotificationOutboxProcessor, EfNotificationOutboxProcessor>();
+builder.Services.AddScoped<IReminderCatchUpService, EfReminderCatchUpService>();
 builder.Services.AddScoped<IReportService, ReportService>();
 builder.Services.AddScoped<IReportRepository, EfReportRepository>();
 builder.Services.AddScoped<IReportFileStorage, LocalReportFileStorage>();
@@ -149,6 +150,8 @@ builder.Services.AddScoped<IReportAnalysisService, ReportAnalysisService>();
 builder.Services.AddScoped<IReportAnalysisQueue, EfReportAnalysisQueue>();
 builder.Services.AddScoped<IUserService, UserService>();
 builder.Services.AddScoped<IUserRepository, EfUserRepository>();
+builder.Services.AddScoped<IAccountFileCleanup>(_ => new LocalAccountFileCleanup(
+    Path.Combine(Directory.GetCurrentDirectory(), "uploads")));
 
 // ---- AI 客户端（使用 IHttpClientFactory 区分 LLM 和 VLM）----
 builder.Services.AddHttpClient<DeepSeekClient>(client =>

backend/tests/Health.Tests/account_deletion_tests.cs

@@ -0,0 +1,120 @@
+using Health.Application.Users;
+using Health.Domain.Entities;
+using Health.Infrastructure.Users;
+
+namespace Health.Tests;
+
+public sealed class AccountDeletionTests
+{
+    [Fact]
+    public async Task LocalCleanup_DeletesOwnedUploadsWithoutTouchingOtherFiles()
+    {
+        var root = Path.Combine(Path.GetTempPath(), $"health-account-delete-{Guid.NewGuid():N}");
+        var userId = Guid.NewGuid();
+        var userDirectory = Path.Combine(root, "users", userId.ToString("N"));
+        var reportPath = Path.Combine(root, "reports", "owned-report.pdf");
+        var chatImagePath = Path.Combine(root, "owned-chat.jpg");
+        var otherUserPath = Path.Combine(root, "users", Guid.NewGuid().ToString("N"), "keep.jpg");
+        var outsidePath = Path.Combine(Path.GetDirectoryName(root)!, "outside-account-file.txt");
+
+        try
+        {
+            Directory.CreateDirectory(userDirectory);
+            Directory.CreateDirectory(Path.GetDirectoryName(reportPath)!);
+            Directory.CreateDirectory(Path.GetDirectoryName(otherUserPath)!);
+            await File.WriteAllTextAsync(Path.Combine(userDirectory, "unlinked-upload.jpg"), "owned");
+            await File.WriteAllTextAsync(reportPath, "owned");
+            await File.WriteAllTextAsync(chatImagePath, "owned");
+            await File.WriteAllTextAsync(otherUserPath, "other");
+            await File.WriteAllTextAsync(outsidePath, "outside");
+
+            var cleanup = new LocalAccountFileCleanup(root);
+            var references = new AccountFileReferences(
+                ["/uploads/reports/owned-report.pdf", "/uploads/../outside-account-file.txt"],
+                ["{\"imageUrl\":\"/uploads/owned-chat.jpg\"}"]);
+
+            await cleanup.DeleteAsync(userId, references, CancellationToken.None);
+
+            Assert.False(Directory.Exists(userDirectory));
+            Assert.False(File.Exists(reportPath));
+            Assert.False(File.Exists(chatImagePath));
+            Assert.True(File.Exists(otherUserPath));
+            Assert.True(File.Exists(outsidePath));
+        }
+        finally
+        {
+            if (Directory.Exists(root)) Directory.Delete(root, recursive: true);
+            if (File.Exists(outsidePath)) File.Delete(outsidePath);
+        }
+    }
+
+    [Fact]
+    public async Task UserService_CleansFilesBeforeDeletingDatabaseData()
+    {
+        var calls = new List<string>();
+        var references = new AccountFileReferences(["/uploads/reports/report.pdf"], []);
+        var repository = new FakeUserRepository(references, calls);
+        var cleanup = new FakeAccountFileCleanup(calls);
+        var service = new UserService(repository, cleanup);
+
+        await service.DeleteAccountAsync(Guid.NewGuid(), CancellationToken.None);
+
+        Assert.Equal(["references", "files", "database"], calls);
+        Assert.Same(references, cleanup.ReceivedReferences);
+    }
+
+    [Fact]
+    public async Task UserService_DoesNotDeleteDatabaseWhenFileCleanupFails()
+    {
+        var calls = new List<string>();
+        var repository = new FakeUserRepository(new AccountFileReferences([], []), calls);
+        var service = new UserService(repository, new FailingAccountFileCleanup(calls));
+
+        await Assert.ThrowsAsync<IOException>(() =>
+            service.DeleteAccountAsync(Guid.NewGuid(), CancellationToken.None));
+
+        Assert.Equal(["references", "files"], calls);
+    }
+
+    private sealed class FakeUserRepository(
+        AccountFileReferences references,
+        List<string> calls) : IUserRepository
+    {
+        public Task<User?> GetAsync(Guid userId, CancellationToken ct) => Task.FromResult<User?>(null);
+
+        public Task<AccountFileReferences> GetAccountFileReferencesAsync(Guid userId, CancellationToken ct)
+        {
+            calls.Add("references");
+            return Task.FromResult(references);
+        }
+
+        public Task SaveChangesAsync(CancellationToken ct) => Task.CompletedTask;
+
+        public Task DeleteAccountDataAsync(Guid userId, CancellationToken ct)
+        {
+            calls.Add("database");
+            return Task.CompletedTask;
+        }
+    }
+
+    private sealed class FakeAccountFileCleanup(List<string> calls) : IAccountFileCleanup
+    {
+        public AccountFileReferences? ReceivedReferences { get; private set; }
+
+        public Task DeleteAsync(Guid userId, AccountFileReferences references, CancellationToken ct)
+        {
+            calls.Add("files");
+            ReceivedReferences = references;
+            return Task.CompletedTask;
+        }
+    }
+
+    private sealed class FailingAccountFileCleanup(List<string> calls) : IAccountFileCleanup
+    {
+        public Task DeleteAsync(Guid userId, AccountFileReferences references, CancellationToken ct)
+        {
+            calls.Add("files");
+            throw new IOException("file is locked");
+        }
+    }
+}

