feat: 应用内通知系统 + 结构化手术史/用药等相关改动

- 新增用户通知 outbox 流水线(EfUserNotificationPipeline)与后台投递 worker
- 通知中心页面及前端通知服务接入
- 健康指标异常、用药/运动提醒等事件统一产出站内通知
- 健康档案结构化手术史、用药提醒扫描、医生/用户端点等配套调整
- AppDbContext 注册通知相关实体

backend/dotnet-tools.json

@@ -0,0 +1,13 @@
+{
+  "version": 1,
+  "isRoot": true,
+  "tools": {
+    "dotnet-ef": {
+      "version": "10.0.8",
+      "commands": [
+        "dotnet-ef"
+      ],
+      "rollForward": false
+    }
+  }
+}

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

@@ -24,7 +24,10 @@ public sealed class PatientContextService(
         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.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})");
             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)}");

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

@@ -1,3 +1,4 @@
+using Health.Domain;
 using Health.Domain.Entities;
 using Health.Domain.Enums;
 
@@ -5,6 +6,7 @@ namespace Health.Application.Diets;
 
 public sealed class DietService(IDietRepository diets) : IDietService
 {
+    private const int MaxCalories = 20000;   // 单条记录/单项热量上限（kcal）
     private readonly IDietRepository _diets = diets;
 
     public async Task<IReadOnlyList<DietRecordDto>> ListAsync(Guid userId, string? date, string? mealType, CancellationToken ct)
@@ -18,6 +20,15 @@ public sealed class DietService(IDietRepository diets) : IDietService
 
     public async Task<Guid> CreateAsync(Guid userId, DietRecordCreateRequest request, CancellationToken ct)
     {
+        ValidateCalories(request.TotalCalories, "总热量");
+        ValidateScore(request.HealthScore);
+        foreach (var item in request.FoodItems)
+        {
+            if (string.IsNullOrWhiteSpace(item.Name))
+                throw new ValidationException("食物名称不能为空");
+            ValidateCalories(item.Calories, $"食物「{item.Name.Trim()}」热量");
+        }
+
         var record = new DietRecord
         {
             Id = Guid.NewGuid(),
@@ -34,7 +45,7 @@ public sealed class DietService(IDietRepository diets) : IDietService
             record.FoodItems.Add(new DietFoodItem
             {
                 Id = Guid.NewGuid(),
-                Name = item.Name,
+                Name = item.Name.Trim(),
                 Portion = item.Portion,
                 Calories = item.Calories,
                 SortOrder = item.SortOrder,
@@ -61,12 +72,27 @@ public sealed class DietService(IDietRepository diets) : IDietService
         var record = await _diets.GetOwnedAsync(userId, recordId, ct);
         if (record == null) return false;
 
+        ValidateCalories(request.TotalCalories, "总热量");
+        ValidateScore(request.HealthScore);
+
         if (request.TotalCalories.HasValue) record.TotalCalories = request.TotalCalories.Value;
         if (request.HealthScore.HasValue) record.HealthScore = request.HealthScore.Value;
         await _diets.SaveChangesAsync(ct);
         return true;
     }
 
+    private static void ValidateCalories(int? calories, string field)
+    {
+        if (calories.HasValue && (calories.Value < 0 || calories.Value > MaxCalories))
+            throw new ValidationException($"{field}应在 0~{MaxCalories} kcal 之间，当前值 {calories.Value} 不合理");
+    }
+
+    private static void ValidateScore(int? score)
+    {
+        if (score.HasValue && (score.Value < 0 || score.Value > 100))
+            throw new ValidationException($"健康评分应在 0~100 之间，当前值 {score.Value} 不合理");
+    }
+
     private static DietRecordDto ToDto(DietRecord record) => new(
         record.Id,
         record.MealType.ToString(),

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

@@ -1,9 +1,11 @@
+using Health.Domain;
 using Health.Domain.Entities;
 
 namespace Health.Application.Exercises;
 
 public sealed class ExerciseService(IExerciseRepository exercises) : IExerciseService
 {
+    private const int MaxDurationMinutes = 1440;  // 单次运动时长上限 24 小时
     private static readonly TimeOnly DefaultReminderTime = new(19, 0);
     private readonly IExerciseRepository _exercises = exercises;
 
@@ -17,6 +19,8 @@ public sealed class ExerciseService(IExerciseRepository exercises) : IExerciseSe
 
     public async Task<Guid> CreateAsync(Guid userId, ExercisePlanCreateRequest request, CancellationToken ct)
     {
+        ValidateDuration(request.DurationMinutes);
+
         var startDate = request.StartDate;
         var endDate = request.EndDate < startDate ? startDate : request.EndDate;
         if (endDate.DayNumber - startDate.DayNumber > 365)
@@ -39,6 +43,9 @@ public sealed class ExerciseService(IExerciseRepository exercises) : IExerciseSe
 
     public async Task<Guid> CreateFromItemsAsync(Guid userId, DateOnly startDate, DateOnly endDate, TimeOnly? reminderTime, IReadOnlyList<ExercisePlanItemInput> items, CancellationToken ct)
     {
+        foreach (var item in items)
+            ValidateDuration(item.DurationMinutes);
+
         var normalizedEnd = endDate < startDate ? startDate : endDate;
         var plan = NewPlan(userId, startDate, normalizedEnd, reminderTime);
         foreach (var item in items.Where(x => x.ScheduledDate >= startDate && x.ScheduledDate <= normalizedEnd).GroupBy(x => x.ScheduledDate).Select(x => x.First()))
@@ -55,6 +62,13 @@ public sealed class ExerciseService(IExerciseRepository exercises) : IExerciseSe
         return plan.Id;
     }
 
+    // 时长上限校验：下限交由各方法兜底为 30，这里只拦截不合理的超大值
+    private static void ValidateDuration(int durationMinutes)
+    {
+        if (durationMinutes > MaxDurationMinutes)
+            throw new ValidationException($"单次运动时长不能超过 {MaxDurationMinutes} 分钟（24 小时），当前值 {durationMinutes} 不合理");
+    }
+
     public async Task<IReadOnlyList<ExercisePlanSummaryDto>> ListAsync(Guid userId, CancellationToken ct)
     {
         var plans = await _exercises.ListAsync(userId, 20, ct);

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

@@ -2,12 +2,22 @@ using Health.Domain.Entities;
 
 namespace Health.Application.HealthArchives;
 
+public sealed record HealthArchiveSurgeryDto(
+    Guid Id,
+    string Type,
+    DateOnly? Date);
+
+public sealed record HealthArchiveSurgeryInput(
+    string Type,
+    DateOnly? Date);
+
 public sealed record HealthArchiveDto(
     Guid Id,
     Guid UserId,
     string? Diagnosis,
     string? SurgeryType,
     DateOnly? SurgeryDate,
+    IReadOnlyList<HealthArchiveSurgeryDto> Surgeries,
     IReadOnlyList<string> Allergies,
     IReadOnlyList<string> DietRestrictions,
     IReadOnlyList<string> ChronicDiseases,
@@ -21,7 +31,8 @@ public sealed record HealthArchiveUpdateRequest(
     IReadOnlyList<string>? Allergies,
     IReadOnlyList<string>? DietRestrictions,
     IReadOnlyList<string>? ChronicDiseases,
-    string? FamilyHistory);
+    string? FamilyHistory,
+    IReadOnlyList<HealthArchiveSurgeryInput>? Surgeries = null);
 
 public interface IHealthArchiveService
 {

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

@@ -42,7 +42,8 @@ public sealed class HealthArchiveService(IHealthArchiveRepository archives) : IH
             "update_diagnosis" => request with
             {
                 SurgeryType = null, SurgeryDate = null, Allergies = null,
-                DietRestrictions = null, ChronicDiseases = null, FamilyHistory = null
+                DietRestrictions = null, ChronicDiseases = null, FamilyHistory = null,
+                Surgeries = null
             },
             "update_surgery" => request with
             {
@@ -77,8 +78,41 @@ public sealed class HealthArchiveService(IHealthArchiveRepository archives) : IH
     private static void Apply(HealthArchive archive, HealthArchiveUpdateRequest request)
     {
         if (request.Diagnosis != null) archive.Diagnosis = request.Diagnosis;
-        if (request.SurgeryType != null) archive.SurgeryType = request.SurgeryType;
-        if (request.SurgeryDate.HasValue) archive.SurgeryDate = request.SurgeryDate.Value;
+        if (request.Surgeries != null)
+        {
+            archive.Surgeries.Clear();
+            var items = request.Surgeries
+                .Where(s => !string.IsNullOrWhiteSpace(s.Type))
+                .Select((s, index) => new HealthArchiveSurgery
+                {
+                    Id = Guid.NewGuid(),
+                    HealthArchiveId = archive.Id,
+                    Type = s.Type.Trim(),
+                    Date = s.Date,
+                    SortOrder = index,
+                })
+                .ToList();
+            foreach (var item in items) archive.Surgeries.Add(item);
+            SyncLegacySurgeryFields(archive);
+        }
+        else if (request.SurgeryType != null)
+        {
+            SeedLegacySurgeryIfNeeded(archive);
+            var type = request.SurgeryType.Trim();
+            if (type.Length > 0 && !archive.Surgeries.Any(s =>
+                    s.Type == type && s.Date == request.SurgeryDate))
+            {
+                archive.Surgeries.Add(new HealthArchiveSurgery
+                {
+                    Id = Guid.NewGuid(),
+                    HealthArchiveId = archive.Id,
+                    Type = type,
+                    Date = request.SurgeryDate,
+                    SortOrder = archive.Surgeries.Count,
+                });
+            }
+            SyncLegacySurgeryFields(archive);
+        }
         if (request.Allergies != null) archive.Allergies = request.Allergies.ToList();
         if (request.DietRestrictions != null) archive.DietRestrictions = request.DietRestrictions.ToList();
         if (request.ChronicDiseases != null) archive.ChronicDiseases = request.ChronicDiseases.ToList();
@@ -91,6 +125,7 @@ public sealed class HealthArchiveService(IHealthArchiveRepository archives) : IH
         archive.Diagnosis,
         archive.SurgeryType,
         SurgeryDate = archive.SurgeryDate?.ToString("yyyy-MM-dd"),
+        surgeries = archive.Surgeries.Select(s => new { s.Type, date = s.Date?.ToString("yyyy-MM-dd") }),
         archive.Allergies,
         archive.DietRestrictions,
         archive.ChronicDiseases,
@@ -103,9 +138,41 @@ public sealed class HealthArchiveService(IHealthArchiveRepository archives) : IH
         archive.Diagnosis,
         archive.SurgeryType,
         archive.SurgeryDate,
+        GetSurgeries(archive),
         archive.Allergies,
         archive.DietRestrictions,
         archive.ChronicDiseases,
         archive.FamilyHistory,
         archive.UpdatedAt);
+
+    private static IReadOnlyList<HealthArchiveSurgeryDto> GetSurgeries(HealthArchive archive)
+    {
+        var surgeries = archive.Surgeries
+            .OrderBy(s => s.SortOrder)
+            .Select(s => new HealthArchiveSurgeryDto(s.Id, s.Type, s.Date))
+            .ToList();
+        if (surgeries.Count == 0 && !string.IsNullOrWhiteSpace(archive.SurgeryType))
+            surgeries.Add(new HealthArchiveSurgeryDto(Guid.Empty, archive.SurgeryType, archive.SurgeryDate));
+        return surgeries;
+    }
+
+    private static void SyncLegacySurgeryFields(HealthArchive archive)
+    {
+        var first = archive.Surgeries.OrderBy(s => s.SortOrder).FirstOrDefault();
+        archive.SurgeryType = first?.Type;
+        archive.SurgeryDate = first?.Date;
+    }
+
+    private static void SeedLegacySurgeryIfNeeded(HealthArchive archive)
+    {
+        if (archive.Surgeries.Count > 0 || string.IsNullOrWhiteSpace(archive.SurgeryType)) return;
+        archive.Surgeries.Add(new HealthArchiveSurgery
+        {
+            Id = Guid.NewGuid(),
+            HealthArchiveId = archive.Id,
+            Type = archive.SurgeryType,
+            Date = archive.SurgeryDate,
+            SortOrder = 0,
+        });
+    }
 }

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

@@ -1,3 +1,4 @@
+using Health.Domain;
 using Health.Domain.Enums;
 
 namespace Health.Application.HealthRecords;
@@ -13,4 +14,48 @@ public static class HealthRecordRules
         HealthMetricType.Weight => false,
         _ => false
     };
+
+    /// <summary>
+    /// 合法性校验——拦截物理上不可能的数值（负数、超量程等），不合法即抛 ValidationException。
+    /// 注意：这与 CheckAbnormal（医学异常预警）是两回事，前者拦脏数据，后者只是标记偏离正常范围。
+    /// </summary>
+    public static void Validate(HealthRecordUpsertRequest request)
+    {
+        switch (request.Type)
+        {
+            case HealthMetricType.BloodPressure:
+                var sys = Required(request.Systolic, "收缩压");
+                var dia = Required(request.Diastolic, "舒张压");
+                InRange(sys, 40, 300, "收缩压", "mmHg");
+                InRange(dia, 20, 250, "舒张压", "mmHg");
+                if (sys <= dia)
+                    throw new ValidationException("收缩压必须大于舒张压");
+                break;
+            case HealthMetricType.HeartRate:
+                InRange(Required(request.Value, "心率"), 20m, 300m, "心率", "次/分");
+                break;
+            case HealthMetricType.Glucose:
+                InRange(Required(request.Value, "血糖"), 0.5m, 60m, "血糖", "mmol/L");
+                break;
+            case HealthMetricType.SpO2:
+                InRange(Required(request.Value, "血氧"), 50m, 100m, "血氧", "%");
+                break;
+            case HealthMetricType.Weight:
+                InRange(Required(request.Value, "体重"), 1m, 500m, "体重", "kg");
+                break;
         }
+    }
+
+    private static int Required(int? value, string field) =>
+        value ?? throw new ValidationException($"{field}不能为空");
+
+    private static decimal Required(decimal? value, string field) =>
+        value ?? throw new ValidationException($"{field}不能为空");
+
+    private static void InRange(decimal value, decimal min, decimal max, string field, string unit)
+    {
+        if (value < min || value > max)
+            throw new ValidationException($"{field}应在 {min}~{max} {unit} 之间，当前值 {value} 不合理");
+    }
+}
+

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

@@ -1,11 +1,17 @@
 using Health.Domain.Entities;
 using Health.Domain.Enums;
+using Health.Application.Notifications;
+using System.Security.Cryptography;
+using System.Text;
 
 namespace Health.Application.HealthRecords;
 
-public sealed class HealthRecordService(IHealthRecordRepository records) : IHealthRecordService
+public sealed class HealthRecordService(
+    IHealthRecordRepository records,
+    IUserNotificationProducer? notifications = null) : IHealthRecordService
 {
     private readonly IHealthRecordRepository _records = records;
+    private readonly IUserNotificationProducer? _notifications = notifications;
 
     public async Task<IReadOnlyList<HealthRecordDto>> GetRecordsAsync(Guid userId, string? type, int? days, CancellationToken ct)
     {
@@ -20,6 +26,8 @@ public sealed class HealthRecordService(IHealthRecordRepository records) : IHeal
 
     public async Task<Guid> CreateAsync(Guid userId, HealthRecordUpsertRequest request, CancellationToken ct)
     {
+        HealthRecordRules.Validate(request);
+
         var record = new HealthRecord
         {
             Id = Guid.NewGuid(),
@@ -37,6 +45,7 @@ public sealed class HealthRecordService(IHealthRecordRepository records) : IHeal
 
         await _records.AddAsync(record, ct);
         await _records.SaveChangesAsync(ct);
+        await EnqueueAbnormalNotificationAsync(record, ct);
         return record.Id;
     }
 
@@ -45,6 +54,8 @@ public sealed class HealthRecordService(IHealthRecordRepository records) : IHeal
         var record = await _records.GetOwnedAsync(userId, id, ct);
         if (record == null) return false;
 
+        HealthRecordRules.Validate(request);
+
         record.MetricType = request.Type;
         record.Systolic = request.Systolic;
         record.Diastolic = request.Diastolic;
@@ -55,6 +66,7 @@ public sealed class HealthRecordService(IHealthRecordRepository records) : IHeal
         record.IsAbnormal = HealthRecordRules.CheckAbnormal(request);
 
         await _records.SaveChangesAsync(ct);
+        await EnqueueAbnormalNotificationAsync(record, ct);
         return true;
     }
 
@@ -98,9 +110,9 @@ public sealed class HealthRecordService(IHealthRecordRepository records) : IHeal
 
     public async Task<IReadOnlyList<object>> GetTrendAsync(Guid userId, HealthMetricType type, int period, CancellationToken ct)
     {
-        var days = period switch { 7 => 7, 30 => 30, 90 => 90, _ => 7 };
+        var days = period switch { 7 => 7, 30 => 30, 90 => 90, 365 => 365, _ => 7 };
         var records = await _records.GetTrendAsync(userId, type, DateTime.UtcNow.AddDays(-days), ct);
-        return records.Select(r => new { r.Id, r.Systolic, r.Diastolic, r.Value, r.IsAbnormal, r.RecordedAt }).Cast<object>().ToList();
+        return records.Select(r => new { r.Id, r.Systolic, r.Diastolic, r.Value, r.Unit, r.IsAbnormal, r.RecordedAt }).Cast<object>().ToList();
     }
 
     public static HealthRecordDto ToDto(HealthRecord record) => new(
@@ -113,4 +125,42 @@ public sealed class HealthRecordService(IHealthRecordRepository records) : IHeal
         record.Source.ToString(),
         record.IsAbnormal,
         record.RecordedAt);
+
+    private async Task EnqueueAbnormalNotificationAsync(HealthRecord record, CancellationToken ct)
+    {
+        if (!record.IsAbnormal || _notifications == null) return;
+
+        var (title, message, severity, target) = record.MetricType switch
+        {
+            HealthMetricType.BloodPressure when record.Systolic >= 140 || record.Diastolic >= 90 =>
+                ("血压偏高提醒", $"本次血压为 {record.Systolic}/{record.Diastolic} mmHg，高于参考范围。建议休息后复测；如伴明显不适，请及时就医。", "warning", "blood_pressure"),
+            HealthMetricType.BloodPressure =>
+                ("血压偏低提醒", $"本次血压为 {record.Systolic}/{record.Diastolic} mmHg，低于参考范围。请留意头晕、乏力等不适，必要时及时就医。", "warning", "blood_pressure"),
+            HealthMetricType.HeartRate when record.Value > 100 =>
+                ("心率偏高提醒", $"本次心率为 {record.Value:0.#} 次/分，高于参考范围。建议安静休息后复测。", "warning", "heart_rate"),
+            HealthMetricType.HeartRate =>
+                ("心率偏低提醒", $"本次心率为 {record.Value:0.#} 次/分，低于参考范围。如伴明显不适，请及时就医。", "warning", "heart_rate"),
+            HealthMetricType.Glucose when record.Value >= 7.0m =>
+                ("血糖偏高提醒", $"本次血糖为 {record.Value:0.#} mmol/L，高于参考范围。请结合测量时段并按计划复测。", "warning", "glucose"),
+            HealthMetricType.Glucose =>
+                ("血糖偏低提醒", $"本次血糖为 {record.Value:0.#} mmol/L，低于参考范围。请及时关注身体状况。", "critical", "glucose"),
+            HealthMetricType.SpO2 =>
+                ("血氧偏低提醒", $"本次血氧为 {record.Value:0.#}%，低于参考范围。建议立即复测；如持续偏低或伴呼吸不适，请及时就医。", "critical", "spo2"),
+            _ => ("健康指标提醒", "检测到一项健康指标超出参考范围，请查看详情。", "warning", "")
+        };
+
+        var window = DateTime.UtcNow.Ticks / TimeSpan.FromMinutes(30).Ticks;
+        var sourceId = DeterministicGuid($"{record.UserId}:{record.MetricType}:{severity}:{window}");
+        await _notifications.EnqueueAsync(
+            record.UserId,
+            sourceId,
+            new NotificationMessage("HealthMetricAlert", title, message, severity, "health", target),
+            ct);
+    }
+
+    private static Guid DeterministicGuid(string value)
+    {
+        var hash = SHA256.HashData(Encoding.UTF8.GetBytes(value));
+        return new Guid(hash.AsSpan(0, 16));
+    }
 }

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

@@ -78,7 +78,6 @@ public interface IMedicationRepository
     Task<bool> DoseLogExistsAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, DateTime startUtc, DateTime endUtc, CancellationToken ct);
     Task<MedicationLog?> GetDoseLogAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, DateTime startUtc, DateTime endUtc, CancellationToken ct);
     Task<IReadOnlyList<Medication>> ListActiveForReminderScanAsync(CancellationToken ct);
-    Task<bool> HasTakenInWindowAsync(Guid userId, Guid medicationId, DateTime startUtc, DateTime endUtc, CancellationToken ct);
     Task AddMedicationAsync(Medication medication, CancellationToken ct);
     Task AddLogAsync(MedicationLog log, CancellationToken ct);
     void DeleteMedication(Medication medication);

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

@@ -21,10 +21,18 @@ public sealed class MedicationReminderScanner(IMedicationRepository medications)
         foreach (var medication in active)
         {
             if (!IsActiveOn(medication, date) || !GetDosesForToday(medication, date)) continue;
-            if (await _medications.HasTakenInWindowAsync(medication.UserId, medication.Id, todayStartUtc, todayEndUtc, ct)) continue;
 
             foreach (var scheduledTime in medication.TimeOfDay.Where(t => IsInWindow(t, windowStart, time)))
             {
+                if (await _medications.DoseLogExistsAsync(
+                    medication.UserId,
+                    medication.Id,
+                    scheduledTime,
+                    todayStartUtc,
+                    todayEndUtc,
+                    ct))
+                    continue;
+
                 tasks.Add(new MedicationReminderTask(
                     Guid.NewGuid(),
                     medication.UserId,

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

@@ -1,3 +1,4 @@
+using Health.Domain;
 using Health.Domain.Entities;
 using Health.Domain.Enums;
 
