feat: AI 提示词模块化 + AI 同意门控 + AI 草稿存储 + 意图路由 + 医疗引用知识库 + 多页面 UI 优化

- AI 提示词拆分为 markdown 模块（Prompts/global + modules + rag + router）
- 新增 AI 同意门控（用户需同意后才能使用 AI 功能）
- 新增 AI 录入草稿存储（AiEntryDraftContracts/EfAiEntryDraftStore/AiEntryDraftRecord）
- 新增 AI 意图路由（ai_intent_router）
- 新增医疗引用知识库（MedicalCitationKnowledge）
- 重构 prompt_manager 和 ai_chat_endpoints
- 优化聊天/趋势/档案/抽屉/医生端等多个页面 UI
- 新增 agent 插画和趋势指标图标资源
- 删除 HANDOFF-2026-07-17.md

.gitignore

@@ -46,6 +46,7 @@ backend/src/Health.WebApi/data-protection-keys/
 *.txt
 *.jpg
 *.png
+!backend/src/Health.WebApi/wwwroot/app-icon.png
 !health_app/assets/branding/*.png
 !health_app/android/app/src/main/res/drawable/launch_brand.png
 !health_app/android/app/src/main/res/drawable-v21/launch_brand.png

AGENTS.md

@@ -0,0 +1,57 @@
+# 项目协作准则
+
+本文件适用于整个 `health_project` 仓库。处理任务时按改动风险分级，验证强度与风险匹配，避免小改动套用重型流程。
+
+## 默认规则
+
+- 默认不执行 `git add`、`git commit`、`git push`、合并、回滚或创建分支；只有用户明确要求时才进行。
+- 保留工作区中用户已有的未提交改动，不覆盖、不清理、不顺带重构。
+- 数据库、上传文件、密钥、生产配置和用户数据不视为普通文件；任何写入、迁移、删除或恢复操作必须先获得用户明确确认。
+- 只修改用户指定的端和功能范围。发现相邻问题可以说明，但不要擅自扩大修改范围。
+
+## 小改动：快速处理
+
+适用于颜色、字号、间距、圆角、文案、图标、单个组件简单布局等不涉及状态、接口和数据的调整。
+
+1. 确认具体文件和修改范围。
+2. 直接完成修改。
+3. 执行格式化。
+4. 进行一次快速编译或静态检查，二者按实际需要选择。
+5. 简要说明改动结果。
+
+不运行完整测试套件，不额外编写计划文档，不提交 Git。
+
+## 中等改动：针对性验证
+
+适用于页面交互、Provider、路由、表单逻辑、接口调用、跨端数据展示、启动脚本和配置修改。
+
+1. 检查相关代码和现有改动。
+2. 修改前简要说明方案。
+3. 完成代码修改和格式化。
+4. 运行静态检查或编译。
+5. 只运行与本次改动直接相关的测试。
+6. 必要时启动对应页面或接口验证一次。
+
+默认不提交 Git。
+
+## 大改动：完整验证
+
+适用于完整新功能、多页面联动、登录、聊天、蓝牙、AI 核心流程、后端结构调整和大范围重构。
+
+1. 阅读相关代码、文档和交接资料。
+2. 与用户确认范围、交互和成功标准。
+3. 分步骤实施，并在关键阶段做针对性检查。
+4. 完成后运行 Flutter 和后端相关完整测试。
+5. 汇总改动、验证结果和遗留问题。
+
+## 高风险改动：确认后执行
+
+适用于数据库迁移或数据修复、大量删除、用户数据、上传文件、签名、生产配置、部署，以及 Git 提交、推送、合并和回滚。
+
+1. 先进行只读检查，确认精确目标和影响。
+2. 向用户说明风险、影响范围和恢复方式。
+3. 必要时先制作可验证的备份。
+4. 获得用户明确确认后再执行。
+5. 执行后进行完整验证并报告结果。
+
+用户在具体任务中的直接指令始终优先于本文件。