backend/tests/Health.Tests/application_service_tests.cs

@@ -42,7 +42,8 @@ public sealed class ApplicationServiceTests
         var userId = Guid.NewGuid();
         var repository = new FakeHealthArchiveRepository(new HealthArchive
         {
-            Id = Guid.NewGuid(), UserId = userId,
+            Id = Guid.NewGuid(),
+            UserId = userId,
         });
         var service = new HealthArchiveService(repository);
 
@@ -75,14 +76,35 @@ public sealed class ApplicationServiceTests
         Assert.InRange((before - repository.RecordedAfter!.Value).TotalDays, 364.99, 365.01);
     }
 
+    [Fact]
+    public async Task HealthRecords_BatchPersistsAllReadingsWithOneSave()
+    {
+        var repository = new CapturingHealthRecordRepository();
+        var service = new HealthRecordService(repository);
+
+        var ids = await service.CreateManyAsync(
+            Guid.NewGuid(),
+            [
+                new HealthRecordUpsertRequest(HealthMetricType.BloodPressure, 116, 89, null, "mmHg", HealthRecordSource.DeviceSync, DateTime.UtcNow),
+                new HealthRecordUpsertRequest(HealthMetricType.HeartRate, null, null, 72, "bpm", HealthRecordSource.DeviceSync, DateTime.UtcNow),
+            ],
+            CancellationToken.None);
+
+        Assert.Equal(2, ids.Count);
+        Assert.Equal(2, repository.Added.Count);
+        Assert.Equal(1, repository.SaveCount);
+    }
+
     [Fact]
     public async Task HealthArchive_AiSurgeryUpdatePreservesLegacySurgery()
     {
         var userId = Guid.NewGuid();
         var repository = new FakeHealthArchiveRepository(new HealthArchive
         {
-            Id = Guid.NewGuid(), UserId = userId,
-            SurgeryType = "Legacy surgery", SurgeryDate = new DateOnly(2010, 1, 2),
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            SurgeryType = "Legacy surgery",
+            SurgeryDate = new DateOnly(2010, 1, 2),
         });
         var service = new HealthArchiveService(repository);
 
@@ -110,13 +132,71 @@ public sealed class ApplicationServiceTests
         Assert.False(result.Created);
     }
 