@@ -16,14 +17,19 @@ public sealed class MedicationService(IMedicationRepository medications) : IMedi
 
     public async Task<Guid> CreateAsync(Guid userId, MedicationUpsertRequest request, CancellationToken ct)
     {
+        var name = ValidateName(request.Name);
+        ValidateDateRange(request.StartDate, request.EndDate);
+        var times = NormalizeTimes(request.TimeOfDay);
+        if (times.Count == 0) times = [new TimeOnly(8, 0)];
+
         var med = new Medication
         {
             Id = Guid.NewGuid(),
             UserId = userId,
-            Name = request.Name,
+            Name = name,
             Dosage = request.Dosage,
             Frequency = request.Frequency,
-            TimeOfDay = request.TimeOfDay.Count > 0 ? request.TimeOfDay.ToList() : [new TimeOnly(8, 0)],
+            TimeOfDay = times,
             StartDate = request.StartDate,
             EndDate = request.EndDate,
             Source = request.Source,
@@ -43,12 +49,13 @@ public sealed class MedicationService(IMedicationRepository medications) : IMedi
         var med = await _medications.GetOwnedAsync(userId, medicationId, ct);
         if (med == null) return false;
 
-        if (!string.IsNullOrWhiteSpace(request.Name)) med.Name = request.Name;
+        if (request.Name != null) med.Name = ValidateName(request.Name);
         if (request.Dosage != null) med.Dosage = request.Dosage;
         if (request.Frequency.HasValue) med.Frequency = request.Frequency.Value;
-        if (request.TimeOfDay != null) med.TimeOfDay = request.TimeOfDay.ToList();
+        if (request.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;
+        ValidateDateRange(med.StartDate, med.EndDate);
         if (request.Notes != null) med.Notes = request.Notes;
         med.UpdatedAt = DateTime.UtcNow;
 
@@ -56,6 +63,28 @@ public sealed class MedicationService(IMedicationRepository medications) : IMedi
         return true;
     }
 
+    // ── 输入校验 ──
+
+    private static string ValidateName(string? name)
+    {
+        var trimmed = name?.Trim();
+        if (string.IsNullOrEmpty(trimmed))
+            throw new ValidationException("药品名称不能为空");
+        if (trimmed.Length > 200)
+            throw new ValidationException("药品名称过长（不超过 200 字）");
+        return trimmed;
+    }
+
+    private static void ValidateDateRange(DateOnly? startDate, DateOnly? endDate)
+    {
+        if (startDate.HasValue && endDate.HasValue && endDate.Value < startDate.Value)
+            throw new ValidationException("结束日期不能早于开始日期");
+    }
+
+    // 同一时间点去重并排序；空集合交由调用方/实体默认处理
+    private static List<TimeOnly> NormalizeTimes(IReadOnlyList<TimeOnly> times) =>
+        times.Distinct().OrderBy(t => t).ToList();
+
     public async Task<bool> DeleteAsync(Guid userId, Guid medicationId, CancellationToken ct)
     {
         var med = await _medications.GetOwnedAsync(userId, medicationId, ct);

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

@@ -5,22 +5,56 @@ public sealed record InAppNotificationDto(
     string Type,
     string Title,
     string Message,
+    string Severity,
+    string? ActionType,
+    string? ActionTargetId,
+    bool IsRead,
     DateTime CreatedAt);
 
+public sealed record NotificationMessage(
+    string Type,
+    string Title,
+    string Message,
+    string Severity,
+    string? ActionType,
+    string? ActionTargetId);
+
 public interface IInAppNotificationService
 {
     Task<IReadOnlyList<InAppNotificationDto>> GetPendingAsync(Guid userId, CancellationToken ct);
+    Task<IReadOnlyList<InAppNotificationDto>> GetHistoryAsync(Guid userId, CancellationToken ct);
     Task<bool> AcknowledgeAsync(Guid userId, Guid notificationId, CancellationToken ct);
+    Task<int> MarkAllReadAsync(Guid userId, CancellationToken ct);
+    Task<bool> DeleteAsync(Guid userId, Guid notificationId, CancellationToken ct);
 }
 
 public interface IInAppNotificationRepository
 {
     Task<IReadOnlyList<InAppNotificationRecord>> GetPendingAsync(Guid userId, CancellationToken ct);
+    Task<IReadOnlyList<InAppNotificationRecord>> GetHistoryAsync(Guid userId, CancellationToken ct);
     Task<bool> AcknowledgeAsync(Guid userId, Guid notificationId, CancellationToken ct);
+    Task<int> MarkAllReadAsync(Guid userId, CancellationToken ct);
+    Task<bool> DeleteAsync(Guid userId, Guid notificationId, CancellationToken ct);
 }
 
 public sealed record InAppNotificationRecord(
     Guid Id,
     string Type,
-    string Payload,
+    string Title,
+    string Message,
+    string Severity,
+    string? ActionType,
+    string? ActionTargetId,
+    bool IsRead,
     DateTime CreatedAt);
+
+public interface IUserNotificationProducer
+{
+    Task<bool> EnqueueAsync(Guid userId, Guid sourceId, NotificationMessage message, CancellationToken ct);
+}
+
+public interface INotificationOutboxProcessor
+{
+    Task RecoverStaleAsync(CancellationToken ct);
+    Task<bool> ProcessNextAsync(CancellationToken ct);
+}

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

@@ -1,5 +1,3 @@
-using System.Text.Json;
-
 namespace Health.Application.Notifications;
 
 public sealed class InAppNotificationService(IInAppNotificationRepository notifications) : IInAppNotificationService
@@ -12,36 +10,22 @@ public sealed class InAppNotificationService(IInAppNotificationRepository notifi
         return records.Select(ToDto).ToList();
     }
 
+    public async Task<IReadOnlyList<InAppNotificationDto>> GetHistoryAsync(Guid userId, CancellationToken ct)
+    {
+        var records = await _notifications.GetHistoryAsync(userId, ct);
+        return records.Select(ToDto).ToList();
+    }
+
     public Task<bool> AcknowledgeAsync(Guid userId, Guid notificationId, CancellationToken ct) =>
         _notifications.AcknowledgeAsync(userId, notificationId, ct);
 
-    private static InAppNotificationDto ToDto(InAppNotificationRecord record)
-    {
-        if (record.Type == "MedicationReminder")
-        {
-            using var json = JsonDocument.Parse(record.Payload);
-            var root = json.RootElement;
-            var name = root.TryGetProperty("Name", out var nameValue) ? nameValue.GetString() : null;
-            var dosage = root.TryGetProperty("Dosage", out var dosageValue) ? dosageValue.GetString() : null;
-            var time = root.TryGetProperty("ScheduledTime", out var timeValue) ? timeValue.GetString() : null;
-            var details = string.Join(" · ", new[] { dosage, time }.Where(x => !string.IsNullOrWhiteSpace(x)));
-            return new InAppNotificationDto(
-                record.Id,
-                record.Type,
-                "用药提醒",
-                $"该服用{name ?? "药物"}{(details.Length > 0 ? $"（{details}）" : "")}了",
-                record.CreatedAt);
-        }
+    public Task<int> MarkAllReadAsync(Guid userId, CancellationToken ct) =>
+        _notifications.MarkAllReadAsync(userId, ct);
 
-        if (record.Type == "ExerciseReminder")
-        {
-            using var json = JsonDocument.Parse(record.Payload);
-            var root = json.RootElement;
-            var type = root.TryGetProperty("ExerciseType", out var typeValue) ? typeValue.GetString() : "运动";
-            var minutes = root.TryGetProperty("DurationMinutes", out var minutesValue) ? minutesValue.GetInt32() : 30;
-            return new InAppNotificationDto(record.Id, record.Type, "运动提醒", $"今天的{type}计划还未完成，目标 {minutes} 分钟", record.CreatedAt);
-        }
+    public Task<bool> DeleteAsync(Guid userId, Guid notificationId, CancellationToken ct) =>
+        _notifications.DeleteAsync(userId, notificationId, ct);
 
-        return new InAppNotificationDto(record.Id, record.Type, "健康提醒", "您有一条新的健康提醒", record.CreatedAt);
-    }
+    private static InAppNotificationDto ToDto(InAppNotificationRecord record) => new(
+        record.Id, record.Type, record.Title, record.Message, record.Severity,
+        record.ActionType, record.ActionTargetId, record.IsRead, record.CreatedAt);
 }

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

@@ -38,6 +38,18 @@ public sealed class HealthArchive
     public DateTime UpdatedAt { get; set; } = DateTime.UtcNow;
 
     public User User { get; set; } = null!;
+    public ICollection<HealthArchiveSurgery> Surgeries { get; set; } = [];
+}
+
+public sealed class HealthArchiveSurgery
+{
+    public Guid Id { get; set; }
+    public Guid HealthArchiveId { get; set; }
+    public string Type { get; set; } = string.Empty;
+    public DateOnly? Date { get; set; }
+    public int SortOrder { get; set; }
+
+    public HealthArchive HealthArchive { get; set; } = null!;
 }
 
 /// <summary>
@@ -97,3 +109,20 @@ public sealed class DeviceToken
 
     public User User { get; set; } = null!;
 }
+
+public sealed class UserNotification
+{
+    public Guid Id { get; set; }
+    public Guid UserId { get; set; }
+    public Guid SourceId { get; set; }
+    public string Type { get; set; } = string.Empty;
+    public string Title { get; set; } = string.Empty;
+    public string Message { get; set; } = string.Empty;
+    public string Severity { get; set; } = "info";
+    public string? ActionType { get; set; }
+    public string? ActionTargetId { get; set; }
+    public bool IsRead { get; set; }
+    public DateTime? ReadAt { get; set; }
+    public bool IsDeleted { get; set; }
+    public DateTime CreatedAt { get; set; } = DateTime.UtcNow;
+}

backend/src/Health.Domain/ValidationException.cs

@@ -0,0 +1,7 @@
+namespace Health.Domain;
+
+/// <summary>
+/// 业务输入校验失败异常——由 Application 层规则抛出，
+/// 中间件统一映射为 400 / code 40001，message 可安全展示给用户。
+/// </summary>
+public sealed class ValidationException(string message) : Exception(message);

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

@@ -55,7 +55,7 @@ public static class CommonAgentHandler
         return new
         {
             found = true, archive.Diagnosis, archive.SurgeryType,
-            SurgeryDate = archive.SurgeryDate?.ToString("yyyy-MM-dd"),
+            SurgeryDate = archive.SurgeryDate?.ToString("yyyy-MM-dd"), archive.Surgeries,
             archive.Allergies, archive.DietRestrictions, archive.ChronicDiseases, archive.FamilyHistory,
         };
     }

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

@@ -18,13 +18,11 @@ public static class HealthDataAgentHandler
 
     public static List<ToolDefinition> Tools => [RecordHealthDataTool, CommonAgentHandler.QueryHealthRecordsTool];
 
-    public static async Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId, IHealthRecordService? healthRecords = null)
+    public static async Task<object> Execute(string toolName, JsonElement args, Guid userId, IHealthRecordService healthRecords)
     {
         return toolName switch
         {
-            "record_health_data" => healthRecords == null
-                ? await ExecuteRecordHealthData(db, userId, args)
-                : await ExecuteRecordHealthData(healthRecords, userId, args),
+            "record_health_data" => await ExecuteRecordHealthData(healthRecords, userId, args),
             _ => new { success = false, message = $"未知工具: {toolName}" }
         };
     }
@@ -62,63 +60,6 @@ public static class HealthDataAgentHandler
         };
     }
 
-    private static async Task<object> ExecuteRecordHealthData(AppDbContext db, Guid userId, JsonElement args)
-    {
-        var type = args.TryGetProperty("type", out var t) ? t.GetString()! : "";
-        var record = new HealthRecord
-        {
-            Id = Guid.NewGuid(), UserId = userId, Source = HealthRecordSource.AiEntry,
-            RecordedAt = args.TryGetProperty("recorded_at", out var ra) && ra.TryGetDateTime(out var dt) ? dt : DateTime.UtcNow,
-            CreatedAt = DateTime.UtcNow,
-        };
-
-        switch (type)
-        {
-            case "blood_pressure":
-                record.MetricType = HealthMetricType.BloodPressure;
-                record.Systolic = args.TryGetProperty("systolic", out var s) ? s.GetInt32() : null;
-                record.Diastolic = args.TryGetProperty("diastolic", out var d) ? d.GetInt32() : null;
-                record.Unit = "mmHg";
-                record.IsAbnormal = record.Systolic >= 140 || record.Diastolic >= 90 || record.Systolic <= 89 || record.Diastolic <= 59;
-                break;
-            case "heart_rate":
-                record.MetricType = HealthMetricType.HeartRate;
-                record.Value = args.TryGetProperty("heart_rate", out var hr) ? hr.GetDecimal() : null;
-                record.Unit = "次/分";
-                record.IsAbnormal = record.Value > 100 || record.Value < 60;
-                break;
-            case "glucose":
-                record.MetricType = HealthMetricType.Glucose;
-                record.Value = args.TryGetProperty("glucose", out var g) ? g.GetDecimal() : null;
-                record.Unit = "mmol/L";
-                record.IsAbnormal = record.Value >= 7.0m || record.Value <= 3.8m;
-                break;
-            case "spo2":
-                record.MetricType = HealthMetricType.SpO2;
-                record.Value = args.TryGetProperty("spo2", out var o) ? o.GetDecimal() : null;
-                record.Unit = "%";
-                record.IsAbnormal = record.Value <= 94;
-                break;
-            case "weight":
-                record.MetricType = HealthMetricType.Weight;
-                record.Value = args.TryGetProperty("weight", out var w) ? w.GetDecimal() : null;
-                record.Unit = "kg";
-                record.IsAbnormal = false;
-                break;
-            default:
-                return new { success = false, message = $"未知指标类型: {type}" };
-        }
-
-        db.HealthRecords.Add(record);
-        await db.SaveChangesAsync();
-        var valStr = record.MetricType switch
-        {
-            HealthMetricType.BloodPressure => $"{record.Systolic}/{record.Diastolic}",
-            _ => record.Value?.ToString() ?? ""
-        };
-        return new { success = true, record_id = record.Id, type = record.MetricType.ToString(), value = valStr, unit = record.Unit, isAbnormal = record.IsAbnormal };
-    }
-
     private static (HealthMetricType? Type, decimal? Value, string Unit, int? Systolic, int? Diastolic) ParseMetric(string type, JsonElement args)
     {
         return type switch

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

@@ -71,7 +71,8 @@ public static class MedicationAgentHandler
         var times = ReadTimes(args);
         var durationDays = args.TryGetProperty("duration_days", out var dd) ? dd.GetInt32() : 0;
         var startDate = ReadStartDate(args);
-        var endDate = durationDays > 0 ? startDate.AddDays(durationDays) : (DateOnly?)null;
+        // 结束日为包含式（IsActiveOn 用 EndDate >= date 判断），故 N 天疗程结束日 = 起始日 + (N-1)
+        var endDate = durationDays > 0 ? startDate.AddDays(durationDays - 1) : (DateOnly?)null;
 
         var medicationId = await medications.CreateAsync(userId, new MedicationUpsertRequest(
             name,

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

@@ -31,7 +31,7 @@ public sealed class AiToolExecutionService(
         var root = json.RootElement;
         return await (toolName switch
         {
-            "record_health_data" => HealthDataAgentHandler.Execute(toolName, root, _db, userId, _healthRecords),
+            "record_health_data" => HealthDataAgentHandler.Execute(toolName, root, userId, _healthRecords),
             "query_health_records" => CommonAgentHandler.Execute(toolName, root, userId, _healthRecords, _healthArchives, ct),
             "check_archive" => CommonAgentHandler.Execute(toolName, root, userId, _healthRecords, _healthArchives, ct),
             "manage_medication" => MedicationAgentHandler.Execute(toolName, root, _db, userId, _medications, ct),

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

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

backend/src/Health.Infrastructure/Data/Migrations/20260621114547_InitialCreate.cs