audit/2026-07-14/08-followups.xml

@@ -0,0 +1 @@
+<?xml version='1.0' encoding='UTF-8' standalone='yes' ?><hierarchy rotation="0"><node index="0" text="" resource-id="" class="android.widget.FrameLayout" package="com.datalumina.YYA" content-desc="" checkable="false" checked="false" clickable="false" enabled="true" focusable="false" focused="false" scrollable="false" long-clickable="false" password="false" selected="false" bounds="[0,0][1440,3200]"><node index="0" text="" resource-id="" class="android.widget.LinearLayout" package="com.datalumina.YYA" content-desc="" checkable="false" checked="false" clickable="false" enabled="true" focusable="false" focused="false" scrollable="false" long-clickable="false" password="false" selected="false" bounds="[0,0][1440,3200]"><node index="0" text="" resource-id="android:id/content" class="android.widget.FrameLayout" package="com.datalumina.YYA" content-desc="" checkable="false" checked="false" clickable="false" enabled="true" focusable="false" focused="false" scrollable="false" long-clickable="false" password="false" selected="false" bounds="[0,0][1440,3200]"><node index="0" text="" resource-id="" class="android.widget.FrameLayout" package="com.datalumina.YYA" content-desc="" checkable="false" checked="false" clickable="false" enabled="true" focusable="true" focused="true" scrollable="false" long-clickable="false" password="false" selected="false" bounds="[0,0][1440,3200]"><node index="0" text="" resource-id="" class="android.view.View" package="com.datalumina.YYA" content-desc="" checkable="false" checked="false" clickable="false" enabled="true" focusable="false" focused="false" scrollable="false" long-clickable="false" password="false" selected="false" bounds="[0,0][1440,3200]"><node index="0" text="" resource-id="" class="android.view.View" package="com.datalumina.YYA" content-desc="" checkable="false" checked="false" clickable="true" enabled="true" focusable="true" focused="false" scrollable="false" long-clickable="false" password="false" selected="false" bounds="[0,0][1440,3200]"><node index="0" text="" resource-id="" class="android.view.View" package="com.datalumina.YYA" content-desc="" checkable="false" checked="false" clickable="false" enabled="true" focusable="false" focused="false" scrollable="false" long-clickable="false" password="false" selected="false" bounds="[0,0][1440,3200]"><node index="0" text="" resource-id="" class="android.view.View" package="com.datalumina.YYA" content-desc="" checkable="false" checked="false" clickable="false" enabled="true" focusable="false" focused="false" scrollable="false" long-clickable="false" password="false" selected="false" bounds="[0,0][1440,3200]"><node index="0" text="" resource-id="" class="android.view.View" package="com.datalumina.YYA" content-desc="" checkable="false" checked="false" clickable="false" enabled="true" focusable="false" focused="false" scrollable="false" long-clickable="false" password="false" selected="false" bounds="[0,0][1440,302]"><node NAF="true" index="0" text="" resource-id="" class="android.widget.Button" package="com.datalumina.YYA" content-desc="" checkable="false" checked="false" clickable="true" enabled="true" focusable="true" focused="false" scrollable="false" long-clickable="false" password="false" selected="false" bounds="[14,127][182,295]" /><node index="1" text="" resource-id="" class="android.view.View" package="com.datalumina.YYA" content-desc="复查随访" checkable="false" checked="false" clickable="false" enabled="true" focusable="true" focused="false" scrollable="false" long-clickable="false" password="false" selected="false" bounds="[600,173][840,250]" /></node><node index="1" text="" resource-id="" class="android.view.View" package="com.datalumina.YYA" content-desc="暂无随访安排" checkable="false" checked="false" clickable="false" enabled="true" focusable="true" focused="false" scrollable="false" long-clickable="false" password="false" selected="false" bounds="[600,1816][840,1872]" /><node index="2" text="" resource-id="" class="android.view.View" package="com.datalumina.YYA" content-desc="医生创建随访后将显示在这里" checkable="false" checked="false" clickable="false" enabled="true" focusable="true" focused="false" scrollable="false" long-clickable="false" password="false" selected="false" bounds="[401,1886][1039,1952]" /></node></node></node></node></node></node></node></node></hierarchy>