+    [Fact]
+    public async Task Conversation_List_ReturnsAtMostThirtyRecentItems()
+    {
+        var userId = Guid.NewGuid();
+        var conversations = Enumerable.Range(0, 35)
+            .Select(index => new Conversation
+            {
+                Id = Guid.NewGuid(),
+                UserId = userId,
+                AgentType = AgentType.Unified,
+                UpdatedAt = DateTime.UtcNow.AddMinutes(-index),
+            })
+            .ToList();
+        var service = new AiConversationService(new ListConversationRepository(conversations));
+
+        var result = await service.ListAsync(userId, CancellationToken.None);
+
+        Assert.Equal(30, result.Count);
+    }
+
+    [Fact]
+    public void Conversation_Delete_ReportsWhetherARecordWasActuallyDeleted()
+    {
+        var method = typeof(IAiConversationService).GetMethod(nameof(IAiConversationService.DeleteAsync));
+
+        Assert.NotNull(method);
+        Assert.Equal(typeof(Task<bool>), method!.ReturnType);
+    }
+
+    [Fact]
+    public async Task Conversation_Open_ReactivatesTheSameOwnedConversation()
+    {
+        var userId = Guid.NewGuid();
+        var conversation = new Conversation
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            AgentType = AgentType.Unified,
+            UpdatedAt = DateTime.UtcNow.AddDays(-1),
+        };
+        var service = new AiConversationService(new FakeConversationRepository(conversation));
+
+        var result = await service.OpenAsync(
+            userId,
+            conversation.Id,
+            AgentType.Unified,
+            "新的追问",
+            CancellationToken.None);
+
+        Assert.True(result.Found);
+        Assert.False(result.Created);
+        Assert.Equal(conversation.Id, result.ConversationId);
+    }
+
     [Fact]
     public async Task Calendar_Month_AggregatesMedicationExerciseAndFollowUp()
     {
         var date = new DateOnly(2026, 6, 19);
         var medication = new Medication
         {
-            Id = Guid.NewGuid(), IsActive = true, Name = "阿司匹林", StartDate = date.AddDays(-1), TimeOfDay = [new TimeOnly(8, 0)]
+            Id = Guid.NewGuid(),
+            IsActive = true,
+            Name = "阿司匹林",
+            StartDate = date.AddDays(-1),
+            TimeOfDay = [new TimeOnly(8, 0)]
         };
         var plan = new ExercisePlan { Id = Guid.NewGuid(), StartDate = date, EndDate = date, ReminderTime = new TimeOnly(19, 0) };
         plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = date, ExerciseType = "散步", DurationMinutes = 30 });
@@ -154,7 +234,11 @@ public sealed class ApplicationServiceTests
         var repository = new FakeExerciseRepository();
         var plan = new ExercisePlan
         {
-            Id = Guid.NewGuid(), UserId = Guid.NewGuid(), StartDate = today, EndDate = today.AddDays(9), ReminderTime = new TimeOnly(19, 0),
+            Id = Guid.NewGuid(),
+            UserId = Guid.NewGuid(),
+            StartDate = today,
+            EndDate = today.AddDays(9),
+            ReminderTime = new TimeOnly(19, 0),
         };
         plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = today, ExerciseType = "跑步", DurationMinutes = 30 });
         plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = today.AddDays(7), ExerciseType = "跑步", DurationMinutes = 30 });
@@ -175,11 +259,19 @@ public sealed class ApplicationServiceTests
         var repository = new FakeExerciseRepository();
         var plan = new ExercisePlan
         {
-            Id = Guid.NewGuid(), UserId = Guid.NewGuid(), StartDate = today.AddDays(-1), EndDate = today, ReminderTime = new TimeOnly(19, 0),
+            Id = Guid.NewGuid(),
+            UserId = Guid.NewGuid(),
+            StartDate = today.AddDays(-1),
+            EndDate = today,
+            ReminderTime = new TimeOnly(19, 0),
         };
         var item = new ExercisePlanItem
         {
-            Id = Guid.NewGuid(), Plan = plan, ScheduledDate = today.AddDays(-1), ExerciseType = "散步", DurationMinutes = 30,
+            Id = Guid.NewGuid(),
+            Plan = plan,
+            ScheduledDate = today.AddDays(-1),
+            ExerciseType = "散步",
+            DurationMinutes = 30,
         };
         plan.Items.Add(item);
         repository.SetPlan(plan);
@@ -199,6 +291,8 @@ public sealed class ApplicationServiceTests
     private sealed class CapturingHealthRecordRepository : IHealthRecordRepository
     {
         public DateTime? RecordedAfter { get; private set; }
+        public List<HealthRecord> Added { get; } = [];
+        public int SaveCount { get; private set; }
         public Task<IReadOnlyList<HealthRecord>> ListAsync(Guid userId, HealthMetricType? type, DateTime? recordedAfter, int limit, CancellationToken ct) =>
             Task.FromResult<IReadOnlyList<HealthRecord>>([]);
         public Task<HealthRecord?> GetOwnedAsync(Guid userId, Guid id, CancellationToken ct) => Task.FromResult<HealthRecord?>(null);
@@ -208,9 +302,9 @@ public sealed class ApplicationServiceTests
             RecordedAfter = recordedAfter;
             return Task.FromResult<IReadOnlyList<HealthRecord>>([]);
         }
-        public Task AddAsync(HealthRecord record, CancellationToken ct) => Task.CompletedTask;
+        public Task AddAsync(HealthRecord record, CancellationToken ct) { Added.Add(record); return Task.CompletedTask; }
         public void Delete(HealthRecord record) { }
-        public Task SaveChangesAsync(CancellationToken ct) => Task.CompletedTask;
+        public Task SaveChangesAsync(CancellationToken ct) { SaveCount++; return Task.CompletedTask; }
     }
 