@@ -0,0 +1,946 @@
+using System;
+using System.Collections.Generic;
+using Microsoft.EntityFrameworkCore.Migrations;
+
+#nullable disable
+
+namespace Health.Infrastructure.Data.Migrations
+{
+    /// <inheritdoc />
+    public partial class InitialCreate : Migration
+    {
+        /// <inheritdoc />
+        protected override void Up(MigrationBuilder migrationBuilder)
+        {
+            migrationBuilder.CreateTable(
+                name: "AiWriteCommands",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    ToolName = table.Column<string>(type: "character varying(64)", maxLength: 64, nullable: false),
+                    Arguments = table.Column<string>(type: "jsonb", nullable: false),
+                    Status = table.Column<string>(type: "character varying(32)", maxLength: 32, nullable: false),
+                    ExpiresAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    UpdatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_AiWriteCommands", x => x.Id);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "DietImageAnalysisTasks",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    FilePaths = table.Column<string>(type: "jsonb", nullable: false),
+                    Status = table.Column<string>(type: "character varying(32)", maxLength: 32, nullable: false),
+                    Attempts = table.Column<int>(type: "integer", nullable: false),
+                    AvailableAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    ResultCode = table.Column<int>(type: "integer", nullable: true),
+                    ResultData = table.Column<string>(type: "text", nullable: true),
+                    ResultMessage = table.Column<string>(type: "text", nullable: true),
+                    LastError = table.Column<string>(type: "text", nullable: true),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    UpdatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_DietImageAnalysisTasks", x => x.Id);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "Doctors",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    Name = table.Column<string>(type: "text", nullable: false),
+                    Title = table.Column<string>(type: "text", nullable: true),
+                    Department = table.Column<string>(type: "text", nullable: true),
+                    Phone = table.Column<string>(type: "character varying(20)", maxLength: 20, nullable: true),
+                    ProfessionalDirection = table.Column<string>(type: "character varying(256)", maxLength: 256, nullable: true),
+                    AvatarUrl = table.Column<string>(type: "text", nullable: true),
+                    Introduction = table.Column<string>(type: "text", nullable: true),
+                    IsActive = table.Column<bool>(type: "boolean", nullable: false),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_Doctors", x => x.Id);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "MedicationReminderTasks",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    MedicationId = table.Column<Guid>(type: "uuid", nullable: false),
+                    Name = table.Column<string>(type: "text", nullable: false),
+                    Dosage = table.Column<string>(type: "text", nullable: true),
+                    ScheduledDate = table.Column<DateOnly>(type: "date", nullable: false),
+                    ScheduledTime = table.Column<TimeOnly>(type: "time without time zone", nullable: false),
+                    Status = table.Column<string>(type: "character varying(32)", maxLength: 32, nullable: false),
+                    Attempts = table.Column<int>(type: "integer", nullable: false),
+                    AvailableAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    LastError = table.Column<string>(type: "text", nullable: true),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    UpdatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_MedicationReminderTasks", x => x.Id);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "NotificationOutbox",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    SourceTaskId = table.Column<Guid>(type: "uuid", nullable: false),
+                    Type = table.Column<string>(type: "character varying(64)", maxLength: 64, nullable: false),
+                    Payload = table.Column<string>(type: "jsonb", nullable: false),
+                    Status = table.Column<string>(type: "character varying(32)", maxLength: 32, nullable: false),
+                    Attempts = table.Column<int>(type: "integer", nullable: false),
+                    AvailableAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    LastError = table.Column<string>(type: "text", nullable: true),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    UpdatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_NotificationOutbox", x => x.Id);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "RefreshTokens",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    Token = table.Column<string>(type: "text", nullable: false),
+                    ExpiresAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    IsRevoked = table.Column<bool>(type: "boolean", nullable: false),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_RefreshTokens", x => x.Id);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "ReportAnalysisTasks",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    ReportId = table.Column<Guid>(type: "uuid", nullable: false),
+                    FilePath = table.Column<string>(type: "text", nullable: false),
+                    Status = table.Column<string>(type: "character varying(32)", maxLength: 32, nullable: false),
+                    Attempts = table.Column<int>(type: "integer", nullable: false),
+                    AvailableAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    LastError = table.Column<string>(type: "text", nullable: true),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    UpdatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_ReportAnalysisTasks", x => x.Id);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "UserNotifications",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    SourceId = table.Column<Guid>(type: "uuid", nullable: false),
+                    Type = table.Column<string>(type: "character varying(64)", maxLength: 64, nullable: false),
+                    Title = table.Column<string>(type: "text", nullable: false),
+                    Message = table.Column<string>(type: "text", nullable: false),
+                    Severity = table.Column<string>(type: "character varying(16)", maxLength: 16, nullable: false),
+                    ActionType = table.Column<string>(type: "character varying(64)", maxLength: 64, nullable: true),
+                    ActionTargetId = table.Column<string>(type: "text", nullable: true),
+                    IsRead = table.Column<bool>(type: "boolean", nullable: false),
+                    ReadAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: true),
+                    IsDeleted = table.Column<bool>(type: "boolean", nullable: false),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_UserNotifications", x => x.Id);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "VerificationCodes",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    Phone = table.Column<string>(type: "text", nullable: false),
+                    Code = table.Column<string>(type: "text", nullable: false),
+                    ExpiresAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    IsUsed = table.Column<bool>(type: "boolean", nullable: false),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_VerificationCodes", x => x.Id);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "Users",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    Phone = table.Column<string>(type: "text", nullable: false),
+                    Role = table.Column<string>(type: "character varying(32)", maxLength: 32, nullable: false, defaultValue: "User"),
+                    DoctorId = table.Column<Guid>(type: "uuid", nullable: true),
+                    Name = table.Column<string>(type: "text", nullable: true),
+                    Gender = table.Column<string>(type: "text", nullable: true),
+                    BirthDate = table.Column<DateOnly>(type: "date", nullable: true),
+                    AvatarUrl = table.Column<string>(type: "text", nullable: true),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    UpdatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_Users", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_Users_Doctors_DoctorId",
+                        column: x => x.DoctorId,
+                        principalTable: "Doctors",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.SetNull);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "Consultations",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    DoctorId = table.Column<Guid>(type: "uuid", nullable: false),
+                    Status = table.Column<string>(type: "text", nullable: false),
+                    Month = table.Column<int>(type: "integer", nullable: false),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    ClosedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: true)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_Consultations", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_Consultations_Doctors_DoctorId",
+                        column: x => x.DoctorId,
+                        principalTable: "Doctors",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                    table.ForeignKey(
+                        name: "FK_Consultations_Users_UserId",
+                        column: x => x.UserId,
+                        principalTable: "Users",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "Conversations",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    AgentType = table.Column<string>(type: "text", nullable: false),
+                    Title = table.Column<string>(type: "text", nullable: true),
+                    Summary = table.Column<string>(type: "text", nullable: true),
+                    MessageCount = table.Column<int>(type: "integer", nullable: false),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    UpdatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_Conversations", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_Conversations_Users_UserId",
+                        column: x => x.UserId,
+                        principalTable: "Users",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "DeviceTokens",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    Platform = table.Column<string>(type: "text", nullable: false),
+                    PushToken = table.Column<string>(type: "text", nullable: false),
+                    IsActive = table.Column<bool>(type: "boolean", nullable: false),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    UpdatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_DeviceTokens", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_DeviceTokens_Users_UserId",
+                        column: x => x.UserId,
+                        principalTable: "Users",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "DietRecords",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    MealType = table.Column<string>(type: "text", nullable: false),
+                    TotalCalories = table.Column<int>(type: "integer", nullable: true),
+                    HealthScore = table.Column<int>(type: "integer", nullable: true),
+                    RecordedAt = table.Column<DateOnly>(type: "date", nullable: false),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_DietRecords", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_DietRecords_Users_UserId",
+                        column: x => x.UserId,
+                        principalTable: "Users",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "DoctorProfiles",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    DoctorId = table.Column<Guid>(type: "uuid", nullable: true),
+                    Name = table.Column<string>(type: "text", nullable: true),
+                    Title = table.Column<string>(type: "text", nullable: true),
+                    Department = table.Column<string>(type: "text", nullable: true),
+                    Hospital = table.Column<string>(type: "text", nullable: true),
+                    AvatarUrl = table.Column<string>(type: "text", nullable: true),
+                    IsOnline = table.Column<bool>(type: "boolean", nullable: false),
+                    IsActive = table.Column<bool>(type: "boolean", nullable: false),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    UpdatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_DoctorProfiles", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_DoctorProfiles_Doctors_DoctorId",
+                        column: x => x.DoctorId,
+                        principalTable: "Doctors",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.SetNull);
+                    table.ForeignKey(
+                        name: "FK_DoctorProfiles_Users_UserId",
+                        column: x => x.UserId,
+                        principalTable: "Users",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "ExercisePlans",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    StartDate = table.Column<DateOnly>(type: "date", nullable: false),
+                    EndDate = table.Column<DateOnly>(type: "date", nullable: false),
+                    ReminderTime = table.Column<TimeOnly>(type: "time without time zone", nullable: false),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    UpdatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_ExercisePlans", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_ExercisePlans_Users_UserId",
+                        column: x => x.UserId,
+                        principalTable: "Users",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "FollowUps",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    Title = table.Column<string>(type: "text", nullable: false),
+                    DoctorName = table.Column<string>(type: "text", nullable: true),
+                    Department = table.Column<string>(type: "text", nullable: true),
+                    ScheduledAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    Notes = table.Column<string>(type: "text", nullable: true),
+                    Status = table.Column<int>(type: "integer", nullable: false),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_FollowUps", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_FollowUps_Users_UserId",
+                        column: x => x.UserId,
+                        principalTable: "Users",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "HealthArchives",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    Diagnosis = table.Column<string>(type: "text", nullable: true),
+                    SurgeryType = table.Column<string>(type: "text", nullable: true),
+                    SurgeryDate = table.Column<DateOnly>(type: "date", nullable: true),
+                    Allergies = table.Column<List<string>>(type: "text[]", nullable: false),
+                    DietRestrictions = table.Column<List<string>>(type: "text[]", nullable: false),
+                    ChronicDiseases = table.Column<List<string>>(type: "text[]", nullable: false),
+                    FamilyHistory = table.Column<string>(type: "text", nullable: true),
+                    UpdatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_HealthArchives", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_HealthArchives_Users_UserId",
+                        column: x => x.UserId,
+                        principalTable: "Users",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "HealthRecords",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    MetricType = table.Column<string>(type: "text", nullable: false),
+                    Systolic = table.Column<int>(type: "integer", nullable: true),
+                    Diastolic = table.Column<int>(type: "integer", nullable: true),
+                    Value = table.Column<decimal>(type: "numeric", nullable: true),
+                    Unit = table.Column<string>(type: "text", nullable: true),
+                    Source = table.Column<string>(type: "text", nullable: false),
+                    IsAbnormal = table.Column<bool>(type: "boolean", nullable: false),
+                    RecordedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_HealthRecords", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_HealthRecords_Users_UserId",
+                        column: x => x.UserId,
+                        principalTable: "Users",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "Medications",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    Name = table.Column<string>(type: "text", nullable: false),
+                    Dosage = table.Column<string>(type: "text", nullable: true),
+                    Frequency = table.Column<string>(type: "text", nullable: false),
+                    TimeOfDay = table.Column<List<TimeOnly>>(type: "time[]", nullable: false),
+                    StartDate = table.Column<DateOnly>(type: "date", nullable: true),
+                    EndDate = table.Column<DateOnly>(type: "date", nullable: true),
+                    IsActive = table.Column<bool>(type: "boolean", nullable: false),
+                    Source = table.Column<string>(type: "text", nullable: false),
+                    Notes = table.Column<string>(type: "text", nullable: true),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false),
+                    UpdatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_Medications", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_Medications_Users_UserId",
+                        column: x => x.UserId,
+                        principalTable: "Users",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "NotificationPreferences",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    MedicationReminder = table.Column<bool>(type: "boolean", nullable: false),
+                    FollowUpReminder = table.Column<bool>(type: "boolean", nullable: false),
+                    DoctorReply = table.Column<bool>(type: "boolean", nullable: false),
+                    AbnormalAlert = table.Column<bool>(type: "boolean", nullable: false),
+                    UpdatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_NotificationPreferences", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_NotificationPreferences_Users_UserId",
+                        column: x => x.UserId,
+                        principalTable: "Users",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "Reports",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    FileUrl = table.Column<string>(type: "text", nullable: false),
+                    FileType = table.Column<string>(type: "text", nullable: false),
+                    Category = table.Column<string>(type: "text", nullable: false),
+                    AiSummary = table.Column<string>(type: "text", nullable: true),
+                    AiIndicators = table.Column<string>(type: "jsonb", nullable: true),
+                    Status = table.Column<string>(type: "text", nullable: false),
+                    Severity = table.Column<string>(type: "text", nullable: true),
+                    DoctorComment = table.Column<string>(type: "text", nullable: true),
+                    DoctorRecommendation = table.Column<string>(type: "text", nullable: true),
+                    DoctorName = table.Column<string>(type: "text", nullable: true),
+                    ReviewedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: true),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_Reports", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_Reports_Users_UserId",
+                        column: x => x.UserId,
+                        principalTable: "Users",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "ConsultationMessages",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    ConsultationId = table.Column<Guid>(type: "uuid", nullable: false),
+                    SenderType = table.Column<string>(type: "text", nullable: false),
+                    SenderName = table.Column<string>(type: "text", nullable: true),
+                    Content = table.Column<string>(type: "text", nullable: false),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_ConsultationMessages", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_ConsultationMessages_Consultations_ConsultationId",
+                        column: x => x.ConsultationId,
+                        principalTable: "Consultations",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "ConversationMessages",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    ConversationId = table.Column<Guid>(type: "uuid", nullable: false),
+                    Role = table.Column<string>(type: "text", nullable: false),
+                    Content = table.Column<string>(type: "text", nullable: false),
+                    Intent = table.Column<string>(type: "text", nullable: true),
+                    MetadataJson = table.Column<string>(type: "jsonb", nullable: true),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_ConversationMessages", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_ConversationMessages_Conversations_ConversationId",
+                        column: x => x.ConversationId,
+                        principalTable: "Conversations",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "DietFoodItems",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    DietRecordId = table.Column<Guid>(type: "uuid", nullable: false),
+                    Name = table.Column<string>(type: "text", nullable: false),
+                    Portion = table.Column<string>(type: "text", nullable: true),
+                    Calories = table.Column<int>(type: "integer", nullable: true),
+                    ProteinGrams = table.Column<decimal>(type: "numeric", nullable: true),
+                    CarbsGrams = table.Column<decimal>(type: "numeric", nullable: true),
+                    FatGrams = table.Column<decimal>(type: "numeric", nullable: true),
+                    Warning = table.Column<string>(type: "text", nullable: true),
+                    SortOrder = table.Column<int>(type: "integer", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_DietFoodItems", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_DietFoodItems_DietRecords_DietRecordId",
+                        column: x => x.DietRecordId,
+                        principalTable: "DietRecords",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "ExercisePlanItems",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    PlanId = table.Column<Guid>(type: "uuid", nullable: false),
+                    ScheduledDate = table.Column<DateOnly>(type: "date", nullable: false),
+                    ExerciseType = table.Column<string>(type: "text", nullable: false),
+                    DurationMinutes = table.Column<int>(type: "integer", nullable: false),
+                    IsCompleted = table.Column<bool>(type: "boolean", nullable: false),
+                    CompletedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: true),
+                    IsRestDay = table.Column<bool>(type: "boolean", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_ExercisePlanItems", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_ExercisePlanItems_ExercisePlans_PlanId",
+                        column: x => x.PlanId,
+                        principalTable: "ExercisePlans",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "HealthArchiveSurgeries",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    HealthArchiveId = table.Column<Guid>(type: "uuid", nullable: false),
+                    Type = table.Column<string>(type: "character varying(256)", maxLength: 256, nullable: false),
+                    Date = table.Column<DateOnly>(type: "date", nullable: true),
+                    SortOrder = table.Column<int>(type: "integer", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_HealthArchiveSurgeries", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_HealthArchiveSurgeries_HealthArchives_HealthArchiveId",
+                        column: x => x.HealthArchiveId,
+                        principalTable: "HealthArchives",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateTable(
+                name: "MedicationLogs",
+                columns: table => new
+                {
+                    Id = table.Column<Guid>(type: "uuid", nullable: false),
+                    MedicationId = table.Column<Guid>(type: "uuid", nullable: false),
+                    UserId = table.Column<Guid>(type: "uuid", nullable: false),
+                    Status = table.Column<string>(type: "text", nullable: false),
+                    ScheduledTime = table.Column<TimeOnly>(type: "time without time zone", nullable: false),
+                    ConfirmedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: true),
+                    CreatedAt = table.Column<DateTime>(type: "timestamp with time zone", nullable: false)
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_MedicationLogs", x => x.Id);
+                    table.ForeignKey(
+                        name: "FK_MedicationLogs_Medications_MedicationId",
+                        column: x => x.MedicationId,
+                        principalTable: "Medications",
+                        principalColumn: "Id",
+                        onDelete: ReferentialAction.Cascade);
+                });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_AiWriteCommands_UserId_Status_ExpiresAt",
+                table: "AiWriteCommands",
+                columns: new[] { "UserId", "Status", "ExpiresAt" });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_ConsultationMessages_ConsultationId_CreatedAt",
+                table: "ConsultationMessages",
+                columns: new[] { "ConsultationId", "CreatedAt" },
+                descending: new[] { false, true });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_Consultations_DoctorId",
+                table: "Consultations",
+                column: "DoctorId");
+
+            migrationBuilder.CreateIndex(
+                name: "IX_Consultations_UserId",
+                table: "Consultations",
+                column: "UserId");
+
+            migrationBuilder.CreateIndex(
+                name: "IX_ConversationMessages_ConversationId_CreatedAt",
+                table: "ConversationMessages",
+                columns: new[] { "ConversationId", "CreatedAt" });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_Conversations_UserId_UpdatedAt",
+                table: "Conversations",
+                columns: new[] { "UserId", "UpdatedAt" },
+                descending: new[] { false, true });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_DeviceTokens_UserId",
+                table: "DeviceTokens",
+                column: "UserId");
+
+            migrationBuilder.CreateIndex(
+                name: "IX_DietFoodItems_DietRecordId",
+                table: "DietFoodItems",
+                column: "DietRecordId");
+
+            migrationBuilder.CreateIndex(
+                name: "IX_DietImageAnalysisTasks_Status_AvailableAt",
+                table: "DietImageAnalysisTasks",
+                columns: new[] { "Status", "AvailableAt" });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_DietRecords_UserId_RecordedAt",
+                table: "DietRecords",
+                columns: new[] { "UserId", "RecordedAt" },
+                descending: new[] { false, true });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_DoctorProfiles_DoctorId",
+                table: "DoctorProfiles",
+                column: "DoctorId");
+
+            migrationBuilder.CreateIndex(
+                name: "IX_DoctorProfiles_UserId",
+                table: "DoctorProfiles",
+                column: "UserId",
+                unique: true);
+
+            migrationBuilder.CreateIndex(
+                name: "IX_ExercisePlanItems_PlanId_ScheduledDate",
+                table: "ExercisePlanItems",
+                columns: new[] { "PlanId", "ScheduledDate" },
+                unique: true);
+
+            migrationBuilder.CreateIndex(
+                name: "IX_ExercisePlans_UserId_StartDate_EndDate",
+                table: "ExercisePlans",
+                columns: new[] { "UserId", "StartDate", "EndDate" });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_FollowUps_UserId",
+                table: "FollowUps",
+                column: "UserId");
+
+            migrationBuilder.CreateIndex(
+                name: "IX_HealthArchives_UserId",
+                table: "HealthArchives",
+                column: "UserId",
+                unique: true);
+
+            migrationBuilder.CreateIndex(
+                name: "IX_HealthArchiveSurgeries_HealthArchiveId_SortOrder",
+                table: "HealthArchiveSurgeries",
+                columns: new[] { "HealthArchiveId", "SortOrder" });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_HealthRecords_UserId_MetricType",
+                table: "HealthRecords",
+                columns: new[] { "UserId", "MetricType" });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_HealthRecords_UserId_RecordedAt",
+                table: "HealthRecords",
+                columns: new[] { "UserId", "RecordedAt" },
+                descending: new[] { false, true });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_MedicationLogs_MedicationId_CreatedAt",
+                table: "MedicationLogs",
+                columns: new[] { "MedicationId", "CreatedAt" },
+                descending: new[] { false, true });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_MedicationReminderTasks_MedicationId_ScheduledDate_Schedule~",
+                table: "MedicationReminderTasks",
+                columns: new[] { "MedicationId", "ScheduledDate", "ScheduledTime" },
+                unique: true);
+
+            migrationBuilder.CreateIndex(
+                name: "IX_MedicationReminderTasks_Status_AvailableAt",
+                table: "MedicationReminderTasks",
+                columns: new[] { "Status", "AvailableAt" });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_Medications_UserId_IsActive",
+                table: "Medications",
+                columns: new[] { "UserId", "IsActive" });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_NotificationOutbox_SourceTaskId",
+                table: "NotificationOutbox",
+                column: "SourceTaskId",
+                unique: true);
+
+            migrationBuilder.CreateIndex(
+                name: "IX_NotificationOutbox_Status_AvailableAt",
+                table: "NotificationOutbox",
+                columns: new[] { "Status", "AvailableAt" });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_NotificationPreferences_UserId",
+                table: "NotificationPreferences",
+                column: "UserId",
+                unique: true);
+
+            migrationBuilder.CreateIndex(
+                name: "IX_ReportAnalysisTasks_ReportId",
+                table: "ReportAnalysisTasks",
+                column: "ReportId");
+
+            migrationBuilder.CreateIndex(
+                name: "IX_ReportAnalysisTasks_Status_AvailableAt",
+                table: "ReportAnalysisTasks",
+                columns: new[] { "Status", "AvailableAt" });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_Reports_UserId",
+                table: "Reports",
+                column: "UserId");
+
+            migrationBuilder.CreateIndex(
+                name: "IX_UserNotifications_SourceId",
+                table: "UserNotifications",
+                column: "SourceId",
+                unique: true);
+
+            migrationBuilder.CreateIndex(
+                name: "IX_UserNotifications_UserId_IsDeleted_IsRead_CreatedAt",
+                table: "UserNotifications",
+                columns: new[] { "UserId", "IsDeleted", "IsRead", "CreatedAt" });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_Users_DoctorId",
+                table: "Users",
+                column: "DoctorId");
+
+            migrationBuilder.CreateIndex(
+                name: "IX_Users_Phone",
+                table: "Users",
+                column: "Phone",
+                unique: true);
+
+            migrationBuilder.CreateIndex(
+                name: "IX_VerificationCodes_Phone_CreatedAt",
+                table: "VerificationCodes",
+                columns: new[] { "Phone", "CreatedAt" },
+                descending: new[] { false, true });
+        }
+
+        /// <inheritdoc />
+        protected override void Down(MigrationBuilder migrationBuilder)
+        {
+            migrationBuilder.DropTable(
+                name: "AiWriteCommands");
+
+            migrationBuilder.DropTable(
+                name: "ConsultationMessages");
+
+            migrationBuilder.DropTable(
+                name: "ConversationMessages");
+
+            migrationBuilder.DropTable(
+                name: "DeviceTokens");
+
+            migrationBuilder.DropTable(
+                name: "DietFoodItems");
+
+            migrationBuilder.DropTable(
+                name: "DietImageAnalysisTasks");
+
+            migrationBuilder.DropTable(
+                name: "DoctorProfiles");
+
+            migrationBuilder.DropTable(
+                name: "ExercisePlanItems");
+
+            migrationBuilder.DropTable(
+                name: "FollowUps");
+
+            migrationBuilder.DropTable(
+                name: "HealthArchiveSurgeries");
+
+            migrationBuilder.DropTable(
+                name: "HealthRecords");
+
+            migrationBuilder.DropTable(
+                name: "MedicationLogs");
+
+            migrationBuilder.DropTable(
+                name: "MedicationReminderTasks");
+
+            migrationBuilder.DropTable(
+                name: "NotificationOutbox");
+
+            migrationBuilder.DropTable(
+                name: "NotificationPreferences");
+
+            migrationBuilder.DropTable(
+                name: "RefreshTokens");
+
+            migrationBuilder.DropTable(
+                name: "ReportAnalysisTasks");
+
+            migrationBuilder.DropTable(
+                name: "Reports");
+
+            migrationBuilder.DropTable(
+                name: "UserNotifications");
+
+            migrationBuilder.DropTable(
+                name: "VerificationCodes");
+
+            migrationBuilder.DropTable(
+                name: "Consultations");
+
+            migrationBuilder.DropTable(
+                name: "Conversations");
+
+            migrationBuilder.DropTable(
+                name: "DietRecords");
+
+            migrationBuilder.DropTable(
+                name: "ExercisePlans");
+
+            migrationBuilder.DropTable(
+                name: "HealthArchives");
+
+            migrationBuilder.DropTable(
+                name: "Medications");
+
+            migrationBuilder.DropTable(
+                name: "Users");
+
+            migrationBuilder.DropTable(
+                name: "Doctors");
+        }
+    }
+}

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

@@ -28,11 +28,13 @@ public sealed class AppDbContext(DbContextOptions<AppDbContext> options) : DbCon
     public DbSet<DoctorProfile> DoctorProfiles => Set<DoctorProfile>();
     public DbSet<FollowUp> FollowUps => Set<FollowUp>();
     public DbSet<HealthArchive> HealthArchives => Set<HealthArchive>();
+    public DbSet<HealthArchiveSurgery> HealthArchiveSurgeries => Set<HealthArchiveSurgery>();
 
     // 支撑表
     public DbSet<RefreshToken> RefreshTokens => Set<RefreshToken>();
     public DbSet<VerificationCode> VerificationCodes => Set<VerificationCode>();
     public DbSet<NotificationPreference> NotificationPreferences => Set<NotificationPreference>();
+    public DbSet<UserNotification> UserNotifications => Set<UserNotification>();
     public DbSet<DeviceToken> DeviceTokens => Set<DeviceToken>();
     public DbSet<AiWriteCommandRecord> AiWriteCommands => Set<AiWriteCommandRecord>();
     public DbSet<ReportAnalysisTaskRecord> ReportAnalysisTasks => Set<ReportAnalysisTaskRecord>();
@@ -154,12 +156,33 @@ public sealed class AppDbContext(DbContextOptions<AppDbContext> options) : DbCon
             e.HasIndex(n => n.UserId).IsUnique();
         });
 
+        builder.Entity<UserNotification>(e =>
+        {
+            e.ToTable("UserNotifications");
+            e.HasIndex(n => n.SourceId).IsUnique();
+            e.HasIndex(n => new { n.UserId, n.IsDeleted, n.IsRead, n.CreatedAt });
+            e.Property(n => n.Type).HasMaxLength(64);
+            e.Property(n => n.Severity).HasMaxLength(16);
+            e.Property(n => n.ActionType).HasMaxLength(64);
+        });
+
         // ---- HealthArchive ----
         builder.Entity<HealthArchive>(e =>
         {
             e.HasIndex(a => a.UserId).IsUnique();
         });
 
+        builder.Entity<HealthArchiveSurgery>(e =>
+        {
+            e.ToTable("HealthArchiveSurgeries");
+            e.HasIndex(s => new { s.HealthArchiveId, s.SortOrder });
+            e.Property(s => s.Type).HasMaxLength(256);
+            e.HasOne(s => s.HealthArchive)
+                .WithMany(a => a.Surgeries)
+                .HasForeignKey(s => s.HealthArchiveId)
+                .OnDelete(DeleteBehavior.Cascade);
+        });
+
         builder.Entity<AiWriteCommandRecord>(e =>
         {
             e.ToTable("AiWriteCommands");

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

@@ -1,13 +0,0 @@
-namespace Health.Infrastructure.Data;
-
-/// <summary>
-/// 数据库种子数据
-/// </summary>
-public static class DataSeeder
-{
-    public static async Task SeedAsync(AppDbContext db)
-    {
-        // 医生不再使用种子数据，通过注册创建
-        await Task.CompletedTask;
-    }
-}