audit/2026-07-14/project-audit-report.md

@@ -0,0 +1,261 @@
+# 小脉健康项目全面检查报告
+
+检查日期：2026-07-14  
+检查范围：Flutter Android 真机主要用户路径、Flutter 静态检查与测试、.NET 后端测试、前后端接口对应关系、用户/医生/管理员业务逻辑、权限安全、合规页面与 Android/iOS 发布准备。  
+本轮只检查，没有修改业务代码，也没有使用 Docker。
+
+## 一、总体结论
+
+项目主体功能已经比较完整，普通用户主路径能进入，当前 Flutter 静态检查通过，Flutter 47 项测试和后端 44 项测试全部通过。但测试通过不等于已经稳定：本次仍确认了多项自动测试没有覆盖的真实断点。
+
+当前不适合进入正式环境或商店审核。最优先的不是继续统一小间距，而是先处理问诊鉴权、管理员验证码、上传文件访问、蓝牙上传、账号注销清理和正式包权限。这些问题会影响真实数据、安全或用户是否能完成任务。
+
+## 二、必须先修的问题
+
+### 1. AI 流式聊天的 token 只被“读出来”，没有验证真伪
+
+- 用户表现：正常用户不一定马上发现，但攻击者可以自己伪造一个 token，冒充任意用户进入 AI 对话、读取该用户上下文，并可能触发健康数据写入。
+- 原因：SSE 接口没有强制登录；备用 token 处理只解析 JWT 内容，没有校验签名、过期时间、签发方和接收方。
+- 位置：`backend/src/Health.WebApi/Endpoints/ai_chat_endpoints.cs` 的 `GetUserIdFromToken`。
+- 优先级：最高。
+
+### 2. 医生问诊实时通道没有登录和问诊归属校验
+
+- 用户表现：知道问诊编号的人可以加入房间，甚至把自己声明成“用户”或“医生”发送消息；消息还会真实写入数据库。
+- 原因：SignalR Hub 没有鉴权，加入房间和发送消息时也没有核对当前账号是否属于该患者或医生。
+- 位置：`backend/src/Health.WebApi/Hubs/ConsultationHub.cs`。
+- 优先级：最高。
+
+### 3. 管理员存在固定手机号和固定验证码
+
+- 用户表现：正式环境若沿用当前代码，知道固定号码的人可用 `000000` 登录管理员端。
+- 原因：管理员手机号和验证码直接写在认证服务中，而且不只在开发环境生效。
+- 位置：`backend/src/Health.Infrastructure/Auth/AuthService.cs`。
+- 优先级：最高。
+
+### 4. 上传的报告、聊天图片和 PDF 可被未登录访问
+
+- 用户表现：文件链接一旦泄露，不登录也能打开健康报告或聊天附件。
+- 原因：整个 `/uploads` 目录作为公开静态目录提供，没有按用户、医生关系或临时授权校验。
+- 位置：`backend/src/Health.WebApi/Program.cs` 的上传目录静态映射。
+- 优先级：最高。
+
+### 5. 蓝牙血压计能读到数据，但自动上传会失败
+
+- 用户表现：设备连接成功、血压已经读取，最后却提示上传失败；血压和心率不会真正保存到后端。
+- 原因：前端提交到 `/api/health-records/batch`，当前后端没有这个接口。
+- 位置：`health_app/lib/pages/device/device_management_page.dart` 与 `backend/src/Health.WebApi/Endpoints/health_endpoints.cs`。
+- 优先级：高。
+
+### 6. 每次打开医生问诊页都会创建一条新问诊并消耗次数
+
+- 用户表现：只是进入页面看一下、没有发送任何内容，也会新增问诊；反复进出会快速消耗每月次数。显示剩余 0 次时仍可能继续创建，甚至出现负数。
+- 原因：前端初始化先查次数，然后无条件创建；后端创建接口没有真正执行三次上限，也没有验证医生仍然有效。
+- 位置：`health_app/lib/providers/consultation_provider.dart`、`backend/src/Health.WebApi/Endpoints/consultation_endpoints.cs`。
+- 优先级：高。
+
+### 7. 问诊消息发送失败时仍显示为已发送
+
+- 用户表现：网络断开或服务器失败后，消息仍留在聊天里，没有失败标记和重试入口，用户会误以为医生已经收到。
+- 原因：发送异常被静默忽略，本地消息没有回滚或转成失败状态。
+- 位置：`health_app/lib/providers/consultation_provider.dart` 的 `sendMessage`。
+- 优先级：高，且不符合“不能假成功”的项目要求。
+