     private sealed class FakeConversationRepository(Conversation conversation) : IAiConversationRepository
@@ -228,6 +322,33 @@ public sealed class ApplicationServiceTests
         public Task SaveChangesAsync(CancellationToken ct) => Task.CompletedTask;
     }
 
+    private sealed class ListConversationRepository(List<Conversation> conversations) : IAiConversationRepository
+    {
+        private readonly List<Conversation> _conversations = conversations;
+        public Task<Conversation?> GetOwnedAsync(Guid userId, Guid conversationId, CancellationToken ct) =>
+            Task.FromResult(_conversations.FirstOrDefault(item => item.Id == conversationId && item.UserId == userId));
+        public Task<Conversation?> GetAsync(Guid conversationId, CancellationToken ct) =>
+            Task.FromResult(_conversations.FirstOrDefault(item => item.Id == conversationId));
+        public Task<IReadOnlyList<Conversation>> ListAsync(Guid userId, CancellationToken ct) =>
+            Task.FromResult<IReadOnlyList<Conversation>>(_conversations
+                .Where(item => item.UserId == userId)
+                .OrderByDescending(item => item.UpdatedAt)
+                .ToList());
+        public Task<IReadOnlyList<ConversationMessage>> GetMessagesAsync(Guid conversationId, CancellationToken ct) =>
+            Task.FromResult<IReadOnlyList<ConversationMessage>>([]);
+        public Task<IReadOnlyList<ConversationMessage>> GetRecentMessagesAsync(Guid conversationId, int limit, CancellationToken ct) =>
+            Task.FromResult<IReadOnlyList<ConversationMessage>>([]);
+        public Task AddConversationAsync(Conversation value, CancellationToken ct)
+        {
+            _conversations.Add(value);
+            return Task.CompletedTask;
+        }
+        public Task AddMessageAsync(ConversationMessage message, CancellationToken ct) => Task.CompletedTask;
+        public Task<int> DeleteLegacyDietCommentaryArtifactsAsync(Guid userId, string promptPrefix, CancellationToken ct) => Task.FromResult(0);
+        public void Delete(Conversation value) => _conversations.Remove(value);
+        public Task SaveChangesAsync(CancellationToken ct) => Task.CompletedTask;
+    }
+
     private sealed class FakeCalendarRepository(CalendarDataSnapshot snapshot) : ICalendarRepository
     {
         public Task<CalendarDataSnapshot> GetSnapshotAsync(Guid userId, DateOnly start, DateOnly end, CancellationToken ct) => Task.FromResult(snapshot);