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

@@ -1,177 +0,0 @@
-using Health.Domain.Entities;
-using Health.Domain.Enums;
-using Microsoft.Extensions.Configuration;
-
-namespace Health.Infrastructure.Data;
-
-/// <summary>
-/// 开发环境测试数据填充。生产环境不要调用！
-/// 开关：DEVDATA_ENABLED=true 才会执行
-/// </summary>
-public static class DevDataSeeder
-{
-    public static async Task SeedIfEnabled(AppDbContext db, IConfiguration config)
-    {
-        // 通过环境变量控制：DEVDATA_ENABLED=true 才填充测试数据
-        var enabled = config["DEVDATA_ENABLED"]?.ToLowerInvariant();
-        if (enabled != "true") return;
-
-        // 已有任何真实用户时跳过（避免污染真实数据）
-        if (db.Users.Any(u => u.Phone != "13800000001")) return;
-
-        // 检查是否已有测试用户（避免重复填充）
-        if (db.Users.Any(u => u.Phone == "13800000001")) return;
-
-        // ---- 种子医生数据 ----
-        if (!db.Doctors.Any())
-        {
-            var doctor1 = new Doctor
-            {
-                Id = Guid.NewGuid(), Name = "张明", Title = "主任医师",
-                Department = "心脏康复科", Phone = "13800000002",
-                ProfessionalDirection = "冠心病康复、术后管理",
-                IsActive = true, CreatedAt = DateTime.UtcNow,
-            };
-            var doctor2 = new Doctor
-            {
-                Id = Guid.NewGuid(), Name = "李芳", Title = "副主任医师",
-                Department = "营养科", Phone = "13800000003",
-                ProfessionalDirection = "糖尿病管理、饮食指导",
-                IsActive = true, CreatedAt = DateTime.UtcNow,
-            };
-            var doctor3 = new Doctor
-            {
-                Id = Guid.NewGuid(), Name = "王建国", Title = "主任医师",
-                Department = "心血管内科", Phone = "13800000004",
-                ProfessionalDirection = "高血压管理、PCI术后随访",
-                IsActive = true, CreatedAt = DateTime.UtcNow,
-            };
-            db.Doctors.AddRange(doctor1, doctor2, doctor3);
-            await db.SaveChangesAsync();
-        }
-
-        // ---- 创建测试患者 ----
-        var doctorWang = db.Doctors.FirstOrDefault(d => d.Name == "王建国");
-        var user = new User
-        {
-            Id = Guid.NewGuid(), Phone = "13800000001", Name = "张三",
-            Gender = "男", BirthDate = new DateOnly(1970, 3, 15),
-            DoctorId = doctorWang?.Id,
-            CreatedAt = DateTime.UtcNow, UpdatedAt = DateTime.UtcNow,
-        };
-        db.Users.Add(user);
-        await db.SaveChangesAsync();
-
-        // ---- 健康档案 ----
-        db.HealthArchives.Add(new HealthArchive
-        {
-            Id = Guid.NewGuid(), UserId = user.Id,
-            Diagnosis = "冠心病", SurgeryType = "PCI支架植入术",
-            SurgeryDate = new DateOnly(2026, 3, 15),
-            Allergies = ["青霉素"], DietRestrictions = ["低盐", "低脂"],
-            ChronicDiseases = ["高血压", "高血脂"],
-            FamilyHistory = "父亲冠心病",
-            UpdatedAt = DateTime.UtcNow,
-        });
-
-        // ---- 健康数据（过去 7 天）----
-        var random = new Random(42);
-        for (int i = 7; i >= 0; i--)
-        {
-            var date = DateTime.UtcNow.AddDays(-i);
-            // 血压
-            db.HealthRecords.Add(new HealthRecord
-            {
-                Id = Guid.NewGuid(), UserId = user.Id, MetricType = HealthMetricType.BloodPressure,
-                Systolic = 120 + random.Next(-5, 15), Diastolic = 75 + random.Next(-5, 10),
-                Unit = "mmHg", Source = HealthRecordSource.AiEntry,
-                IsAbnormal = false, RecordedAt = date,
-            });
-            // 心率
-            db.HealthRecords.Add(new HealthRecord
-            {
-                Id = Guid.NewGuid(), UserId = user.Id, MetricType = HealthMetricType.HeartRate,
-                Value = 68 + random.Next(-5, 10), Unit = "次/分",
-                Source = HealthRecordSource.AiEntry,
-                IsAbnormal = false, RecordedAt = date,
-            });
-            // 血糖
-            db.HealthRecords.Add(new HealthRecord
-            {
-                Id = Guid.NewGuid(), UserId = user.Id, MetricType = HealthMetricType.Glucose,
-                Value = 5.0m + (decimal)(random.NextDouble() * 1.5),
-                Unit = "mmol/L", Source = HealthRecordSource.AiEntry,
-                IsAbnormal = false, RecordedAt = date,
-            });
-            // 血氧
-            db.HealthRecords.Add(new HealthRecord
-            {
-                Id = Guid.NewGuid(), UserId = user.Id, MetricType = HealthMetricType.SpO2,
-                Value = 96 + random.Next(0, 3), Unit = "%",
-                Source = HealthRecordSource.AiEntry,
-                IsAbnormal = false, RecordedAt = date,
-            });
-        }
-        // 一条异常血压
-        db.HealthRecords.Add(new HealthRecord
-        {
-            Id = Guid.NewGuid(), UserId = user.Id, MetricType = HealthMetricType.BloodPressure,
-            Systolic = 148, Diastolic = 92, Unit = "mmHg",
-            Source = HealthRecordSource.AiEntry, IsAbnormal = true,
-            RecordedAt = DateTime.UtcNow.AddDays(-1),
-        });
-
-        // ---- 用药计划 ----
-        db.Medications.Add(new Medication
-        {
-            Id = Guid.NewGuid(), UserId = user.Id, Name = "阿司匹林", Dosage = "100mg",
-            Frequency = MedicationFrequency.Daily, TimeOfDay = [new TimeOnly(8, 0)],
-            Source = MedicationSource.Prescription, IsActive = true, StartDate = new DateOnly(2026, 4, 1),
-        });
-        db.Medications.Add(new Medication
-        {
-            Id = Guid.NewGuid(), UserId = user.Id, Name = "阿托伐他汀", Dosage = "20mg",
-            Frequency = MedicationFrequency.Daily, TimeOfDay = [new TimeOnly(20, 0)],
-            Source = MedicationSource.Prescription, IsActive = true, StartDate = new DateOnly(2026, 4, 1),
-        });
-
-        // ---- 运动计划 ----
-        var monday = DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8).AddDays(-(int)DateTime.UtcNow.AddHours(8).DayOfWeek + 1));
-        var plan = new ExercisePlan { Id = Guid.NewGuid(), UserId = user.Id, StartDate = monday, EndDate = monday.AddDays(6), ReminderTime = new TimeOnly(19, 0) };
-        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = monday, ExerciseType = "散步", DurationMinutes = 30, IsCompleted = true, CompletedAt = DateTime.UtcNow.AddDays(-1) });
-        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = monday.AddDays(1), ExerciseType = "慢跑", DurationMinutes = 20 });
-        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = monday.AddDays(2), ExerciseType = "散步", DurationMinutes = 30 });
-        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = monday.AddDays(3), IsRestDay = true });
-        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = monday.AddDays(4), ExerciseType = "太极", DurationMinutes = 40 });
-        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = monday.AddDays(5), IsRestDay = true });
-        plan.Items.Add(new ExercisePlanItem { Id = Guid.NewGuid(), ScheduledDate = monday.AddDays(6), ExerciseType = "散步", DurationMinutes = 30 });
-        db.ExercisePlans.Add(plan);
-
-        // ---- 饮食记录 ----
-        var lunch = new DietRecord
-        {
-            Id = Guid.NewGuid(), UserId = user.Id, MealType = MealType.Lunch,
-            TotalCalories = 644, HealthScore = 3, RecordedAt = DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8)),
-        };
-        lunch.FoodItems.Add(new DietFoodItem { Id = Guid.NewGuid(), Name = "米饭", Portion = "约1碗", Calories = 174, SortOrder = 1 });
-        lunch.FoodItems.Add(new DietFoodItem { Id = Guid.NewGuid(), Name = "红烧肉", Portion = "约5块", Calories = 470, Warning = "脂肪含量偏高", SortOrder = 2 });
-        db.DietRecords.Add(lunch);
-
-        // ---- 复查计划 ----
-        db.FollowUps.Add(new FollowUp
-        {
-            Id = Guid.NewGuid(), UserId = user.Id, Title = "心内科复查",
-            DoctorName = "王建国", Department = "心血管内科",
-            ScheduledAt = DateTime.UtcNow.AddDays(3), Status = FollowUpStatus.Upcoming,
-        });
-        db.FollowUps.Add(new FollowUp
-        {
-            Id = Guid.NewGuid(), UserId = user.Id, Title = "术后3周复查",
-            DoctorName = "王建国", Department = "心血管内科",
-            ScheduledAt = DateTime.UtcNow.AddDays(-14), Status = FollowUpStatus.Completed,
-        });
-
-        await db.SaveChangesAsync();
-        Console.WriteLine($"[DEV] 测试数据已填充：用户 {user.Phone}");
-    }
-}

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

@@ -25,15 +25,28 @@ public sealed class DietImageAnalysisQueue(AppDbContext db) : IDietImageAnalysis
         return task.Id;
     }
 
-    public Task RecoverStaleAsync(CancellationToken ct)
+    public async Task RecoverStaleAsync(CancellationToken ct)
     {
         var now = DateTime.UtcNow;
-        return _db.DietImageAnalysisTasks
-            .Where(x => x.Status == "Processing" && x.UpdatedAt < now.AddMinutes(-5) && x.Attempts < MaxAttempts)
+        var staleCutoff = now.AddMinutes(-5);
+
+        // 超时但仍有重试余量 → 重新排队
+        await _db.DietImageAnalysisTasks
+            .Where(x => x.Status == "Processing" && x.UpdatedAt < staleCutoff && x.Attempts < MaxAttempts)
             .ExecuteUpdateAsync(setters => setters
                 .SetProperty(x => x.Status, "Pending")
                 .SetProperty(x => x.AvailableAt, now)
                 .SetProperty(x => x.UpdatedAt, now), ct);
+
+        // 超时且已达重试上限（多为最后一次执行中进程崩溃）→ 标记失败，避免永久卡在 Processing（也让 WaitForResultAsync 能尽快返回失败）
+        await _db.DietImageAnalysisTasks
+            .Where(x => x.Status == "Processing" && x.UpdatedAt < staleCutoff && x.Attempts >= MaxAttempts)
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Failed")
+                .SetProperty(x => x.ResultCode, 50001)
+                .SetProperty(x => x.ResultMessage, "食物识别超时且已达最大重试次数")
+                .SetProperty(x => x.LastError, "任务执行超时且已达最大重试次数")
+                .SetProperty(x => x.UpdatedAt, now), ct);
     }
 
     public async Task<DietImageAnalysisJob?> TryTakeAsync(CancellationToken ct)

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

@@ -1,12 +1,13 @@
 using System.Text.Json;
 using Health.Application.Exercises;
-using Health.Infrastructure.Data.Records;
+using Health.Application.Notifications;
 
 namespace Health.Infrastructure.Exercises;
 
-public sealed class ExerciseReminderProducer(AppDbContext db) : IExerciseReminderProducer
+public sealed class ExerciseReminderProducer(AppDbContext db, IUserNotificationProducer notifications) : IExerciseReminderProducer
 {
     private readonly AppDbContext _db = db;
+    private readonly IUserNotificationProducer _notifications = notifications;
 
     public async Task<int> ProduceDueAsync(DateTime utcNow, CancellationToken ct)
     {
@@ -17,28 +18,22 @@ public sealed class ExerciseReminderProducer(AppDbContext db) : IExerciseReminde
             .Include(x => x.Plan)
             .Where(x => x.ScheduledDate == today && !x.IsCompleted && !x.IsRestDay && x.Plan.ReminderTime <= currentTime)
             .ToListAsync(ct);
-        var sourceIds = dueItems.Select(x => x.Id).ToList();
-        var existing = await _db.NotificationOutbox.AsNoTracking()
-            .Where(x => sourceIds.Contains(x.SourceTaskId))
-            .Select(x => x.SourceTaskId)
-            .ToListAsync(ct);
-        var existingSet = existing.ToHashSet();
-        var now = DateTime.UtcNow;
-        foreach (var item in dueItems.Where(x => !existingSet.Contains(x.Id)))
+        var created = 0;
+        foreach (var item in dueItems)
         {
-            await _db.NotificationOutbox.AddAsync(new NotificationOutboxRecord
-            {
-                Id = Guid.NewGuid(), UserId = item.Plan.UserId, SourceTaskId = item.Id,
-                Type = "ExerciseReminder",
-                Payload = JsonSerializer.Serialize(new
-                {
-                    item.ExerciseType, item.DurationMinutes, item.ScheduledDate,
-                    ReminderTime = item.Plan.ReminderTime,
-                }),
-                Status = "AwaitingProvider", AvailableAt = now, CreatedAt = now, UpdatedAt = now,
-            }, ct);
+            if (await _notifications.EnqueueAsync(
+                item.Plan.UserId,
+                item.Id,
+                new NotificationMessage(
+                    "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))
+                created++;
         }
-        if (_db.ChangeTracker.HasChanges()) await _db.SaveChangesAsync(ct);
-        return dueItems.Count - existingSet.Count;
+        return created;
     }
 }

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

@@ -7,7 +7,9 @@ public sealed class EfHealthArchiveRepository(AppDbContext db) : IHealthArchiveR
     private readonly AppDbContext _db = db;
 
     public Task<HealthArchive?> GetByUserIdAsync(Guid userId, CancellationToken ct) =>
-        _db.HealthArchives.FirstOrDefaultAsync(a => a.UserId == userId, ct);
+        _db.HealthArchives
+            .Include(a => a.Surgeries)
+            .FirstOrDefaultAsync(a => a.UserId == userId, ct);
 
     public async Task AddAsync(HealthArchive archive, CancellationToken ct) =>
         await _db.HealthArchives.AddAsync(archive, ct);

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

@@ -56,12 +56,6 @@ public sealed class EfMedicationRepository(AppDbContext db) : IMedicationReposit
             .Where(m => m.IsActive && m.TimeOfDay.Count > 0)
             .ToListAsync(ct);
 
-    public Task<bool> HasTakenInWindowAsync(Guid userId, Guid medicationId, DateTime startUtc, DateTime endUtc, CancellationToken ct) =>
-        _db.MedicationLogs.AnyAsync(l =>
-            l.UserId == userId && l.MedicationId == medicationId
-            && l.CreatedAt >= startUtc && l.CreatedAt < endUtc
-            && l.Status == MedicationLogStatus.Taken, ct);
-
     public async Task AddMedicationAsync(Medication medication, CancellationToken ct) =>
         await _db.Medications.AddAsync(medication, ct);
 

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

@@ -45,15 +45,26 @@ public sealed class MedicationReminderQueue(AppDbContext db) : IMedicationRemind
         }
     }
 
-    public Task RecoverStaleAsync(CancellationToken ct)
+    public async Task RecoverStaleAsync(CancellationToken ct)
     {
         var now = DateTime.UtcNow;
-        return _db.MedicationReminderTasks
-            .Where(x => x.Status == "Processing" && x.UpdatedAt < now.AddMinutes(-5) && x.Attempts < MaxAttempts)
+        var staleCutoff = now.AddMinutes(-5);
+
+        // 超时但仍有重试余量 → 重新排队
+        await _db.MedicationReminderTasks
+            .Where(x => x.Status == "Processing" && x.UpdatedAt < staleCutoff && x.Attempts < MaxAttempts)
             .ExecuteUpdateAsync(setters => setters
                 .SetProperty(x => x.Status, "Pending")
                 .SetProperty(x => x.AvailableAt, now)
                 .SetProperty(x => x.UpdatedAt, now), ct);
+
+        // 超时且已达重试上限（多为最后一次执行中进程崩溃）→ 标记失败，避免永久卡在 Processing
+        await _db.MedicationReminderTasks
+            .Where(x => x.Status == "Processing" && x.UpdatedAt < staleCutoff && x.Attempts >= MaxAttempts)
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Failed")
+                .SetProperty(x => x.LastError, "任务执行超时且已达最大重试次数")
+                .SetProperty(x => x.UpdatedAt, now), ct);
     }
 
     public async Task<MedicationReminderTask?> TryTakeAsync(CancellationToken ct)

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

@@ -1,43 +1,35 @@
 using System.Text.Json;
 using Health.Application.Medications;
-using Health.Infrastructure.Data.Records;
+using Health.Application.Notifications;
 using Microsoft.Extensions.Logging;
 
 namespace Health.Infrastructure.Medications;
 
 public sealed class OutboxMedicationReminderDispatcher(
-    AppDbContext db,
+    IUserNotificationProducer notifications,
     ILogger<OutboxMedicationReminderDispatcher> logger) : IMedicationReminderDispatcher
 {
-    private readonly AppDbContext _db = db;
+    private readonly IUserNotificationProducer _notifications = notifications;
     private readonly ILogger<OutboxMedicationReminderDispatcher> _logger = logger;
 
     public async Task DispatchAsync(MedicationReminderTask task, CancellationToken ct)
     {
-        if (await _db.NotificationOutbox.AsNoTracking().AnyAsync(x => x.SourceTaskId == task.TaskId, ct))
-            return;
-
-        var now = DateTime.UtcNow;
-        await _db.NotificationOutbox.AddAsync(new NotificationOutboxRecord
+        var details = string.Join(" · ", new[]
         {
-            Id = Guid.NewGuid(),
-            UserId = task.UserId,
-            SourceTaskId = task.TaskId,
-            Type = "MedicationReminder",
-            Payload = JsonSerializer.Serialize(new
-            {
-                task.MedicationId,
-                task.Name,
             task.Dosage,
-                task.ScheduledDate,
-                task.ScheduledTime,
-            }),
-            Status = "AwaitingProvider",
-            AvailableAt = now,
-            CreatedAt = now,
-            UpdatedAt = now,
-        }, ct);
-        await _db.SaveChangesAsync(ct);
+            task.ScheduledTime.ToString("HH:mm")
+        }.Where(x => !string.IsNullOrWhiteSpace(x)));
+        await _notifications.EnqueueAsync(
+            task.UserId,
+            task.TaskId,
+            new NotificationMessage(
+                "MedicationReminder",
+                "用药时间到了",
+                $"请按计划服用{task.Name}{(details.Length > 0 ? $"（{details}）" : "")}，服用后记得打卡。",
+                "info",
+                "medication",
+                task.MedicationId.ToString()),
+            ct);
 
         _logger.LogInformation(
             "用药提醒已写入通知 Outbox，等待推送服务: {TaskId} {UserId}",

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

@@ -7,20 +7,46 @@ public sealed class EfInAppNotificationRepository(AppDbContext db) : IInAppNotif
     private readonly AppDbContext _db = db;
 
     public async Task<IReadOnlyList<InAppNotificationRecord>> GetPendingAsync(Guid userId, CancellationToken ct) =>
-        await _db.NotificationOutbox.AsNoTracking()
-            .Where(x => x.UserId == userId && x.Status == "AwaitingProvider")
+        await _db.UserNotifications.AsNoTracking()
+            .Where(x => x.UserId == userId && !x.IsRead && !x.IsDeleted)
             .OrderBy(x => x.CreatedAt)
             .Take(10)
-            .Select(x => new InAppNotificationRecord(x.Id, x.Type, x.Payload, x.CreatedAt))
+            .Select(x => new InAppNotificationRecord(x.Id, x.Type, x.Title, x.Message,
+                x.Severity, x.ActionType, x.ActionTargetId, x.IsRead, x.CreatedAt))
+            .ToListAsync(ct);
+
+    public async Task<IReadOnlyList<InAppNotificationRecord>> GetHistoryAsync(Guid userId, CancellationToken ct) =>
+        await _db.UserNotifications.AsNoTracking()
+            .Where(x => x.UserId == userId && !x.IsDeleted)
+            .OrderByDescending(x => x.CreatedAt)
+            .Take(100)
+            .Select(x => new InAppNotificationRecord(x.Id, x.Type, x.Title, x.Message,
+                x.Severity, x.ActionType, x.ActionTargetId, x.IsRead, x.CreatedAt))
             .ToListAsync(ct);
 
     public async Task<bool> AcknowledgeAsync(Guid userId, Guid notificationId, CancellationToken ct)
     {
-        var updated = await _db.NotificationOutbox
-            .Where(x => x.Id == notificationId && x.UserId == userId && x.Status == "AwaitingProvider")
+        var updated = await _db.UserNotifications
+            .Where(x => x.Id == notificationId && x.UserId == userId && !x.IsRead && !x.IsDeleted)
             .ExecuteUpdateAsync(setters => setters
-                .SetProperty(x => x.Status, "InAppDelivered")
-                .SetProperty(x => x.UpdatedAt, DateTime.UtcNow), ct);
+                .SetProperty(x => x.IsRead, true)
+                .SetProperty(x => x.ReadAt, DateTime.UtcNow), ct);
         return updated > 0;
     }
+
+    public Task<int> MarkAllReadAsync(Guid userId, CancellationToken ct) =>
+        _db.UserNotifications
+            .Where(x => x.UserId == userId && !x.IsRead && !x.IsDeleted)
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.IsRead, true)
+                .SetProperty(x => x.ReadAt, DateTime.UtcNow), ct);
+
+    public async Task<bool> DeleteAsync(Guid userId, Guid notificationId, CancellationToken ct)
+    {
+        var deleted = await _db.UserNotifications
+            .Where(x => x.Id == notificationId && x.UserId == userId && !x.IsDeleted)
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.IsDeleted, true), ct);
+        return deleted > 0;
+    }
 }

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

@@ -0,0 +1,139 @@
+using System.Text.Json;
+using Health.Application.Notifications;
+using Health.Infrastructure.Data.Records;
+using Npgsql;
+
+namespace Health.Infrastructure.Notifications;
+
+public sealed class EfUserNotificationProducer(AppDbContext db) : IUserNotificationProducer
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<bool> EnqueueAsync(
+        Guid userId,
+        Guid sourceId,
+        NotificationMessage message,
+        CancellationToken ct)
+    {
+        if (await _db.NotificationOutbox.AsNoTracking().AnyAsync(x => x.SourceTaskId == sourceId, ct))
+            return false;
+
+        var now = DateTime.UtcNow;
+        await _db.NotificationOutbox.AddAsync(new NotificationOutboxRecord
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            SourceTaskId = sourceId,
+            Type = message.Type,
+            Payload = JsonSerializer.Serialize(message),
+            Status = "Pending",
+            AvailableAt = now,
+            CreatedAt = now,
+            UpdatedAt = now,
+        }, ct);
+
+        try
+        {
+            await _db.SaveChangesAsync(ct);
+            return true;
+        }
+        catch (DbUpdateException ex) when (
+            ex.InnerException is PostgresException { SqlState: PostgresErrorCodes.UniqueViolation })
+        {
+            _db.ChangeTracker.Clear();
+            return false;
+        }
+    }
+}
+
+public sealed class EfNotificationOutboxProcessor(AppDbContext db) : INotificationOutboxProcessor
+{
+    private const int MaxAttempts = 5;
+    private readonly AppDbContext _db = db;
+
+    public async Task RecoverStaleAsync(CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        await _db.NotificationOutbox
+            .Where(x => x.Status == "Processing" &&
+                x.UpdatedAt < now.AddMinutes(-5) && x.Attempts < MaxAttempts)
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Pending")
+                .SetProperty(x => x.AvailableAt, now)
+                .SetProperty(x => x.UpdatedAt, now), ct);
+
+        await _db.NotificationOutbox
+            .Where(x => x.Status == "Processing" &&
+                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.UpdatedAt, now), ct);
+    }
+
+    public async Task<bool> ProcessNextAsync(CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        var candidate = await _db.NotificationOutbox.AsNoTracking()
+            .Where(x => x.Status == "Pending" &&
+                x.AvailableAt <= now && x.Attempts < MaxAttempts)
+            .OrderBy(x => x.CreatedAt)
+            .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;
+
+        try
+        {
+            var message = JsonSerializer.Deserialize<NotificationMessage>(candidate.Payload)
+                ?? throw new InvalidOperationException("通知消息内容为空");
+
+            if (!await _db.UserNotifications.AsNoTracking()
+                    .AnyAsync(x => x.SourceId == candidate.SourceTaskId, ct))
+            {
+                await _db.UserNotifications.AddAsync(new UserNotification
+                {
+                    Id = Guid.NewGuid(),
+                    UserId = candidate.UserId,
+                    SourceId = candidate.SourceTaskId,
+                    Type = message.Type,
+                    Title = message.Title,
+                    Message = message.Message,
+                    Severity = message.Severity,
+                    ActionType = message.ActionType,
+                    ActionTargetId = message.ActionTargetId,
+                    CreatedAt = candidate.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);
+        }
+        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);
+        }
+
+        return true;
+    }
+}

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

@@ -1,12 +1,16 @@
 using Health.Application.Reports;
+using Health.Application.Notifications;
 using Health.Infrastructure.Data.Records;
 
 namespace Health.Infrastructure.Reports;
 
-public sealed class EfReportAnalysisQueue(AppDbContext db) : IReportAnalysisQueue
+public sealed class EfReportAnalysisQueue(
+    AppDbContext db,
+    IUserNotificationProducer? notifications = null) : IReportAnalysisQueue
 {
     private const int MaxAttempts = 3;
     private readonly AppDbContext _db = db;
+    private readonly IUserNotificationProducer? _notifications = notifications;
 
     public async Task EnqueueAsync(ReportAnalysisJob job, CancellationToken ct = default)
     {
@@ -25,15 +29,26 @@ public sealed class EfReportAnalysisQueue(AppDbContext db) : IReportAnalysisQueu
         await _db.SaveChangesAsync(ct);
     }
 
-    public Task RecoverStaleAsync(CancellationToken ct)
+    public async Task RecoverStaleAsync(CancellationToken ct)
     {
         var now = DateTime.UtcNow;
-        return _db.ReportAnalysisTasks
-            .Where(x => x.Status == "Processing" && x.UpdatedAt < now.AddMinutes(-5) && x.Attempts < MaxAttempts)
+        var staleCutoff = now.AddMinutes(-5);
+
+        // 超时但仍有重试余量 → 重新排队
+        await _db.ReportAnalysisTasks
+            .Where(x => x.Status == "Processing" && x.UpdatedAt < staleCutoff && x.Attempts < MaxAttempts)
             .ExecuteUpdateAsync(setters => setters
                 .SetProperty(x => x.Status, "Pending")
                 .SetProperty(x => x.AvailableAt, now)
                 .SetProperty(x => x.UpdatedAt, now), ct);
+
+        // 超时且已达重试上限（多为最后一次执行中进程崩溃）→ 标记失败，避免永久卡在 Processing
+        await _db.ReportAnalysisTasks
+            .Where(x => x.Status == "Processing" && x.UpdatedAt < staleCutoff && x.Attempts >= MaxAttempts)
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Failed")
+                .SetProperty(x => x.LastError, "任务执行超时且已达最大重试次数")
+                .SetProperty(x => x.UpdatedAt, now), ct);
     }
 
     public async Task<ReportAnalysisJob?> TryTakeAsync(CancellationToken ct)
@@ -82,5 +97,27 @@ public sealed class EfReportAnalysisQueue(AppDbContext db) : IReportAnalysisQueu
             task.AvailableAt = DateTime.UtcNow.AddSeconds(Math.Pow(2, task.Attempts) * 5);
         }
         await _db.SaveChangesAsync(ct);
+
+        if (task.Status == "Failed" && _notifications != null)
+        {
+            var report = await _db.Reports.AsNoTracking()
+                .Where(x => x.Id == task.ReportId)
+                .Select(x => new { x.Id, x.UserId })
+                .FirstOrDefaultAsync(ct);
+            if (report != null)
+            {
+                await _notifications.EnqueueAsync(
+                    report.UserId,
+                    task.Id,
+                    new NotificationMessage(
+                        "ReportAnalysisFailed",
+                        "报告分析未完成",
+                        "这份报告暂时无法完成分析，您可以进入报告页面重新尝试。",
+                        "warning",
+                        "report",
+                        report.Id.ToString()),
+                    ct);
+            }
+        }
     }
 }

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

@@ -1,4 +1,5 @@
 using Health.Application.Reports;
+using Health.Application.Notifications;
 using Health.Infrastructure.AI;
 using Microsoft.Extensions.Logging;
 
@@ -8,11 +9,13 @@ public sealed class ReportAnalysisService(
     IReportRepository reports,
     VisionClient vision,
     DeepSeekClient llm,
+    IUserNotificationProducer notifications,
     ILogger<ReportAnalysisService> logger) : IReportAnalysisService
 {
     private readonly IReportRepository _reports = reports;
     private readonly VisionClient _vision = vision;
     private readonly DeepSeekClient _llm = llm;
+    private readonly IUserNotificationProducer _notifications = notifications;
     private readonly ILogger<ReportAnalysisService> _logger = logger;
 
     public async Task AnalyzeAsync(ReportAnalysisJob job, CancellationToken ct)
@@ -32,6 +35,7 @@ public sealed class ReportAnalysisService(
                 report.AiIndicators = "[]";
                 report.Status = ReportStatus.AnalysisFailed;
                 await _reports.SaveChangesAsync(ct);
+                await NotifyAsync(report, job.TaskId, false, ct);
                 return;
             }
 
@@ -44,8 +48,14 @@ public sealed class ReportAnalysisService(
             report.Status = ReportStatus.PendingDoctor;
 
             await _reports.SaveChangesAsync(ct);
+            await NotifyAsync(report, job.TaskId, true, ct);
             _logger.LogInformation("报告 AI 分析完成: {ReportId}", job.ReportId);
         }
+        catch (OperationCanceledException) when (ct.IsCancellationRequested)
+        {
+            // 进程停机导致的取消：不算失败，不消耗重试，交还给恢复机制
+            throw;
+        }
         catch (Exception ex)
         {
             _logger.LogError(ex, "报告 AI 分析失败: {ReportId}", job.ReportId);
@@ -53,6 +63,10 @@ public sealed class ReportAnalysisService(
             report.AiSummary = "AI 暂时无法完成解读，可能是图片不清晰或服务暂时不可用。请稍后重试，或重新上传更清晰的报告图片。";
             report.AiIndicators = "[]";
             await _reports.SaveChangesAsync(ct);
+
+            // 重新抛出，使 Worker 进入 RetryAsync（指数退避重试，超限后任务置 Failed）；
+            // 若为可恢复的瞬时故障，重试成功会把状态改回 PendingDoctor。
+            throw;
         }
     }
 
@@ -91,7 +105,8 @@ public sealed class ReportAnalysisService(
             ct: ct);
 
         var content = response.Choices?.FirstOrDefault()?.Message?.Content ?? "";
-        _logger.LogInformation("报告 VLM 返回: {Content}", content[..Math.Min(content.Length, 200)]);
+        // 不记录 VLM 返回正文：可能包含检验指标等敏感医疗信息，生产日志只记录长度
+        _logger.LogInformation("报告 VLM 返回长度: {Length}", content.Length);
 
         var json = TryParseJson(content);
         return json ?? throw new InvalidOperationException("报告识别结果格式异常");
@@ -162,4 +177,17 @@ public sealed class ReportAnalysisService(
         try { return JsonDocument.Parse(content).RootElement; }
         catch (JsonException) { return null; }
     }
+
+    private Task NotifyAsync(Report report, Guid sourceId, bool succeeded, CancellationToken ct) =>
+        _notifications.EnqueueAsync(
+            report.UserId,
+            sourceId,
+            new NotificationMessage(
+                succeeded ? "ReportAnalysisCompleted" : "ReportAnalysisFailed",
+                succeeded ? "报告分析完成" : "报告分析未完成",
+                succeeded ? "您的报告已完成 AI 预解读，点击查看分析结果。" : "这份报告暂时无法完成分析，您可以进入报告页面重新尝试。",
+                succeeded ? "success" : "warning",
+                "report",
+                report.Id.ToString()),
+            ct);
 }

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

@@ -40,6 +40,8 @@ public sealed class EfUserRepository(AppDbContext db) : IUserRepository
         await _db.FollowUps.Where(f => f.UserId == userId).ExecuteDeleteAsync(ct);
         await _db.RefreshTokens.Where(t => t.UserId == userId).ExecuteDeleteAsync(ct);
         await _db.DeviceTokens.Where(t => t.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.UserNotifications.Where(n => n.UserId == userId).ExecuteDeleteAsync(ct);
+        await _db.NotificationOutbox.Where(n => n.UserId == userId).ExecuteDeleteAsync(ct);
         await _db.NotificationPreferences.Where(p => p.UserId == userId).ExecuteDeleteAsync(ct);
         await _db.HealthArchives.Where(a => a.UserId == userId).ExecuteDeleteAsync(ct);
         await _db.AiWriteCommands.Where(c => c.UserId == userId).ExecuteDeleteAsync(ct);

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

@@ -0,0 +1,37 @@
+using Health.Application.Notifications;
+
+namespace Health.WebApi.BackgroundServices;
+
+public sealed class NotificationOutboxWorker(
+    IServiceScopeFactory scopeFactory,
+    ILogger<NotificationOutboxWorker> logger) : BackgroundService
+{
+    protected override async Task ExecuteAsync(CancellationToken stoppingToken)
+    {
+        var nextRecovery = DateTime.MinValue;
+        while (!stoppingToken.IsCancellationRequested)
+        {
+            try
+            {
+                using var scope = scopeFactory.CreateScope();
+                var processor = scope.ServiceProvider.GetRequiredService<INotificationOutboxProcessor>();
+                if (DateTime.UtcNow >= nextRecovery)
+                {
+                    await processor.RecoverStaleAsync(stoppingToken);
+                    nextRecovery = DateTime.UtcNow.AddMinutes(1);
+                }
+                if (!await processor.ProcessNextAsync(stoppingToken))
+                    await Task.Delay(TimeSpan.FromSeconds(2), stoppingToken);
+            }
+            catch (OperationCanceledException) when (stoppingToken.IsCancellationRequested)
+            {
+                break;
+            }
+            catch (Exception ex)
+            {
+                logger.LogError(ex, "通知 Outbox 消费失败");
+                await Task.Delay(TimeSpan.FromSeconds(2), stoppingToken);
+            }
+        }
+    }
+}

backend/src/Health.WebApi/Data/AppDbContextFactory.cs

@@ -0,0 +1,52 @@
+using Health.Infrastructure.Data;
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Design;
+
+namespace Health.WebApi.Data;
+
+/// <summary>
+/// 设计时 DbContext 工厂——仅供 dotnet-ef（migrations / database update）使用。
+/// 不会启动 Web 服务或后台 Worker，只负责构建 AppDbContext 的连接配置。
+/// 连接串优先级：DB_CONNECTION 环境变量 → backend/.env 文件 → 本地默认。
+/// </summary>
+public sealed class AppDbContextFactory : IDesignTimeDbContextFactory<AppDbContext>
+{
+    private const string FallbackConnection =
+        "Host=localhost;Database=health_manager;Username=postgres;Password=postgres123";
+
+    public AppDbContext CreateDbContext(string[] args)
+    {
+        var connection = Environment.GetEnvironmentVariable("DB_CONNECTION")
+            ?? ReadConnectionFromEnvFile()
+            ?? FallbackConnection;
+
+        var options = new DbContextOptionsBuilder<AppDbContext>()
+            .UseNpgsql(connection)
+            .Options;
+
+        return new AppDbContext(options);
+    }
+
+    // 从 backend 目录的 .env 读取 DB_CONNECTION（设计时不走 Program.cs 的加载逻辑）
+    private static string? ReadConnectionFromEnvFile()
+    {
+        var dir = new DirectoryInfo(Directory.GetCurrentDirectory());
+        for (var i = 0; i < 6 && dir != null; i++, dir = dir.Parent)
+        {
+            var envPath = Path.Combine(dir.FullName, ".env");
+            if (!File.Exists(envPath)) continue;
+
+            foreach (var line in File.ReadAllLines(envPath))
+            {
+                var trimmed = line.Trim();
+                if (trimmed.Length == 0 || trimmed.StartsWith('#')) continue;
+                var eq = trimmed.IndexOf('=');
+                if (eq <= 0) continue;
+                if (trimmed[..eq].Trim() != "DB_CONNECTION") continue;
+                var value = trimmed[(eq + 1)..].Trim();
+                return value.Length > 0 ? value : null;
+            }
+        }
+        return null;
+    }
+}

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

@@ -132,6 +132,7 @@ public static class DoctorEndpoints
 
             var user = await db.Users
                 .Include(u => u.HealthArchive)
+                .ThenInclude(a => a!.Surgeries)
                 .FirstOrDefaultAsync(u => u.Id == id && u.DoctorId == doctorId);
             if (user == null)
                 return Results.Ok(new { code = 404, data = (object?)null, message = "患者不存在" });
@@ -179,7 +180,18 @@ public static class DoctorEndpoints
                 data = new
                 {
                     profile = new { user.Id, user.Phone, user.Name, user.Gender, BirthDate = user.BirthDate?.ToString("yyyy-MM-dd"), user.AvatarUrl },
-                    archive = user.HealthArchive == null ? null : new { user.HealthArchive.Diagnosis, user.HealthArchive.SurgeryType, SurgeryDate = user.HealthArchive.SurgeryDate?.ToString("yyyy-MM-dd"), user.HealthArchive.Allergies, user.HealthArchive.DietRestrictions, user.HealthArchive.ChronicDiseases, user.HealthArchive.FamilyHistory },
+                    archive = user.HealthArchive == null ? null : new
+                    {
+                        user.HealthArchive.Diagnosis,
+                        user.HealthArchive.SurgeryType,
+                        SurgeryDate = user.HealthArchive.SurgeryDate?.ToString("yyyy-MM-dd"),
+                        surgeries = user.HealthArchive.Surgeries.OrderBy(s => s.SortOrder)
+                            .Select(s => new { s.Type, Date = s.Date.HasValue ? s.Date.Value.ToString("yyyy-MM-dd") : null }),
+                        user.HealthArchive.Allergies,
+                        user.HealthArchive.DietRestrictions,
+                        user.HealthArchive.ChronicDiseases,
+                        user.HealthArchive.FamilyHistory
+                    },
                     latestRecords,
                     trendRecords,
                     medications,

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

@@ -17,6 +17,19 @@ public static class NotificationEndpoints
             return Results.Ok(new { code = 0, data = result, message = (string?)null });
         });
 
+        group.MapGet("", async (HttpContext http, IInAppNotificationService notifications, CancellationToken ct) =>
+        {
+            var userId = GetUserId(http);
+            if (userId == Guid.Empty) return Results.Unauthorized();
+            var result = await notifications.GetHistoryAsync(userId, ct);
+            return Results.Ok(new
+            {
+                code = 0,
+                data = new { unreadCount = result.Count(x => !x.IsRead), items = result },
+                message = (string?)null
+            });
+        });
+
         group.MapPost("/{id:guid}/acknowledge", async (Guid id, HttpContext http, IInAppNotificationService notifications, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
@@ -24,6 +37,25 @@ public static class NotificationEndpoints
             var acknowledged = await notifications.AcknowledgeAsync(userId, id, ct);
             return Results.Ok(new { code = 0, data = new { acknowledged }, message = (string?)null });
         });
+
+        group.MapPost("/read-all", async (HttpContext http, IInAppNotificationService notifications, CancellationToken ct) =>
+        {
+            var userId = GetUserId(http);
+            if (userId == Guid.Empty) return Results.Unauthorized();
+            var count = await notifications.MarkAllReadAsync(userId, ct);
+            return Results.Ok(new { code = 0, data = new { count }, message = (string?)null });
+        });
+
+
+        group.MapDelete("/{id:guid}", async (Guid id, HttpContext http, IInAppNotificationService notifications, CancellationToken ct) =>
+        {
+            var userId = GetUserId(http);
+            if (userId == Guid.Empty) return Results.Unauthorized();
+            var deleted = await notifications.DeleteAsync(userId, id, ct);
+            return deleted
+                ? Results.Ok(new { code = 0, data = new { deleted = true }, message = (string?)null })
+                : Results.NotFound(new { code = 404, data = (object?)null, message = "通知不存在" });
+        });
     }
 
     private static Guid GetUserId(HttpContext http) =>

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

@@ -36,6 +36,9 @@ public static class UserEndpoints
         group.MapPut("/health-archive", async (UpdateArchiveRequest req, HttpContext http, IHealthArchiveService archives, CancellationToken ct) =>
         {
             var surgeryDate = DateOnly.TryParse(req.SurgeryDate, out var parsed) ? parsed : (DateOnly?)null;
+            var surgeries = req.Surgeries?.Select(s => new HealthArchiveSurgeryInput(
+                s.Type,
+                DateOnly.TryParse(s.Date, out var date) ? date : null)).ToList();
             await archives.UpdateAsync(
                 GetUserId(http),
                 new HealthArchiveUpdateRequest(
@@ -45,7 +48,8 @@ public static class UserEndpoints
                     req.Allergies,
                     req.DietRestrictions,
                     req.ChronicDiseases,
-                    req.FamilyHistory),
+                    req.FamilyHistory,
+                    surgeries),
                 ct);
             return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
         });
@@ -65,4 +69,7 @@ public sealed record UpdateProfileRequest(string? Name, string? Gender, string?
 public sealed record UpdateArchiveRequest(
     string? Diagnosis, string? SurgeryType, string? SurgeryDate,
     List<string>? Allergies, List<string>? DietRestrictions,
-    List<string>? ChronicDiseases, string? FamilyHistory);
+    List<string>? ChronicDiseases, string? FamilyHistory,
+    List<UpdateArchiveSurgeryRequest>? Surgeries);
+
+public sealed record UpdateArchiveSurgeryRequest(string Type, string? Date);

backend/src/Health.WebApi/Health.WebApi.csproj

@@ -10,6 +10,10 @@
     <PackageReference Include="Microsoft.AspNetCore.Authentication.JwtBearer" Version="10.0.8" />
     <PackageReference Include="Microsoft.AspNetCore.OpenApi" Version="10.0.8" />
     <PackageReference Include="Microsoft.EntityFrameworkCore" Version="10.0.8" />
+    <PackageReference Include="Microsoft.EntityFrameworkCore.Design" Version="10.0.8">
+      <IncludeAssets>runtime; build; native; contentfiles; analyzers; buildtransitive</IncludeAssets>
+      <PrivateAssets>all</PrivateAssets>
+    </PackageReference>
     <PackageReference Include="System.Drawing.Common" Version="10.0.8" />
   </ItemGroup>
 

backend/src/Health.WebApi/Middleware/exception_middleware.cs

@@ -16,6 +16,14 @@ public sealed class ExceptionMiddleware(RequestDelegate next, ILogger<ExceptionM
         {
             await _next(context);
         }
+        catch (Health.Domain.ValidationException vex)
+        {
+            // 业务输入校验失败：返回 400，message 为我们自己产生的提示，可安全展示
+            context.Response.StatusCode = (int)HttpStatusCode.BadRequest;
+            context.Response.ContentType = "application/json";
+            var result = new { code = 40001, data = (object?)null, message = vex.Message };
+            await context.Response.WriteAsync(JsonSerializer.Serialize(result));
+        }
         catch (Exception ex)
         {
             // 生产环境不暴露内部异常详情

backend/src/Health.WebApi/Program.cs

@@ -79,7 +79,9 @@ builder.Services.ConfigureHttpJsonOptions(options =>
 
 // ---- 数据库 ----
 builder.Services.AddDbContext<AppDbContext>(options =>
-    options.UseNpgsql(builder.Configuration.GetConnectionString("Default") ?? builder.Configuration["DB_CONNECTION"] ?? "Host=localhost;Database=health_manager;Username=postgres;Password=postgres"));
+    options.UseNpgsql(
+        builder.Configuration.GetConnectionString("Default") ?? builder.Configuration["DB_CONNECTION"] ?? "Host=localhost;Database=health_manager;Username=postgres;Password=postgres",
+        npgsql => npgsql.MigrationsAssembly(typeof(AppDbContext).Assembly.FullName)));
 
 // ---- JWT 认证 ----
 var jwtSecret = builder.Configuration["JWT_SECRET"];
@@ -137,6 +139,8 @@ builder.Services.AddScoped<IMaintenanceService, MaintenanceService>();
 builder.Services.AddScoped<IMaintenanceRepository, EfMaintenanceRepository>();
 builder.Services.AddScoped<IInAppNotificationService, InAppNotificationService>();
 builder.Services.AddScoped<IInAppNotificationRepository, EfInAppNotificationRepository>();
+builder.Services.AddScoped<IUserNotificationProducer, EfUserNotificationProducer>();
+builder.Services.AddScoped<INotificationOutboxProcessor, EfNotificationOutboxProcessor>();
 builder.Services.AddScoped<IReportService, ReportService>();
 builder.Services.AddScoped<IReportRepository, EfReportRepository>();
 builder.Services.AddScoped<IReportFileStorage, LocalReportFileStorage>();
@@ -144,7 +148,6 @@ builder.Services.AddScoped<IReportAnalysisService, ReportAnalysisService>();
 builder.Services.AddScoped<IReportAnalysisQueue, EfReportAnalysisQueue>();
 builder.Services.AddScoped<IUserService, UserService>();
 builder.Services.AddScoped<IUserRepository, EfUserRepository>();
-builder.Services.AddScoped<DatabaseSchemaMigrator>();
 