backend/tests/Health.Tests/doctor_endpoint_tests.cs

@@ -0,0 +1,17 @@
+using Health.WebApi.Endpoints;
+
+namespace Health.Tests;
+
+public sealed class DoctorEndpointTests
+{
+    [Fact]
+    public void BeijingDayRange_MapsEarlyUtcTimeToTheCorrectLocalDate()
+    {
+        var utcNow = new DateTime(2026, 7, 13, 17, 30, 0, DateTimeKind.Utc);
+
+        var (startUtc, endUtc) = DoctorEndpoints.GetBeijingDayRange(utcNow);
+
+        Assert.Equal(new DateTime(2026, 7, 13, 16, 0, 0, DateTimeKind.Utc), startUtc);
+        Assert.Equal(new DateTime(2026, 7, 14, 16, 0, 0, DateTimeKind.Utc), endUtc);
+    }
+}

backend/tests/Health.Tests/entity_tests.cs

@@ -184,6 +184,7 @@ public class EntityTests
             DietRestrictions = ["低盐", "低脂"],
             ChronicDiseases = ["高血压", "高血脂"],
             FamilyHistory = "父亲冠心病",
+            SurgeryHistoryStatus = "有",
         };
         db.HealthArchives.Add(archive);
         await db.SaveChangesAsync();
@@ -193,6 +194,7 @@ public class EntityTests
         Assert.Equal("冠心病", saved!.Diagnosis);
         Assert.Equal(2, saved.DietRestrictions.Count);
         Assert.Contains("低盐", saved.DietRestrictions);
+        Assert.Equal("有", saved.SurgeryHistoryStatus);
     }
 
     [Fact]

backend/tests/Health.Tests/medication_schedule_tests.cs

@@ -0,0 +1,29 @@
+using Health.Application.Medications;
+using Health.Domain.Enums;
+
+namespace Health.Tests;
+
+public sealed class MedicationScheduleTests
+{
+    [Fact]
+    public void FutureDoseOutsideReminderWindow_RemainsVisibleAsScheduled()
+    {
+        var status = MedicationScheduleStatus.Resolve(
+            new TimeOnly(18, 0),
+            new TimeOnly(8, 0),
+            logStatus: null);
+
+        Assert.Equal("scheduled", status);
+    }
+
+    [Fact]
+    public void LoggedDose_UsesItsActualStatus()
+    {
+        var status = MedicationScheduleStatus.Resolve(
+            new TimeOnly(8, 0),
+            new TimeOnly(12, 0),
+            MedicationLogStatus.Taken);
+
+        Assert.Equal("taken", status);
+    }
+}

backend/tests/Health.Tests/medication_update_tests.cs

@@ -0,0 +1,54 @@
+using Health.Application.Medications;
+using Health.Domain.Entities;
+
+namespace Health.Tests;
+
+public sealed class MedicationUpdateTests
+{
+    [Fact]
+    public async Task Update_CanClearAnExistingEndDate()
+    {
+        var medication = new Medication
+        {
+            Id = Guid.NewGuid(),
+            UserId = Guid.NewGuid(),
+            Name = "阿司匹林",
+            StartDate = new DateOnly(2026, 7, 1),
+            EndDate = new DateOnly(2026, 7, 31),
+        };
+        var repository = new FakeMedicationRepository(medication);
+        var service = new MedicationService(repository);
+
+        var updated = await service.UpdateAsync(
+            medication.UserId,
+            medication.Id,
+            new MedicationPatchRequest(
+                null, null, null, null, null, null, null,
+                ClearEndDate: true),
+            CancellationToken.None);
+
+        Assert.True(updated);
+        Assert.Null(medication.EndDate);
+        Assert.True(repository.Saved);
+    }
+
+    private sealed class FakeMedicationRepository(Medication medication) : IMedicationRepository
+    {
+        public bool Saved { get; private set; }
+
+        public Task<IReadOnlyList<Medication>> ListAsync(Guid userId, string? filter, CancellationToken ct) => Task.FromResult<IReadOnlyList<Medication>>([medication]);
+        public Task<IReadOnlyList<Medication>> ListActiveForRemindersAsync(Guid userId, DateOnly today, CancellationToken ct) => Task.FromResult<IReadOnlyList<Medication>>([medication]);
+        public Task<IReadOnlyList<MedicationLog>> ListLogsInWindowAsync(Guid userId, DateTime startUtc, DateTime endUtc, CancellationToken ct) => Task.FromResult<IReadOnlyList<MedicationLog>>([]);
+        public Task<Medication?> GetOwnedAsync(Guid userId, Guid medicationId, CancellationToken ct) => Task.FromResult<Medication?>(medication.UserId == userId && medication.Id == medicationId ? medication : null);
+        public Task<bool> ExistsOwnedAsync(Guid userId, Guid medicationId, CancellationToken ct) => Task.FromResult(medication.UserId == userId && medication.Id == medicationId);
+        public Task<MedicationLog?> GetTodayTakenLogAsync(Guid userId, Guid medicationId, DateTime startUtc, DateTime endUtc, CancellationToken ct) => Task.FromResult<MedicationLog?>(null);
+        public Task<bool> DoseLogExistsAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, DateTime startUtc, DateTime endUtc, CancellationToken ct) => Task.FromResult(false);
+        public Task<MedicationLog?> GetDoseLogAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, DateTime startUtc, DateTime endUtc, CancellationToken ct) => Task.FromResult<MedicationLog?>(null);
+        public Task<IReadOnlyList<Medication>> ListActiveForReminderScanAsync(CancellationToken ct) => Task.FromResult<IReadOnlyList<Medication>>([medication]);
+        public Task AddMedicationAsync(Medication value, CancellationToken ct) => Task.CompletedTask;
+        public Task AddLogAsync(MedicationLog log, CancellationToken ct) => Task.CompletedTask;
+        public void DeleteMedication(Medication value) { }
+        public void DeleteLog(MedicationLog log) { }
+        public Task SaveChangesAsync(CancellationToken ct) { Saved = true; return Task.CompletedTask; }
+    }
+}