 // ---- AI 客户端（使用 IHttpClientFactory 区分 LLM 和 VLM）----
 builder.Services.AddHttpClient<DeepSeekClient>(client =>
@@ -167,6 +170,7 @@ builder.Services.AddHostedService<MedicationReminderWorker>();
 builder.Services.AddHostedService<CleanupService>();
 builder.Services.AddHostedService<ReportAnalysisWorker>();
 builder.Services.AddHostedService<DietImageAnalysisWorker>();
+builder.Services.AddHostedService<NotificationOutboxWorker>();
 
 // ---- OpenAPI ----
 builder.Services.AddOpenApi();
@@ -202,14 +206,12 @@ app.UseStaticFiles(new StaticFileOptions
 if (app.Environment.IsDevelopment())
     app.MapOpenApi();
 
-// ---- 初始化数据库：创建空库，并用版本化补丁更新已有本地结构 ----
+// ---- 数据库迁移（EF Core Migrations，可用 AUTO_MIGRATE=false 禁用自动迁移）----
 using (var scope = app.Services.CreateScope())
 {
     var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
-    await db.Database.EnsureCreatedAsync();
-    await scope.ServiceProvider.GetRequiredService<DatabaseSchemaMigrator>().ApplyAsync();
-    await DataSeeder.SeedAsync(db);
-    await DevDataSeeder.SeedIfEnabled(db, app.Configuration);
+    if (app.Configuration.GetValue<bool>("AUTO_MIGRATE", true))
+        await db.Database.MigrateAsync();
 }
 
 // ---- 注册 API 端点 ----

backend/tests/Health.Tests/ai_agent_tests.cs

@@ -1,287 +0,0 @@
-using System.Net.Http.Headers;
-using System.Text;
-using System.Text.Json;
-using Health.Domain.Entities;
-using Health.Domain.Enums;
-using Health.Infrastructure.AI;
-using Health.Infrastructure.Data;
-using Microsoft.EntityFrameworkCore;
-using Microsoft.Extensions.Configuration;
-
-namespace Health.Tests;
-
-/// <summary>
-/// AI 智能体集成测试 — 模拟真实用户对话，验证 Tool Calling 与数据库写入
-/// 运行前需确保后端已启动: dotnet run --project src/Health.WebApi
-/// </summary>
-public class AiAgentTests
-{
-    private static readonly HttpClient Http = new()
-    {
-        BaseAddress = new Uri("http://localhost:5000"),
-        Timeout = TimeSpan.FromSeconds(120)
-    };
-
-    private static readonly JsonSerializerOptions JsonOpts = new()
-    {
-        PropertyNamingPolicy = JsonNamingPolicy.CamelCase,
-        PropertyNameCaseInsensitive = true
-    };
-
-    // ==================== PromptManager 单元测试 ====================
-
-    [Fact]
-    public void PromptManager_Default_Should_Contain_HeartKeywords()
-    {
-        var pm = new PromptManager();
-        var prompt = pm.GetSystemPrompt(AgentType.Default);
-        Assert.Contains("心脏", prompt);
-        Assert.Contains("健康", prompt);
-    }
-
-    [Fact]
-    public void PromptManager_Consultation_Should_Contain_TriageRules()
-    {
-        var pm = new PromptManager();
-        var prompt = pm.GetSystemPrompt(AgentType.Consultation);
-        Assert.Contains("剧烈胸痛", prompt);
-        Assert.Contains("呼吸困难", prompt);
-        Assert.Contains("160/100", prompt);
-    }
-
-    [Fact]
-    public void PromptManager_Health_Should_Contain_NormalRanges()
-    {
-        var pm = new PromptManager();
-        var prompt = pm.GetSystemPrompt(AgentType.Health);
-        Assert.Contains("139", prompt);   // 收缩压上界
-        Assert.Contains("89", prompt);    // 舒张压下界
-        Assert.Contains("100", prompt);   // 心率上界
-    }
-
-    [Fact]
-    public void PromptManager_Diet_Should_Contain_VlmKeywords()
-    {
-        var pm = new PromptManager();
-        var prompt = pm.GetSystemPrompt(AgentType.Diet);
-        Assert.Contains("VLM", prompt);
-        Assert.Contains("能不能吃", prompt);
-    }
-
-    [Fact]
-    public void PromptManager_Medication_Should_Contain_ParseRules()
-    {
-        var pm = new PromptManager();
-        var prompt = pm.GetSystemPrompt(AgentType.Medication);
-        Assert.Contains("药名", prompt);
-        Assert.Contains("剂量", prompt);
-    }
-
-    [Fact]
-    public void PromptManager_Report_Should_Contain_Disclaimer()
-    {
-        var pm = new PromptManager();
-        var prompt = pm.GetSystemPrompt(AgentType.Report);
-        Assert.Contains("AI预解读", prompt);
-        Assert.Contains("医生确认", prompt);
-    }
-
-    [Fact]
-    public void PromptManager_Exercise_Should_Contain_RehabKeywords()
-    {
-        var pm = new PromptManager();
-        var prompt = pm.GetSystemPrompt(AgentType.Exercise);
-        Assert.Contains("心脏康复", prompt);
-        Assert.Contains("循序渐进", prompt);
-    }
-
-    [Fact]
-    public void PromptManager_All_Agents_Should_Return_NonEmpty()
-    {
-        var pm = new PromptManager();
-        foreach (AgentType agent in Enum.GetValues<AgentType>())
-        {
-            var prompt = pm.GetSystemPrompt(agent);
-            Assert.False(string.IsNullOrWhiteSpace(prompt), $"{agent} 的 SystemPrompt 为空");
-        }
-    }
-
-    // ==================== DeepSeekClient 连通性测试 ====================
-
-    [Fact]
-    public void DeepSeekClient_ApiKey_Should_Be_Configured()
-    {
-        // 仅验证 API Key 已配置（实际调用通过集成测试验证）
-        CreateDeepSeekClient();
-        var config = new ConfigurationBuilder().AddEnvironmentVariables().Build();
-        var apiKey = config["DEEPSEEK_API_KEY"] ?? "";
-        Assert.False(string.IsNullOrEmpty(apiKey) || apiKey.StartsWith("sk-your-key"),
-            "DEEPSEEK_API_KEY 未配置或为占位符，请在 backend/.env 中设置真实 Key");
-    }
-
-    // ==================== AI 对话 + Tool Calling 集成测试 ====================
-
-    [Fact]
-    public async Task HealthAgent_RecordBloodPressure_Should_SaveToDb()
-    {
-        // 先登录获取 token
-        var token = await LoginAsync("13800000001");
-
-        // 发送对话消息触发 Tool Calling
-        var events = await SendChatMessage(token, "health", "我刚刚测了血压，138/86");
-        var toolResults = events.Where(e => e.Action == "tool_result").ToList();
-
-        Assert.NotEmpty(toolResults);
-    }
-
-    [Fact]
-    public async Task HealthAgent_RecordHeartRate_Should_SaveToDb()
-    {
-        var token = await LoginAsync("13800000001");
-        var events = await SendChatMessage(token, "health", "心率72");
-        var toolResults = events.Where(e => e.Action == "tool_result").ToList();
-
-        Assert.NotEmpty(toolResults);
-    }
-
-    [Fact]
-    public async Task MedicationAgent_Query_Should_Return_Medications()
-    {
-        var token = await LoginAsync("13800000001");
-        var events = await SendChatMessage(token, "medication", "我现在在吃什么药？");
-
-        var answers = events.Where(e => e.Action == "answer")
-            .Select(e => e.Data?.ToString() ?? "");
-
-        var fullResponse = string.Join("", answers);
-        Assert.NotEmpty(fullResponse);
-        // 应该提到阿司匹林或阿托伐他汀
-        Assert.True(fullResponse.Contains("阿司匹林") || fullResponse.Contains("阿托伐他汀") ||
-                      fullResponse.Contains("Aspirin"));
-    }
-
-    [Fact]
-    public async Task ConsultationAgent_SymptomCheck_Should_AskFollowUp()
-    {
-        var token = await LoginAsync("13800000001");
-        var events = await SendChatMessage(token, "consultation", "最近胸口有点不舒服");
-
-        var answers = events.Where(e => e.Action == "answer")
-            .Select(e => e.Data?.ToString() ?? "");
-
-        var fullResponse = string.Join("", answers);
-        Assert.NotEmpty(fullResponse);
-    }
-
-    [Fact]
-    public async Task DefaultAgent_GeneralQuestion_Should_Respond()
-    {
-        var token = await LoginAsync("13800000001");
-        var events = await SendChatMessage(token, "default", "你好，介绍一下你自己");
-
-        var answers = events.Where(e => e.Action == "answer")
-            .Select(e => e.Data?.ToString() ?? "");
-
-        var fullResponse = string.Join("", answers);
-        Assert.NotEmpty(fullResponse);
-        Assert.True(fullResponse.Length > 10, "默认 Agent 应返回有效回复");
-    }
-
-    // ==================== 辅助方法 ====================
-
-    /// <summary>
-    /// 发送验证码 + 登录，返回 accessToken
-    /// </summary>
-    private static async Task<string> LoginAsync(string phone)
-    {
-        // 发送验证码
-        var smsPayload = JsonSerializer.Serialize(new { phone }, JsonOpts);
-        var smsResp = await Http.PostAsync("/api/auth/send-sms",
-            new StringContent(smsPayload, Encoding.UTF8, "application/json"));
-        var smsJson = JsonDocument.Parse(await smsResp.Content.ReadAsStringAsync());
-        var devCode = smsJson.RootElement.GetProperty("data").GetProperty("devCode").GetString()!;
-
-        // 登录
-        var loginPayload = JsonSerializer.Serialize(new { phone, smsCode = devCode }, JsonOpts);
-        var loginResp = await Http.PostAsync("/api/auth/login",
-            new StringContent(loginPayload, Encoding.UTF8, "application/json"));
-        var loginJson = JsonDocument.Parse(await loginResp.Content.ReadAsStringAsync());
-
-        return loginJson.RootElement.GetProperty("data").GetProperty("accessToken").GetString()!;
-    }
-
-    /// <summary>
-    /// 向指定 Agent 发送消息，返回所有 SSE 事件
-    /// </summary>
-    private static async Task<List<SseEvent>> SendChatMessage(string token, string agentType, string message)
-    {
-        var url = $"/api/ai/{agentType}/chat?message={Uri.EscapeDataString(message)}&token={Uri.EscapeDataString(token)}";
-
-        Http.DefaultRequestHeaders.Authorization = null;  // token 走 query string
-        var response = await Http.GetAsync(url, HttpCompletionOption.ResponseHeadersRead);
-        response.EnsureSuccessStatusCode();
-
-        var events = new List<SseEvent>();
-        using var stream = await response.Content.ReadAsStreamAsync();
-        using var reader = new StreamReader(stream);
-
-        string? line;
-        while ((line = await reader.ReadLineAsync()) != null)
-        {
-            if (string.IsNullOrWhiteSpace(line)) continue;
-            if (!line.StartsWith("data: ")) continue;
-
-            var data = line["data: ".Length..];
-            if (data == "[DONE]") break;
-
-            try
-            {
-                var parsed = JsonSerializer.Deserialize<SseEvent>(data, JsonOpts);
-                if (parsed != null) events.Add(parsed);
-            }
-            catch { /* 跳过无法解析的 chunk */ }
-        }
-
-        return events;
-    }
-
-    /// <summary>
-    /// 创建 DeepSeekClient（读取 .env 配置）
-    /// </summary>
-    private static DeepSeekClient CreateDeepSeekClient()
-    {
-        // 从测试输出目录向上 5 级找到 backend/.env
-        // bin/Debug/net10.0 → Health.Tests → tests → backend
-        var baseDir = AppContext.BaseDirectory;
-        var envPath = Path.GetFullPath(Path.Combine(baseDir, "..", "..", "..", "..", "..", ".env"));
-
-        if (File.Exists(envPath))
-        {
-            foreach (var envLine in File.ReadAllLines(envPath))
-            {
-                var trimmed = envLine.Trim();
-                if (string.IsNullOrEmpty(trimmed) || trimmed.StartsWith('#')) continue;
-                var eqIdx = trimmed.IndexOf('=');
-                if (eqIdx <= 0) continue;
-                var key = trimmed[..eqIdx].Trim();
-                var value = trimmed[(eqIdx + 1)..].Trim();
-                Environment.SetEnvironmentVariable(key, value);
-            }
-        }
-
-        var config = new ConfigurationBuilder().AddEnvironmentVariables().Build();
-        var apiKey = config["DEEPSEEK_API_KEY"] ?? "";
-        var baseUrl = (config["DEEPSEEK_BASE_URL"] ?? "https://api.deepseek.com/v1").TrimEnd('/') + "/";
-        var httpClient = new HttpClient { BaseAddress = new Uri(baseUrl), Timeout = TimeSpan.FromSeconds(120) };
-        httpClient.DefaultRequestHeaders.Authorization = new AuthenticationHeaderValue("Bearer", apiKey);
-        return new DeepSeekClient(httpClient, config);
-    }
-}
-
-/// <summary>SSE 事件模型</summary>
-public class SseEvent
-{
-    public string? Action { get; set; }
-    public object? Data { get; set; }
-    public string? Message { get; set; }
-}

backend/tests/Health.Tests/application_service_tests.cs

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

backend/tests/Health.Tests/persistence_pipeline_tests.cs

@@ -1,6 +1,11 @@
+using Health.Application.Medications;
+using Health.Domain.Entities;
+using Health.Domain.Enums;
 using Health.Infrastructure.AI;
 using Health.Infrastructure.Data;
 using Health.Infrastructure.Data.Records;
+using Health.Infrastructure.Medications;
+using Health.Infrastructure.Notifications;
 using Health.Infrastructure.Reports;
 using Microsoft.EntityFrameworkCore;
 
@@ -57,6 +62,112 @@ public sealed class PersistencePipelineTests
         Assert.Equal(2000, task.LastError!.Length);
     }
 
+    [Fact]
+    public async Task ReportTask_OnlyEnqueuesFailureNotificationAtFinalAttempt()
+    {
+        await using var db = CreateDbContext();
+        var userId = Guid.NewGuid();
+        var report = new Report
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            FileUrl = "report.jpg",
+            Status = ReportStatus.Analyzing,
+        };
+        var task = NewReportTask(attempts: 2);
+        task.ReportId = report.Id;
+        db.Reports.Add(report);
+        db.ReportAnalysisTasks.Add(task);
+        await db.SaveChangesAsync();
+        var queue = new EfReportAnalysisQueue(db, new EfUserNotificationProducer(db));
+
+        await queue.RetryAsync(task.Id, "temporary failure", CancellationToken.None);
+        Assert.Empty(db.NotificationOutbox);
+
+        task.Status = "Processing";
+        task.Attempts = 3;
+        await db.SaveChangesAsync();
+        await queue.RetryAsync(task.Id, "final failure", CancellationToken.None);
+
+        var notification = Assert.Single(db.NotificationOutbox);
+        Assert.Equal(task.Id, notification.SourceTaskId);
+        Assert.Equal("ReportAnalysisFailed", notification.Type);
+        Assert.Equal(userId, notification.UserId);
+    }
+
+    [Fact]
+    public async Task MedicationReminder_MorningDoseDoesNotSuppressEveningDose()
+    {
+        await using var db = CreateDbContext();
+        var userId = Guid.NewGuid();
+        var medicationId = Guid.NewGuid();
+        var scanTimeUtc = new DateTime(2026, 6, 20, 12, 2, 0, DateTimeKind.Utc);
+        db.Medications.Add(new Medication
+        {
+            Id = medicationId,
+            UserId = userId,
+            Name = "测试药物",
+            Frequency = MedicationFrequency.TwiceDaily,
+            TimeOfDay = [new TimeOnly(8, 0), new TimeOnly(20, 0)],
+            StartDate = new DateOnly(2026, 6, 20),
+            IsActive = true,
+        });
+        db.MedicationLogs.Add(new MedicationLog
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            MedicationId = medicationId,
+            Status = MedicationLogStatus.Taken,
+            ScheduledTime = new TimeOnly(8, 0),
+            ConfirmedAt = new DateTime(2026, 6, 20, 0, 1, 0, DateTimeKind.Utc),
+            CreatedAt = new DateTime(2026, 6, 20, 0, 1, 0, DateTimeKind.Utc),
+        });
+        await db.SaveChangesAsync();
+        var scanner = new MedicationReminderScanner(new EfMedicationRepository(db));
+
+        var tasks = await scanner.ScanAsync(scanTimeUtc, CancellationToken.None);
+
+        var reminder = Assert.Single(tasks);
+        Assert.Equal(new TimeOnly(20, 0), reminder.ScheduledTime);
+    }
+
+    [Fact]
+    public async Task MedicationReminder_ConfirmedDoseIsNotRemindedAgain()
+    {
+        await using var db = CreateDbContext();
+        var userId = Guid.NewGuid();
+        var medicationId = Guid.NewGuid();
+        var confirmedAt = new DateTime(2026, 6, 20, 12, 0, 0, DateTimeKind.Utc);
+        db.Medications.Add(new Medication
+        {
+            Id = medicationId,
+            UserId = userId,
+            Name = "测试药物",
+            Frequency = MedicationFrequency.Daily,
+            TimeOfDay = [new TimeOnly(20, 0)],
+            StartDate = new DateOnly(2026, 6, 20),
+            IsActive = true,
+        });
+        db.MedicationLogs.Add(new MedicationLog
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            MedicationId = medicationId,
+            Status = MedicationLogStatus.Taken,
+            ScheduledTime = new TimeOnly(20, 0),
+            ConfirmedAt = confirmedAt,
+            CreatedAt = confirmedAt,
+        });
+        await db.SaveChangesAsync();
+        var scanner = new MedicationReminderScanner(new EfMedicationRepository(db));
+
+        var tasks = await scanner.ScanAsync(
+            new DateTime(2026, 6, 20, 12, 2, 0, DateTimeKind.Utc),
+            CancellationToken.None);
+
+        Assert.Empty(tasks);
+    }
+
     private static ReportAnalysisTaskRecord NewReportTask(int attempts) => new()
     {
         Id = Guid.NewGuid(),

docs/project_deep_review.md

@@ -113,6 +113,8 @@ AI 问诊、饮食分析、报告解读是项目亮点，但要注意：
 
 ### 5.1 API 配置不适合真实移动端
 
+> 2026-06-20 更新：已支持 `--dart-define=API_BASE_URL=...`，并保留 `http://localhost:5000` 作为 USB `adb reverse` 本地开发默认值。本节的环境配置问题已处理。
+
 `health_app/lib/core/api_client.dart` 中 `baseUrl` 默认是 `http://localhost:5000`。这在 Android/iOS 真机上通常不可用，也不适合测试/生产环境切换。
 
 建议：
@@ -174,6 +176,8 @@ AI 问诊、饮食分析、报告解读是项目亮点，但要注意：
 
 ### 5.6 错误处理过于安静
 
+> 2026-06-20 更新：`ApiClient` 已统一识别 `{ code, message }` 业务错误及 HTTP/Dio 网络错误，并转换为可直接展示的 `ApiException`。后端历史 endpoint 的 HTTP 状态码仍需按模块逐步规范，避免一次性破坏现有前端协议。
+
 一些 provider 会 catch 异常后返回 fallback 数据，例如医生列表、运动计划。这个方式能让页面不崩，但会掩盖真实后端错误。
 
 建议：
@@ -481,6 +485,8 @@ static IQueryable<User> ScopePatientsToDoctor(AppDbContext db, Guid doctorId) =>
 
 ### 11.7 前端状态和生命周期问题
 
+> 2026-06-20 更新：健康最新值、用药列表、用药提醒、当前运动计划已改为 `autoDispose`；AI 确认写入后会同时刷新这些核心数据。报告和饮食使用各自 Notifier/页面加载流程，尚未强行合并成一个全局缓存。
+
 前端现在能跑起来，但长期运行会有状态残留风险：
 
 - `ConsultationChatNotifier` 里 Hub 和轮询 timer 需要自动释放。建议 `build()` 中调用 `ref.onDispose(stop)`。

health_app/lib/core/api_client.dart

@@ -3,8 +3,21 @@ import 'dart:io';
 import 'package:dio/dio.dart';
 import 'local_database.dart';
 
-/// API 基础地址
-const String baseUrl = 'http://localhost:5000';  // adb reverse 或同WiFi直连时改为PC的IP
+/// API 基础地址。可通过 --dart-define=API_BASE_URL=http://host:5000 覆盖。
+const String baseUrl = String.fromEnvironment(
+  'API_BASE_URL',
+  defaultValue: 'http://localhost:5000',
+);
+
+class ApiException implements Exception {
+  final int? code;
+  final String message;
+
+  const ApiException(this.message, {this.code});
+
+  @override
+  String toString() => message;
+}
 
 /// Dio HTTP 客户端封装——带 token 注入、401 自动刷新
 class ApiClient {
@@ -40,22 +53,22 @@ class ApiClient {
 
   /// 带 token 的 GET 请求
   Future<Response> get(String path, {Map<String, dynamic>? queryParameters}) async {
-    return _dio.get(path, queryParameters: queryParameters);
+    return _request(_dio.get(path, queryParameters: queryParameters));
   }
 
   /// 带 token 的 POST 请求
   Future<Response> post(String path, {dynamic data}) async {
-    return _dio.post(path, data: data);
+    return _request(_dio.post(path, data: data));
   }
 
   /// 带 token 的 PUT 请求
   Future<Response> put(String path, {dynamic data}) async {
-    return _dio.put(path, data: data);
+    return _request(_dio.put(path, data: data));
   }
 
   /// 带 token 的 DELETE 请求
   Future<Response> delete(String path) async {
-    return _dio.delete(path);
+    return _request(_dio.delete(path));
   }
 
   /// 上传文件（multipart），返回文件 URL
@@ -63,7 +76,7 @@ class ApiClient {
     final formData = FormData.fromMap({
       fieldName: await MultipartFile.fromFile(file.path, filename: file.path.split('/').last),
     });
-    final res = await _dio.post(path, data: formData);
+    final res = await _request(_dio.post(path, data: formData));
     final data = res.data;
     if (data is Map) {
       final topUrl = data['url']?.toString();
@@ -82,6 +95,46 @@ class ApiClient {
     }
     return null;
   }
+
+  Response _ensureBusinessSuccess(Response response) {
+    final body = response.data;
+    if (body is Map && body.containsKey('code')) {
+      final rawCode = body['code'];
+      final code = rawCode is int ? rawCode : int.tryParse('$rawCode');
+      if (code != null && code != 0) {
+        throw ApiException(
+          body['message']?.toString().trim().isNotEmpty == true
+              ? body['message'].toString()
+              : '请求失败',
+          code: code,
+        );
+      }
+    }
+    return response;
+  }
+
+  Future<Response> _request(Future<Response> request) async {
+    try {
+      return _ensureBusinessSuccess(await request);
+    } on DioException catch (error) {
+      final body = error.response?.data;
+      final message = body is Map && body['message']?.toString().trim().isNotEmpty == true
+          ? body['message'].toString()
+          : error.type == DioExceptionType.connectionTimeout ||
+                  error.type == DioExceptionType.receiveTimeout
+              ? '请求超时，请稍后重试'
+              : error.type == DioExceptionType.connectionError
+                  ? '无法连接服务器，请检查网络或后端地址'
+                  : '请求失败，请稍后重试';
+      final rawCode = body is Map ? body['code'] : null;
+      throw ApiException(
+        message,
+        code: rawCode is int
+            ? rawCode
+            : int.tryParse('$rawCode') ?? error.response?.statusCode,
+      );
+    }
+  }
 }
 
 /// 认证拦截器：自动注入 token + 401 刷新

health_app/lib/core/app_router.dart

@@ -12,6 +12,7 @@ import '../pages/report/ai_analysis_page.dart';
 import '../pages/consultation/consultation_pages.dart';
 import '../pages/settings/settings_pages.dart';
 import '../pages/settings/notification_prefs_page.dart';
+import '../pages/notifications/notification_center_page.dart';
 import '../pages/profile/profile_page.dart';
 import '../pages/diet/diet_capture_page.dart';
 import '../pages/device/device_scan_page.dart';
@@ -97,6 +98,8 @@ Widget buildPage(RouteInfo route, WidgetRef ref) {
       return const SettingsPage();
     case 'notificationPrefs':
       return const NotificationPrefsPage();
+    case 'notifications':
+      return const NotificationCenterPage();
     case 'staticText':
       return StaticTextPage(type: params['type']!);
     case 'dietDetail':

health_app/lib/pages/doctor/doctor_patient_detail_page.dart

@@ -121,7 +121,17 @@ class DoctorPatientDetailPage extends ConsumerWidget {
                 const SizedBox(height: 8),
                 if (archive['diagnosis'] != null)
                   _row('诊断', archive['diagnosis']),
-                if (archive['surgeryType'] != null)
+                if (archive['surgeries'] is List &&
+                    (archive['surgeries'] as List).isNotEmpty)
+                  _row(
+                    '手术史',
+                    (archive['surgeries'] as List).map((item) {
+                      final surgery = item as Map;
+                      final date = surgery['date']?.toString() ?? '';
+                      return '${surgery['type'] ?? ''}${date.isEmpty ? '' : ' $date'}';
+                    }).join('；'),
+                  )
+                else if (archive['surgeryType'] != null)
                   _row(
                     '手术史',
                     '${archive['surgeryType']} ${archive['surgeryDate'] ?? ''}',

health_app/lib/pages/home/home_page.dart

@@ -12,7 +12,6 @@ import '../../providers/auth_provider.dart';
 import '../../providers/chat_provider.dart';
 import '../../providers/data_providers.dart';
 import '../../widgets/health_drawer.dart';
-import '../../services/in_app_notification_service.dart';
 import '../diet/diet_capture_page.dart';
 import 'widgets/chat_messages_view.dart';
 
@@ -29,15 +28,16 @@ class _HomePageState extends ConsumerState<HomePage> {
   String? _pickedImagePath;
   int _lastMsgCount = 0;
   Timer? _notificationTimer;
-  bool _checkingNotifications = false;
 
   @override
   void initState() {
     super.initState();
-    WidgetsBinding.instance.addPostFrameCallback((_) => _checkNotifications());
+    WidgetsBinding.instance.addPostFrameCallback(
+      (_) => ref.invalidate(notificationUnreadCountProvider),
+    );
     _notificationTimer = Timer.periodic(
       const Duration(seconds: 30),
-      (_) => _checkNotifications(),
+      (_) => ref.invalidate(notificationUnreadCountProvider),
     );
   }
 
@@ -50,52 +50,6 @@ class _HomePageState extends ConsumerState<HomePage> {
     super.dispose();
   }
 
-  Future<void> _checkNotifications() async {
-    if (!mounted || _checkingNotifications) return;
-    if (!ref.read(authProvider).isLoggedIn) return;
-    _checkingNotifications = true;
-    try {
-      final service = InAppNotificationService(ref.read(apiClientProvider));
-      final notifications = await service.getPending();
-      for (final notification in notifications) {
-        if (!mounted) return;
-        ScaffoldMessenger.of(context).showSnackBar(
-          SnackBar(
-            behavior: SnackBarBehavior.floating,
-            duration: const Duration(seconds: 5),
-            content: Row(
-              children: [
-                Icon(
-                  notification.type == 'ExerciseReminder'
-                      ? Icons.directions_run_outlined
-                      : Icons.medication_outlined,
-                  color: Colors.white,
-                ),
-                const SizedBox(width: 12),
-                Expanded(
-                  child: Column(
-                    mainAxisSize: MainAxisSize.min,
-                    crossAxisAlignment: CrossAxisAlignment.start,
-                    children: [
-                      Text(notification.title,
-                          style: const TextStyle(fontWeight: FontWeight.w700)),
-                      Text(notification.message),
-                    ],
-                  ),
-                ),
-              ],
-            ),
-          ),
-        );
-        await service.acknowledge(notification.id);
-      }
-    } catch (_) {
-      // App 内提醒失败不阻断主页使用，下次轮询会重试。
-    } finally {
-      _checkingNotifications = false;
-    }
-  }
-
   void _sendMessage() {
     final text = _textCtrl.text.trim();
     final imagePath = _pickedImagePath;
@@ -169,6 +123,7 @@ class _HomePageState extends ConsumerState<HomePage> {
     final name = (user?.name != null && user!.name!.isNotEmpty)
         ? user.name
         : '用户';
+    final unreadCount = ref.watch(notificationUnreadCountProvider).value ?? 0;
     return Container(
       padding: const EdgeInsets.fromLTRB(14, 10, 14, 10),
       decoration: BoxDecoration(
@@ -221,7 +176,8 @@ class _HomePageState extends ConsumerState<HomePage> {
           ),
           _HeaderIconButton(
             icon: LucideIcons.bell,
-            onTap: () => pushRoute(ref, 'notificationPrefs'),
+            badgeCount: unreadCount,
+            onTap: () => pushRoute(ref, 'notifications'),
           ),
         ],
       ),
@@ -565,13 +521,21 @@ class _HomePageState extends ConsumerState<HomePage> {
 class _HeaderIconButton extends StatelessWidget {
   final IconData icon;
   final VoidCallback onTap;
-  const _HeaderIconButton({required this.icon, required this.onTap});
+  final int badgeCount;
+  const _HeaderIconButton({
+    required this.icon,
+    required this.onTap,
+    this.badgeCount = 0,
+  });
 
   @override
   Widget build(BuildContext context) {
     return GestureDetector(
       onTap: onTap,
-      child: Container(
+      child: Stack(
+        clipBehavior: Clip.none,
+        children: [
+          Container(
             width: 38,
             height: 38,
             decoration: BoxDecoration(
@@ -582,6 +546,31 @@ class _HeaderIconButton extends StatelessWidget {
             ),
             child: Icon(icon, size: 20, color: AppColors.textPrimary),
           ),
+          if (badgeCount > 0)
+            Positioned(
+              right: -5,
+              top: -5,
+              child: Container(
+                constraints: const BoxConstraints(minWidth: 18, minHeight: 18),
+                padding: const EdgeInsets.symmetric(horizontal: 4),
+                decoration: BoxDecoration(
+                  color: AppColors.error,
+                  borderRadius: BorderRadius.circular(10),
+                  border: Border.all(color: Colors.white, width: 2),
+                ),
+                alignment: Alignment.center,
+                child: Text(
+                  badgeCount > 99 ? '99+' : '$badgeCount',
+                  style: const TextStyle(
+                    color: Colors.white,
+                    fontSize: 10,
+                    fontWeight: FontWeight.w800,
+                  ),
+                ),
+              ),
+            ),
+        ],
+      ),
     );
   }
 }

health_app/lib/pages/home/widgets/chat_messages_view.dart

@@ -1464,13 +1464,13 @@ class ChatMessagesView extends ConsumerWidget {
         ? '${bp['systolic'] ?? '--'}/${bp['diastolic'] ?? '--'}'
         : null;
     final hr = healthData['HeartRate'];
-    final hrText = hr is int ? '$hr' : null;
-    final bs = healthData['BloodSugar'];
-    final bsText = bs is num ? '$bs' : null;
-    final bo = healthData['BloodOxygen'];
-    final boText = bo is num ? '$bo' : null;
+    final hrText = hr is Map && hr['value'] is num ? '${hr['value']}' : null;
+    final bs = healthData['Glucose'];
+    final bsText = bs is Map && bs['value'] is num ? '${bs['value']}' : null;
+    final bo = healthData['SpO2'];
+    final boText = bo is Map && bo['value'] is num ? '${bo['value']}' : null;
     final wt = healthData['Weight'];
-    final wtText = wt is num ? '$wt' : null;
+    final wtText = wt is Map && wt['value'] is num ? '${wt['value']}' : null;
     final allNull =
         bpText == null &&
         hrText == null &&

health_app/lib/pages/medication/medication_checkin_page.dart

@@ -5,6 +5,7 @@ import '../../core/navigation_provider.dart';
 import 'package:flutter_riverpod/flutter_riverpod.dart';
 import '../../providers/auth_provider.dart';
 import '../../providers/data_providers.dart';
+import '../../widgets/app_error_state.dart';
 
 class MedicationCheckInPage extends ConsumerStatefulWidget {
   final String? medId; // 可选：指定药品，null 显示全部
@@ -43,6 +44,9 @@ class _MedicationCheckInPageState extends ConsumerState<MedicationCheckInPage> {
           if (snap.connectionState == ConnectionState.waiting) {
             return const Center(child: CircularProgressIndicator(color: AppTheme.primary));
           }
+          if (snap.hasError) {
+            return AppErrorState(title: '用药信息加载失败', onRetry: _load);
+          }
           final reminders = snap.data ?? [];
           if (reminders.isEmpty) {
             return Center(

health_app/lib/pages/medication/medication_list_page.dart

@@ -5,6 +5,7 @@ import '../../core/app_theme.dart';
 import '../../core/navigation_provider.dart';
 import '../../providers/data_providers.dart';
 import '../../widgets/app_empty_state.dart';
+import '../../widgets/app_future_view.dart';
 import '../../widgets/common_widgets.dart';
 
 class MedicationListPage extends ConsumerStatefulWidget {
@@ -85,10 +86,11 @@ class _MedicationListPageState extends ConsumerState<MedicationListPage>
       ),
       body: Container(
         decoration: const BoxDecoration(gradient: AppColors.bgGradient),
-        child: FutureBuilder<List<Map<String, dynamic>>>(
+        child: AppFutureView<List<Map<String, dynamic>>>(
           future: _future,
-          builder: (ctx, snap) {
-            final list = snap.data ?? [];
+          onRetry: _load,
+          errorTitle: '用药信息加载失败',
+          onData: (ctx, list) {
             if (list.isEmpty) {
               return const AppEmptyState(
                 icon: Icons.medication_outlined,

health_app/lib/pages/notifications/notification_center_page.dart

@@ -0,0 +1,593 @@
+import 'package:flutter/material.dart';
+import 'package:flutter_riverpod/flutter_riverpod.dart';
+import 'package:shadcn_ui/shadcn_ui.dart';
+
+import '../../core/app_colors.dart';
+import '../../core/app_theme.dart';
+import '../../core/navigation_provider.dart';
+import '../../providers/data_providers.dart';
+import '../../services/in_app_notification_service.dart';
+
+class NotificationCenterPage extends ConsumerStatefulWidget {
+  const NotificationCenterPage({super.key});
+
+  @override
+  ConsumerState<NotificationCenterPage> createState() =>
+      _NotificationCenterPageState();
+}
+
+class _NotificationCenterPageState
+    extends ConsumerState<NotificationCenterPage> {
+  InAppNotificationHistory? _history;
+  bool _loading = true;
+  bool _markingAll = false;
+  String? _error;
+
+  InAppNotificationService get _service =>
+      ref.read(inAppNotificationServiceProvider);
+
+  @override
+  void initState() {
+    super.initState();
+    Future.microtask(_load);
+  }
+
+  Future<void> _load() async {
+    if (mounted) {
+      setState(() {
+        _loading = true;
+        _error = null;
+      });
+    }
+    try {
+      final history = await _service.getHistory();
+      if (!mounted) return;
+      setState(() {
+        _history = history;
+        _loading = false;
+      });
+      ref.invalidate(notificationUnreadCountProvider);
+    } catch (error) {
+      if (mounted) {
+        setState(() {
+          _error = '$error';
+          _loading = false;
+        });
+      }
+    }
+  }
+
+  Future<void> _open(InAppNotification item) async {
+    if (!item.isRead) {
+      await _service.acknowledge(item.id);
+      if (!mounted) return;
+      setState(() {
+        final current = _history;
+        if (current == null) return;
+        _history = InAppNotificationHistory(
+          unreadCount: (current.unreadCount - 1).clamp(0, current.unreadCount),
+          items: current.items
+              .map(
+                (value) =>
+                    value.id == item.id ? value.copyWith(isRead: true) : value,
+              )
+              .toList(),
+        );
+      });
+      ref.invalidate(notificationUnreadCountProvider);
+    }
+
+    if (!mounted || item.actionType == null) return;
+    switch (item.actionType) {
+      case 'medication':
+        pushRoute(ref, 'medCheckIn', params: {'id': item.actionTargetId ?? ''});
+        return;
+      case 'exercise':
+        pushRoute(ref, 'exercisePlan');
+        return;
+      case 'health':
+        pushRoute(ref, 'trend', params: {'type': item.actionTargetId ?? ''});
+        return;
+      case 'report':
+        final reportId = item.actionTargetId;
+        if (reportId != null && reportId.isNotEmpty) {
+          pushRoute(ref, 'aiAnalysis', params: {'id': reportId});
+        }
+        return;
+    }
+  }
+
+  Future<void> _markAllRead() async {
+    if (_markingAll || (_history?.unreadCount ?? 0) == 0) return;
+    setState(() => _markingAll = true);
+    try {
+      await _service.markAllRead();
+      if (!mounted) return;
+      final current = _history;
+      if (current != null) {
+        setState(
+          () => _history = InAppNotificationHistory(
+            unreadCount: 0,
+            items: current.items
+                .map((item) => item.copyWith(isRead: true))
+                .toList(),
+          ),
+        );
+      }
+      ref.invalidate(notificationUnreadCountProvider);
+    } finally {
+      if (mounted) setState(() => _markingAll = false);
+    }
+  }
+
+  Future<void> _delete(InAppNotification item) async {
+    try {
+      await _service.delete(item.id);
+      if (!mounted) return;
+      final current = _history;
+      if (current != null) {
+        setState(
+          () => _history = InAppNotificationHistory(
+            unreadCount: item.isRead
+                ? current.unreadCount
+                : (current.unreadCount - 1).clamp(0, current.unreadCount),
+            items: current.items.where((value) => value.id != item.id).toList(),
+          ),
+        );
+      }
+      ref.invalidate(notificationUnreadCountProvider);
+    } catch (_) {
+      if (mounted) await _load();
+    }
+  }
+
+  @override
+  Widget build(BuildContext context) {
+    final items = _history?.items ?? const <InAppNotification>[];
+    return Scaffold(
+      body: AppBackground(
+        safeArea: true,
+        child: Column(
+          children: [
+            _Header(
+              unreadCount: _history?.unreadCount ?? 0,
+              markingAll: _markingAll,
+              onBack: () => popRoute(ref),
+              onMarkAllRead: _markAllRead,
+            ),
+            Expanded(
+              child: RefreshIndicator(
+                onRefresh: _load,
+                color: const Color(0xFF438CE1),
+                child: _buildBody(items),
+              ),
+            ),
+          ],
+        ),
+      ),
+    );
+  }
+
+  Widget _buildBody(List<InAppNotification> items) {
+    if (_loading) {
+      return const Center(child: CircularProgressIndicator());
+    }
+    if (_error != null) {
+      return _MessageState(
+        icon: LucideIcons.wifiOff,
+        title: '通知加载失败',
+        message: '请检查网络连接后重试',
+        buttonText: '重新加载',
+        onPressed: _load,
+      );
+    }
+    if (items.isEmpty) {
+      return const _MessageState(
+        icon: LucideIcons.bellOff,
+        title: '暂时没有通知',
+        message: '用药、运动、健康指标和报告消息会显示在这里',
+      );
+    }
+
+    final today = <InAppNotification>[];
+    final earlier = <InAppNotification>[];
+    final now = DateTime.now();
+    for (final item in items) {
+      final local = item.createdAt.toLocal();
+      final isToday =
+          local.year == now.year &&
+          local.month == now.month &&
+          local.day == now.day;
+      (isToday ? today : earlier).add(item);
+    }
+
+    return ListView(
+      physics: const AlwaysScrollableScrollPhysics(),
+      padding: const EdgeInsets.fromLTRB(16, 6, 16, 32),
+      children: [
+        if (today.isNotEmpty) ...[
+          const _SectionTitle('今天'),
+          ...today.map(_buildDismissible),
+        ],
+        if (earlier.isNotEmpty) ...[
+          const SizedBox(height: 10),
+          const _SectionTitle('更早'),
+          ...earlier.map(_buildDismissible),
+        ],
+      ],
+    );
+  }
+
+  Widget _buildDismissible(InAppNotification item) => Padding(
+    padding: const EdgeInsets.only(bottom: 10),
+    child: Dismissible(
+      key: ValueKey(item.id),
+      direction: DismissDirection.endToStart,
+      background: Container(
+        alignment: Alignment.centerRight,
+        padding: const EdgeInsets.only(right: 24),
+        decoration: BoxDecoration(
+          color: AppColors.error,
+          borderRadius: BorderRadius.circular(18),
+        ),
+        child: const Icon(LucideIcons.trash2, color: Colors.white),
+      ),
+      onDismissed: (_) => _delete(item),
+      child: _NotificationCard(item: item, onTap: () => _open(item)),
+    ),
+  );
+}
+
+class _Header extends StatelessWidget {
+  final int unreadCount;
+  final bool markingAll;
+  final VoidCallback onBack;
+  final VoidCallback onMarkAllRead;
+
+  const _Header({
+    required this.unreadCount,
+    required this.markingAll,
+    required this.onBack,
+    required this.onMarkAllRead,
+  });
+
+  @override
+  Widget build(BuildContext context) => Padding(
+    padding: const EdgeInsets.fromLTRB(8, 8, 12, 10),
+    child: Row(
+      children: [
+        IconButton(
+          tooltip: '返回',
+          onPressed: onBack,
+          icon: const Icon(LucideIcons.chevronLeft),
+        ),
+        const SizedBox(width: 2),
+        Expanded(
+          child: Column(
+            crossAxisAlignment: CrossAxisAlignment.start,
+            children: [
+              const Text(
+                '通知中心',
+                style: TextStyle(
+                  fontSize: 21,
+                  fontWeight: FontWeight.w800,
+                  color: AppColors.textPrimary,
+                ),
+              ),
+              const SizedBox(height: 2),
+              Text(
+                unreadCount == 0 ? '所有消息均已读' : '$unreadCount 条未读消息',
+                style: const TextStyle(
+                  fontSize: 12,
+                  color: AppColors.textSecondary,
+                ),
+              ),
+            ],
+          ),
+        ),
+        if (unreadCount > 0)
+          TextButton.icon(
+            onPressed: markingAll ? null : onMarkAllRead,
+            icon: markingAll
+                ? const SizedBox(
+                    width: 14,
+                    height: 14,
+                    child: CircularProgressIndicator(strokeWidth: 2),
+                  )
+                : const Icon(LucideIcons.checkCheck, size: 17),
+            label: const Text('全部已读'),
+          ),
+      ],
+    ),
+  );
+}
+
+class _SectionTitle extends StatelessWidget {
+  final String text;
+  const _SectionTitle(this.text);
+
+  @override
+  Widget build(BuildContext context) => Padding(
+    padding: const EdgeInsets.fromLTRB(4, 6, 4, 10),
+    child: Text(
+      text,
+      style: const TextStyle(
+        fontSize: 13,
+        fontWeight: FontWeight.w700,
+        color: AppColors.textSecondary,
+      ),
+    ),
+  );
+}
+
+class _NotificationCard extends StatelessWidget {
+  final InAppNotification item;
+  final VoidCallback onTap;
+
+  const _NotificationCard({required this.item, required this.onTap});
+
+  @override
+  Widget build(BuildContext context) {
+    final visual = _NotificationVisual.of(item);
+    return Material(
+      color: item.isRead
+          ? Colors.white.withValues(alpha: 0.72)
+          : Colors.white.withValues(alpha: 0.96),
+      borderRadius: BorderRadius.circular(18),
+      elevation: item.isRead ? 0 : 1,
+      shadowColor: visual.color.withValues(alpha: 0.12),
+      child: InkWell(
+        onTap: onTap,
+        borderRadius: BorderRadius.circular(18),
+        child: Container(
+          padding: const EdgeInsets.all(14),
+          decoration: BoxDecoration(
+            borderRadius: BorderRadius.circular(18),
+            border: Border.all(
+              color: item.isRead
+                  ? const Color(0xFFE9EEF5)
+                  : visual.color.withValues(alpha: 0.18),
+            ),
+          ),
+          child: Row(
+            crossAxisAlignment: CrossAxisAlignment.start,
+            children: [
+              Container(
+                width: 46,
+                height: 46,
+                decoration: BoxDecoration(
+                  gradient: LinearGradient(
+                    begin: Alignment.topLeft,
+                    end: Alignment.bottomRight,
+                    colors: [visual.lightColor, Colors.white],
+                  ),
+                  borderRadius: BorderRadius.circular(14),
+                ),
+                child: Icon(visual.icon, size: 22, color: visual.color),
+              ),
+              const SizedBox(width: 12),
+              Expanded(
+                child: Column(
+                  crossAxisAlignment: CrossAxisAlignment.start,
+                  children: [
+                    Row(
+                      children: [
+                        Expanded(
+                          child: Text(
+                            item.title,
+                            style: TextStyle(
+                              fontSize: 15,
+                              fontWeight: item.isRead
+                                  ? FontWeight.w600
+                                  : FontWeight.w800,
+                              color: AppColors.textPrimary,
+                            ),
+                          ),
+                        ),
+                        if (!item.isRead)
+                          Container(
+                            width: 8,
+                            height: 8,
+                            decoration: BoxDecoration(
+                              color: visual.color,
+                              shape: BoxShape.circle,
+                              boxShadow: [
+                                BoxShadow(
+                                  color: visual.color.withValues(alpha: 0.3),
+                                  blurRadius: 5,
+                                ),
+                              ],
+                            ),
+                          ),
+                      ],
+                    ),
+                    const SizedBox(height: 5),
+                    Text(
+                      item.message,
+                      style: const TextStyle(
+                        fontSize: 13,
+                        height: 1.45,
+                        color: AppColors.textSecondary,
+                      ),
+                    ),
+                    const SizedBox(height: 9),
+                    Row(
+                      children: [
+                        Text(
+                          _formatTime(item.createdAt),
+                          style: const TextStyle(
+                            fontSize: 11,
+                            color: AppColors.textHint,
+                          ),
+                        ),
+                        const Spacer(),
+                        if (item.actionType != null)
+                          Row(
+                            children: [
+                              Text(
+                                '查看详情',
+                                style: TextStyle(
+                                  fontSize: 12,
+                                  fontWeight: FontWeight.w600,
+                                  color: visual.color,
+                                ),
+                              ),
+                              const SizedBox(width: 2),
+                              Icon(
+                                LucideIcons.chevronRight,
+                                size: 14,
+                                color: visual.color,
+                              ),
+                            ],
+                          ),
+                      ],
+                    ),
+                  ],
+                ),
+              ),
+            ],
+          ),
+        ),
+      ),
+    );
+  }
+
+  static String _formatTime(DateTime value) {
+    final local = value.toLocal();
+    final now = DateTime.now();
+    final time =
+        '${local.hour.toString().padLeft(2, '0')}:'
+        '${local.minute.toString().padLeft(2, '0')}';
+    if (local.year == now.year &&
+        local.month == now.month &&
+        local.day == now.day) {
+      return time;
+    }
+    if (local.year == now.year) return '${local.month}月${local.day}日 $time';
+    return '${local.year}年${local.month}月${local.day}日 $time';
+  }
+}
+
+class _NotificationVisual {
+  final IconData icon;
+  final Color color;
+  final Color lightColor;
+
+  const _NotificationVisual(this.icon, this.color, this.lightColor);
+
+  factory _NotificationVisual.of(InAppNotification item) {
+    switch (item.actionType) {
+      case 'exercise':
+        return const _NotificationVisual(
+          LucideIcons.activity,
+          Color(0xFF2C9A70),
+          Color(0xFFDDF7EC),
+        );
+      case 'health':
+        if (item.severity == 'critical') {
+          return const _NotificationVisual(
+            LucideIcons.triangleAlert,
+            Color(0xFFE55353),
+            Color(0xFFFFE7E7),
+          );
+        }
+        return const _NotificationVisual(
+          LucideIcons.heartPulse,
+          Color(0xFFE8863A),
+          Color(0xFFFFEEDC),
+        );
+      case 'report':
+        if (item.severity == 'error') {
+          return const _NotificationVisual(
+            LucideIcons.fileWarning,
+            Color(0xFFE55353),
+            Color(0xFFFFE7E7),
+          );
+        }
+        return const _NotificationVisual(
+          LucideIcons.fileCheck2,
+          Color(0xFF7B68CE),
+          Color(0xFFEDE9FF),
+        );
+      default:
+        return const _NotificationVisual(
+          LucideIcons.pill,
+          Color(0xFF468AD8),
+          Color(0xFFE4F0FF),
+        );
+    }
+  }
+}
+
+class _MessageState extends StatelessWidget {
+  final IconData icon;
+  final String title;
+  final String message;
+  final String? buttonText;
+  final VoidCallback? onPressed;
+
+  const _MessageState({
+    required this.icon,
+    required this.title,
+    required this.message,
+    this.buttonText,
+    this.onPressed,
+  });
+
+  @override
+  Widget build(BuildContext context) => ListView(
+    physics: const AlwaysScrollableScrollPhysics(),
+    padding: const EdgeInsets.fromLTRB(28, 120, 28, 32),
+    children: [
+      Container(
+        padding: const EdgeInsets.symmetric(horizontal: 24, vertical: 34),
+        decoration: BoxDecoration(
+          gradient: LinearGradient(
+            colors: [
+              Colors.white.withValues(alpha: 0.95),
+              const Color(0xFFF1F7FF).withValues(alpha: 0.9),
+            ],
+          ),
+          borderRadius: BorderRadius.circular(24),
+          border: Border.all(color: const Color(0xFFE5EDF7)),
+        ),
+        child: Column(
+          children: [
+            Container(
+              width: 64,
+              height: 64,
+              decoration: BoxDecoration(
+                color: const Color(0xFFE5F0FF),
+                borderRadius: BorderRadius.circular(20),
+              ),
+              child: Icon(icon, size: 29, color: const Color(0xFF5D91CF)),
+            ),
+            const SizedBox(height: 18),
+            Text(
+              title,
+              style: const TextStyle(
+                fontSize: 17,
+                fontWeight: FontWeight.w800,
+                color: AppColors.textPrimary,
+              ),
+            ),
+            const SizedBox(height: 7),
+            Text(
+              message,
+              textAlign: TextAlign.center,
+              style: const TextStyle(
+                fontSize: 13,
+                height: 1.5,
+                color: AppColors.textSecondary,
+              ),
+            ),
+            if (buttonText != null) ...[
+              const SizedBox(height: 20),
+              FilledButton(onPressed: onPressed, child: Text(buttonText!)),
+            ],
+          ],
+        ),
+      ),
+    ],
+  );
+}