backend/tests/Health.Tests/persistence_pipeline_tests.cs

@@ -213,6 +213,178 @@ public sealed class PersistencePipelineTests
         Assert.Empty(tasks);
     }
 
+    [Fact]
+    public async Task NotificationOutbox_PushDisabledDoesNotCreateInAppNotification()
+    {
+        await using var db = CreateDbContext();
+        var userId = Guid.NewGuid();
+        var sourceId = Guid.NewGuid();
+        db.NotificationPreferences.Add(new NotificationPreference
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            PushEnabled = false,
+            MedicationReminder = true,
+            HealthRecordReminder = false,
+        });
+        db.NotificationOutbox.Add(new NotificationOutboxRecord
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            SourceTaskId = sourceId,
+            Type = "MedicationReminder",
+            Payload = """
+                {"Type":"MedicationReminder","Title":"用药时间到了","Message":"请按计划服药","Severity":"info","ActionType":"medication","ActionTargetId":null}
+                """,
+            Status = "Pending",
+            AvailableAt = DateTime.UtcNow,
+            CreatedAt = DateTime.UtcNow,
+            UpdatedAt = DateTime.UtcNow,
+        });
+        await db.SaveChangesAsync();
+        var processor = new EfNotificationOutboxProcessor(db);
+
+        await processor.ProcessNextAsync(CancellationToken.None);
+
+        Assert.Empty(db.UserNotifications);
+    }
+
+    [Fact]
+    public async Task ReminderCatchUp_PushDisabledDoesNotCreateHealthRecordReminder()
+    {
+        await using var db = CreateDbContext();
+        var userId = Guid.NewGuid();
+        db.NotificationPreferences.Add(new NotificationPreference
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            PushEnabled = false,
+            HealthRecordReminder = true,
+            HealthRecordReminderBloodPressure = true,
+            HealthRecordReminderHeartRate = false,
+            HealthRecordReminderGlucose = false,
+            HealthRecordReminderSpO2 = false,
+            HealthRecordReminderWeight = false,
+        });
+        await db.SaveChangesAsync();
+        var service = new EfReminderCatchUpService(db);
+        var nowUtc = new DateTime(2026, 7, 13, 5, 0, 0, DateTimeKind.Utc); // 13:00 Beijing
+
+        var created = await service.CheckDueAsync(userId, nowUtc, CancellationToken.None);
+        var secondPass = await service.CheckDueAsync(userId, nowUtc, CancellationToken.None);
+
+        Assert.Equal(0, created.CreatedCount);
+        Assert.Equal(0, secondPass.CreatedCount);
+        Assert.Empty(db.UserNotifications);
+    }
+
+    [Fact]
+    public async Task ReminderCatchUp_PushEnabledCreatesOnlySelectedMissingMetric()
+    {
+        await using var db = CreateDbContext();
+        var userId = Guid.NewGuid();
+        db.NotificationPreferences.Add(new NotificationPreference
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            PushEnabled = true,
+            HealthRecordReminder = true,
+            HealthRecordReminderBloodPressure = true,
+            HealthRecordReminderHeartRate = false,
+            HealthRecordReminderGlucose = false,
+            HealthRecordReminderSpO2 = false,
+            HealthRecordReminderWeight = false,
+        });
+        await db.SaveChangesAsync();
+        var service = new EfReminderCatchUpService(db);
+        var nowUtc = new DateTime(2026, 7, 13, 5, 0, 0, DateTimeKind.Utc);
+
+        var result = await service.CheckDueAsync(userId, nowUtc, CancellationToken.None);
+
+        Assert.Equal(1, result.CreatedCount);
+        var notification = Assert.Single(db.UserNotifications);
+        Assert.Contains("血压", notification.Message);
+        Assert.DoesNotContain("心率", notification.Message);
+    }
+
+    [Fact]
+    public async Task ReminderCatchUp_DndStillPreventsReminder()
+    {
+        await using var db = CreateDbContext();
+        var userId = Guid.NewGuid();
+        db.NotificationPreferences.Add(new NotificationPreference
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            PushEnabled = true,
+            HealthRecordReminder = true,
+            HealthRecordReminderBloodPressure = true,
+            DndEnabled = true,
+            DndStartMinutes = 12 * 60,
+            DndEndMinutes = 14 * 60,
+        });
+        await db.SaveChangesAsync();
+        var service = new EfReminderCatchUpService(db);
+        var nowUtc = new DateTime(2026, 7, 13, 5, 0, 0, DateTimeKind.Utc);
+
+        var result = await service.CheckDueAsync(userId, nowUtc, CancellationToken.None);
+
+        Assert.Equal(0, result.CreatedCount);
+        Assert.Empty(db.UserNotifications);
+    }
+
+    [Fact]
+    public async Task ReminderCatchUp_CreatesMedicationAndExerciseRemindersForDueItems()
+    {
+        await using var db = CreateDbContext();
+        var userId = Guid.NewGuid();
+        var date = new DateOnly(2026, 7, 13);
+        db.NotificationPreferences.Add(new NotificationPreference
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            PushEnabled = true,
+            MedicationReminder = true,
+            HealthRecordReminder = false,
+        });
+        db.Medications.Add(new Medication
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            Name = "测试药物",
+            Dosage = "1片",
+            Frequency = MedicationFrequency.Daily,
+            TimeOfDay = [new TimeOnly(8, 0)],
+            StartDate = date,
+            IsActive = true,
+        });
+        var plan = new ExercisePlan
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            StartDate = date,
+            EndDate = date,
+            ReminderTime = new TimeOnly(9, 0),
+        };
+        plan.Items.Add(new ExercisePlanItem
+        {
+            Id = Guid.NewGuid(),
+            ScheduledDate = date,
+            ExerciseType = "散步",
+            DurationMinutes = 30,
+        });
+        db.ExercisePlans.Add(plan);
+        await db.SaveChangesAsync();
+        var service = new EfReminderCatchUpService(db);
+        var nowUtc = new DateTime(2026, 7, 13, 2, 0, 0, DateTimeKind.Utc); // 10:00 Beijing
+
+        var created = await service.CheckDueAsync(userId, nowUtc, CancellationToken.None);
+
+        Assert.Equal(2, created.CreatedCount);
+        Assert.Contains(db.UserNotifications, x => x.Type == "MedicationReminder");
+        Assert.Contains(db.UserNotifications, x => x.Type == "ExerciseReminder");
+    }
+
     private static ReportAnalysisTaskRecord NewReportTask(int attempts) => new()
     {
         Id = Guid.NewGuid(),

backend/tests/Health.Tests/prompt_manager_tests.cs

@@ -0,0 +1,18 @@
+using Health.Infrastructure.AI;
+using Health.Domain.Enums;
+
+namespace Health.Tests;
+
+public sealed class PromptManagerTests
+{
+    [Fact]
+    public void UnifiedPrompt_DistinguishesQuestionsFromEntryRequests()
+    {
+        var prompt = new PromptManager().GetSystemPrompt(AgentType.Unified);
+
+        Assert.Contains("先判断用户是在咨询数值，还是希望记录数据", prompt);
+        Assert.Contains("血氧98%是不是太高了", prompt);
+        Assert.Contains("先回答问题，不调用 record_health_data", prompt);
+        Assert.Contains("帮我记录血压116/89", prompt);
+    }
+}