health_app/lib/pages/remaining_pages.dart

@@ -6,6 +6,8 @@ import '../core/navigation_provider.dart';
 import '../providers/auth_provider.dart';
 import '../providers/data_providers.dart';
 import '../widgets/common_widgets.dart';
+import '../widgets/app_error_state.dart';
+import '../widgets/app_future_view.dart';
 
 /// 饮食记录列表（趋势+日历+胶囊详情+侧滑编辑删除）
 class DietRecordListPage extends ConsumerStatefulWidget {
@@ -722,10 +724,11 @@ class _ExercisePlanPageState extends ConsumerState<ExercisePlanPage> {
       ),
       body: Container(
         decoration: const BoxDecoration(gradient: AppColors.bgGradient),
-        child: FutureBuilder<List<Map<String, dynamic>>>(
+        child: AppFutureView<List<Map<String, dynamic>>>(
           future: _future,
-          builder: (ctx, snap) {
-            final plans = snap.data ?? [];
+          onRetry: _load,
+          errorTitle: '运动计划加载失败',
+          onData: (ctx, plans) {
             if (plans.isEmpty) return _empty(context, '运动计划', '暂无计划，点击右下角新建');
             return ListView.builder(
               padding: const EdgeInsets.all(12),
@@ -1083,6 +1086,9 @@ class _FollowUpListPageState extends ConsumerState<FollowUpListPage> {
               child: CircularProgressIndicator(color: AppTheme.primaryLight),
             );
           }
+          if (snap.hasError) {
+            return AppErrorState(title: '随访加载失败', onRetry: _load);
+          }
           final list = snap.data ?? [];
           if (list.isEmpty) {
             return Center(
@@ -1288,11 +1294,19 @@ class _HealthArchivePageState extends ConsumerState<HealthArchivePage> {
       final a = await srv.getHealthArchive();
       if (a != null && mounted) {
         _diagnosisCtrl.text = a['diagnosis'] ?? '';
+        final surgeries = a['surgeries'] as List?;
+        if (surgeries != null && surgeries.isNotEmpty) {
+          _surgeries.addAll(surgeries.whereType<Map>().map((item) => {
+            'type': item['type']?.toString() ?? '',
+            'date': item['date']?.toString() ?? '',
+          }));
+        } else {
           final st = a['surgeryType'] as String?;
           final sd = a['surgeryDate'] as String?;
           if (st != null && st.isNotEmpty) {
             _surgeries.add({'type': st, 'date': sd ?? ''});
           }
+        }
         _allergiesCtrl.text = (a['allergies'] as List?)?.join('、') ?? '';
         _chronicCtrl.text = (a['chronicDiseases'] as List?)?.join('、') ?? '';
         _dietCtrl.text = (a['dietRestrictions'] as List?)?.join('、') ?? '';
@@ -1333,18 +1347,19 @@ class _HealthArchivePageState extends ConsumerState<HealthArchivePage> {
         gender: _genderCtrl.text,
         birthDate: _birthDate,
       );
-      final surgeryType = _surgeries
-          .map((s) => s['type'] ?? '')
-          .where((s) => s.isNotEmpty)
-          .join('、');
-      final surgeryDate = _surgeries
-          .map((s) => s['date'] ?? '')
-          .where((s) => s.isNotEmpty)
-          .join('、');
+      final surgeries = _surgeries
+          .where((s) => (s['type'] ?? '').trim().isNotEmpty)
+          .map((s) => {
+                'type': s['type']!.trim(),
+                'date': (s['date'] ?? '').trim().isEmpty ? null : s['date']!.trim(),
+              })
+          .toList();
+      final firstSurgery = surgeries.isEmpty ? null : surgeries.first;
       await srv.updateHealthArchive({
         'diagnosis': _diagnosisCtrl.text,
-        'surgeryType': surgeryType,
-        'surgeryDate': surgeryDate,
+        'surgeryType': firstSurgery?['type'],
+        'surgeryDate': firstSurgery?['date'],
+        'surgeries': surgeries,
         'allergies': _allergiesCtrl.text
             .split('、')
             .where((s) => s.isNotEmpty)
@@ -1359,6 +1374,7 @@ class _HealthArchivePageState extends ConsumerState<HealthArchivePage> {
             .toList(),
         'familyHistory': _familyCtrl.text,
       });
+      await ref.read(authProvider.notifier).refreshProfile();
       if (mounted) {
         ScaffoldMessenger.of(context).showSnackBar(
           const SnackBar(

health_app/lib/providers/auth_provider.dart

@@ -85,6 +85,8 @@ class AuthNotifier extends Notifier<AuthState> {
     }
   }
 
+  Future<void> refreshProfile() => _loadProfile();
+
   /// 发送验证码
   Future<({String? error, String? devCode})> sendSms(String phone) async {
     try {

health_app/lib/providers/chat_provider.dart

@@ -119,7 +119,9 @@ class ChatNotifier extends Notifier<ChatState> {
     msgs[i].confirmed = true;
     state = state.copyWith(messages: msgs);
     ref.invalidate(medicationListProvider);
+    ref.invalidate(medicationReminderProvider);
     ref.invalidate(latestHealthProvider);
+    ref.invalidate(currentExercisePlanProvider);
     return null;
   }
 

health_app/lib/providers/data_providers.dart

@@ -2,6 +2,7 @@ import 'package:flutter_riverpod/flutter_riverpod.dart';
 import 'auth_provider.dart';
 import '../services/health_service.dart';
 import '../services/admin_service.dart';
+import '../services/in_app_notification_service.dart';
 
 final exerciseServiceProvider = Provider<ExerciseService>((ref) {
   return ExerciseService(ref.watch(apiClientProvider));
@@ -36,8 +37,25 @@ final adminServiceProvider = Provider<AdminService>((ref) {
   return AdminService(ref.watch(apiClientProvider));
 });
 
+final inAppNotificationServiceProvider = Provider<InAppNotificationService>((
+  ref,
+) {
+  return InAppNotificationService(ref.watch(apiClientProvider));
+});
+
+final notificationUnreadCountProvider = FutureProvider.autoDispose<int>((
+  ref,
+) async {
+  final history = await ref
+      .watch(inAppNotificationServiceProvider)
+      .getHistory();
+  return history.unreadCount;
+});
+
 /// 最新健康数据 Provider
-final latestHealthProvider = FutureProvider<Map<String, dynamic>>((ref) async {
+final latestHealthProvider = FutureProvider.autoDispose<Map<String, dynamic>>((
+  ref,
+) async {
   final service = ref.watch(healthServiceProvider);
   return service.getLatest();
 });
@@ -49,48 +67,61 @@ void refreshHealthData(WidgetRef ref) {
 }
 
 /// 用药列表 Provider
-final medicationListProvider = FutureProvider<List<Map<String, dynamic>>>((ref) async {
+final medicationListProvider =
+    FutureProvider.autoDispose<List<Map<String, dynamic>>>((ref) async {
       final service = ref.watch(medicationServiceProvider);
       return service.getList();
     });
 
-final medicationReminderProvider = FutureProvider<List<Map<String, dynamic>>>((ref) async {
+final medicationReminderProvider =
+    FutureProvider.autoDispose<List<Map<String, dynamic>>>((ref) async {
       final service = ref.watch(medicationServiceProvider);
       return service.getReminders();
     });
 
 /// 医生列表 Provider
-final doctorListProvider = FutureProvider<List<Map<String, dynamic>>>((ref) async {
+final doctorListProvider = FutureProvider<List<Map<String, dynamic>>>((
+  ref,
+) async {
   final service = ref.watch(consultationServiceProvider);
   return service.getDoctors().timeout(const Duration(seconds: 8));
 });
 
 /// 问诊配额 Provider
-final consultationQuotaProvider = FutureProvider<Map<String, dynamic>>((ref) async {
+final consultationQuotaProvider = FutureProvider<Map<String, dynamic>>((
+  ref,
+) async {
   final service = ref.watch(consultationServiceProvider);
   return service.getQuota();
 });
 
 /// 当前运动计划 Provider
-final currentExercisePlanProvider = FutureProvider<Map<String, dynamic>?>((ref) async {
+final currentExercisePlanProvider =
+    FutureProvider.autoDispose<Map<String, dynamic>?>((ref) async {
       final service = ref.watch(exerciseServiceProvider);
       return service.getCurrentPlan().timeout(const Duration(seconds: 8));
     });
 
 /// 拍照/相册直接触发（无需跳转页面）
-final cameraActionProvider = NotifierProvider<CameraActionNotifier, String?>(CameraActionNotifier.new);
+final cameraActionProvider = NotifierProvider<CameraActionNotifier, String?>(
+  CameraActionNotifier.new,
+);
 
 class CameraActionNotifier extends Notifier<String?> {
-  @override String? build() => null;
+  @override
+  String? build() => null;
   void trigger(String action) => state = action;
   void clear() => state = null;
 }
 
 /// 拍饮食动作触发（不用跳多余页面）
-final dietActionProvider = NotifierProvider<DietActionNotifier, String?>(DietActionNotifier.new);
+final dietActionProvider = NotifierProvider<DietActionNotifier, String?>(
+  DietActionNotifier.new,
+);
 
 class DietActionNotifier extends Notifier<String?> {
-  @override String? build() => null;
+  @override
+  String? build() => null;
   void trigger(String action) => state = action;
   void clear() => state = null;
 }

health_app/lib/services/in_app_notification_service.dart

@@ -5,12 +5,22 @@ class InAppNotification {
   final String type;
   final String title;
   final String message;
+  final String severity;
+  final String? actionType;
+  final String? actionTargetId;
+  final bool isRead;
+  final DateTime createdAt;
 
   const InAppNotification({
     required this.id,
     required this.type,
     required this.title,
     required this.message,
+    required this.severity,
+    this.actionType,
+    this.actionTargetId,
+    required this.isRead,
+    required this.createdAt,
   });
 
   factory InAppNotification.fromJson(Map<String, dynamic> json) =>
@@ -19,7 +29,36 @@ class InAppNotification {
         type: json['type']?.toString() ?? '',
         title: json['title']?.toString() ?? '健康提醒',
         message: json['message']?.toString() ?? '',
+        severity: json['severity']?.toString() ?? 'info',
+        actionType: json['actionType']?.toString(),
+        actionTargetId: json['actionTargetId']?.toString(),
+        isRead: json['isRead'] == true,
+        createdAt:
+            DateTime.tryParse(json['createdAt']?.toString() ?? '') ??
+            DateTime.now(),
       );
+
+  InAppNotification copyWith({bool? isRead}) => InAppNotification(
+    id: id,
+    type: type,
+    title: title,
+    message: message,
+    severity: severity,
+    actionType: actionType,
+    actionTargetId: actionTargetId,
+    isRead: isRead ?? this.isRead,
+    createdAt: createdAt,
+  );
+}
+
+class InAppNotificationHistory {
+  final int unreadCount;
+  final List<InAppNotification> items;
+
+  const InAppNotificationHistory({
+    required this.unreadCount,
+    required this.items,
+  });
 }
 
 class InAppNotificationService {
@@ -32,7 +71,9 @@ class InAppNotificationService {
     final items = response.data['data'] as List? ?? const [];
     return items
         .whereType<Map>()
-        .map((item) => InAppNotification.fromJson(Map<String, dynamic>.from(item)))
+        .map(
+          (item) => InAppNotification.fromJson(Map<String, dynamic>.from(item)),
+        )
         .where((item) => item.id.isNotEmpty)
         .toList();
   }
@@ -40,4 +81,29 @@ class InAppNotificationService {
   Future<void> acknowledge(String id) async {
     await _api.post('/api/notifications/$id/acknowledge');
   }
+
+  Future<void> markAllRead() async {
+    await _api.post('/api/notifications/read-all');
+  }
+
+  Future<InAppNotificationHistory> getHistory() async {
+    final response = await _api.get('/api/notifications');
+    final data = response.data['data'] as Map? ?? const {};
+    final rawItems = data['items'] as List? ?? const [];
+    return InAppNotificationHistory(
+      unreadCount: data['unreadCount'] as int? ?? 0,
+      items: rawItems
+          .whereType<Map>()
+          .map(
+            (item) =>
+                InAppNotification.fromJson(Map<String, dynamic>.from(item)),
+          )
+          .where((item) => item.id.isNotEmpty)
+          .toList(),
+    );
+  }
+
+  Future<void> delete(String id) async {
+    await _api.delete('/api/notifications/$id');
+  }
 }

health_app/lib/widgets/app_error_state.dart

@@ -0,0 +1,82 @@
+import 'package:flutter/material.dart';
+import '../core/app_colors.dart';
+
+/// 统一的"加载失败"状态——与 AppEmptyState 风格一致，区别在于明确表达"出错了，可重试"，
+/// 避免把网络/服务失败误显示成"暂无数据"。
+class AppErrorState extends StatelessWidget {
+  final String title;
+  final String? subtitle;
+  final VoidCallback? onRetry;
+
+  const AppErrorState({
+    super.key,
+    this.title = '加载失败',
+    this.subtitle = '网络异常或服务暂时不可用，请稍后重试',
+    this.onRetry,
+  });
+
+  @override
+  Widget build(BuildContext context) {
+    return Center(
+      child: Padding(
+        padding: const EdgeInsets.all(48),
+        child: Column(
+          mainAxisSize: MainAxisSize.min,
+          children: [
+            Container(
+              width: 80,
+              height: 80,
+              decoration: BoxDecoration(
+                gradient: AppColors.softGlassGradient,
+                borderRadius: BorderRadius.circular(40),
+                border: Border.all(color: AppColors.borderLight),
+                boxShadow: AppColors.cardShadowLight,
+              ),
+              child: const Icon(
+                Icons.cloud_off_outlined,
+                size: 34,
+                color: AppColors.primaryDark,
+              ),
+            ),
+            const SizedBox(height: 18),
+            Text(
+              title,
+              style: const TextStyle(
+                fontSize: 18,
+                fontWeight: FontWeight.w700,
+                color: AppColors.textPrimary,
+              ),
+              textAlign: TextAlign.center,
+            ),
+            if (subtitle != null) ...[
+              const SizedBox(height: 6),
+              Text(
+                subtitle!,
+                style: const TextStyle(
+                  fontSize: 14,
+                  color: AppColors.textSecondary,
+                ),
+                textAlign: TextAlign.center,
+              ),
+            ],
+            if (onRetry != null) ...[
+              const SizedBox(height: 20),
+              OutlinedButton.icon(
+                onPressed: onRetry,
+                icon: const Icon(Icons.refresh, size: 18),
+                label: const Text('重试'),
+                style: OutlinedButton.styleFrom(
+                  foregroundColor: AppColors.primaryDark,
+                  side: const BorderSide(color: AppColors.borderLight),
+                  shape: RoundedRectangleBorder(
+                    borderRadius: BorderRadius.circular(12),
+                  ),
+                ),
+              ),
+            ],
+          ],
+        ),
+      ),
+    );
+  }
+}

health_app/lib/widgets/app_future_view.dart

@@ -0,0 +1,54 @@
+import 'package:flutter/material.dart';
+import '../core/app_colors.dart';
+import 'app_error_state.dart';
+
+/// 基于 FutureBuilder 的四态封装：统一处理"加载中 / 失败"，
+/// "空数据 / 有数据"交由 onData 自行判断（不同页面空态文案不同）。
+///
+/// onData 拿到非空数据后，自行判断 isEmpty 决定显示空态还是列表。
+class AppFutureView<T> extends StatelessWidget {
+  final Future<T>? future;
+  final Widget Function(BuildContext context, T data) onData;
+  final VoidCallback? onRetry;
+  final Widget? loading;
+  final String? errorTitle;
+
+  const AppFutureView({
+    super.key,
+    required this.future,
+    required this.onData,
+    this.onRetry,
+    this.loading,
+    this.errorTitle,
+  });
+
+  @override
+  Widget build(BuildContext context) {
+    return FutureBuilder<T>(
+      future: future,
+      builder: (ctx, snap) {
+        // 失败优先于其它判断，避免把错误显示成"暂无数据"
+        if (snap.hasError) {
+          return AppErrorState(
+            title: errorTitle ?? '加载失败',
+            onRetry: onRetry,
+          );
+        }
+        // 首次加载、尚无数据 → 转圈
+        if (snap.connectionState == ConnectionState.waiting && !snap.hasData) {
+          return loading ??
+              const Center(
+                child: CircularProgressIndicator(color: AppColors.primary),
+              );
+        }
+        if (!snap.hasData) {
+          return loading ??
+              const Center(
+                child: CircularProgressIndicator(color: AppColors.primary),
+              );
+        }
+        return onData(ctx, snap.data as T);
+      },
+    );
+  }
+}