+### 8. Android 正式包没有网络权限
+
+- 用户表现：Debug 真机可联网，但以后构建 release 包后，所有登录、数据、AI 和报告请求都无法联网。
+- 原因：`INTERNET` 只在 debug/profile Manifest 中，main Manifest 没有；release 不会合并 debug 配置。
+- 位置：`health_app/android/app/src/main/AndroidManifest.xml`。
+- 优先级：正式包前必须修。
+
+### 9. 账号注销只删数据库记录，不会清理服务器上传文件
+
+- 用户表现：App 显示账号已删除，但报告原图、聊天图片、PDF 等仍可能留在服务器目录；公开链接仍可能继续访问。
+- 原因：账号注销批量删除数据库数据时没有收集并删除物理文件。单独删除报告有删文件，注销账号没有走同一流程。
+- 位置：`backend/src/Health.Infrastructure/Users/EfUserRepository.cs`。
+- 优先级：高，涉及合规承诺和真实删除。
+
+### 10. iOS 相机和相册权限说明缺失
+
+- 用户表现：以后在 iPhone 上拍饮食、拍报告或选相册时，系统可能直接终止 App，而不是正常弹出权限框。
+- 原因：Info.plist 有蓝牙说明，但没有 `NSCameraUsageDescription` 和 `NSPhotoLibraryUsageDescription`。
+- 位置：`health_app/ios/Runner/Info.plist`。
+- 优先级：iOS 调试前必须修。
+
+## 三、重要功能和稳定性问题
+
+### 11. 多个请求同时遇到登录过期时，可能刚刷新成功又被强制退出
+
+多个 401 会同时拿同一个刷新 token。第一个请求刷新并保存新 token 后，第二个请求可能因旧 token 已失效而失败，随后把刚保存的新 token 一并清掉。用户会偶发跳回登录页。
+
+位置：`health_app/lib/core/api_client.dart` 的 401 刷新逻辑。
+
+### 12. 启动时只要服务器暂时连不上，就把用户当成未登录
+
+刷新 token 的请求遇到断网或本地后端未启动时，认证状态直接变为未登录，但本地 token 又没有清除。用户会看到登录页，网络恢复后也不会自动重试，只能重启或重新操作。
+
+位置：`health_app/lib/providers/auth_provider.dart` 的 `_checkAuth`。
+
+### 13. 问诊轮询用随机 GUID 判断“之后的消息”，可能漏消息
+
+SignalR 失败后会回退轮询。后端把随机消息 ID 与上一条随机 ID 做大小比较，这不等于消息时间顺序，可能漏掉医生新回复。正确游标应基于服务器时间或稳定递增字段。
+
+位置：`backend/src/Health.WebApi/Endpoints/consultation_endpoints.cs`。
+
+### 14. 问诊 AI 开场白只存在前端，没有保存
+
+用户看到的“AI 分身问候”不是数据库消息，医生端看不到；重新进入又会新建问诊并生成另一条本地问候，历史不连续。
+
+位置：`health_app/lib/providers/consultation_provider.dart`。
+
+### 15. 短信验证码没有频率、次数和防刷限制
+
+发送接口可反复调用，验证码校验也没有失败次数限制。正式短信接入后会产生短信轰炸、费用和验证码暴力尝试风险。
+
+位置：认证端点和 `AuthService`。
+
+### 16. 管理员新增、停用、修改、删除医生时，几套医生数据可能不同步
+
+- 手机号已属于普通用户时，仍可创建医生实体，但不会把已有用户升级并绑定医生档案。
+- 修改医生手机号/姓名时，没有同步医生登录账号与医生档案。
+- 停用医生只改一处状态，医生档案的状态可能仍是启用。
+- 删除医生后，医生登录用户仍可能保留 Doctor 角色，但档案已失去关联，登录后只能看到“档案未关联”。
+- 医生手机号没有唯一约束，可能出现重复医生。
+
+位置：`backend/src/Health.Infrastructure/Admin/AdminService.cs`。
+
+### 17. 附件本地路径没有限制在 uploads 目录内
+
+附件 URL 中的相对路径直接拼到服务器路径，没有做规范化后再确认最终路径仍位于 uploads 内，也没有核对文件是否属于当前用户。这会带来跨用户读取或路径越界风险。
+
+位置：`backend/src/Health.Infrastructure/AI/AttachmentContextBuilder.cs`。
+
+### 18. 通知点击先联网标记已读，失败时目的页面也打不开
+
+用户点一条未读通知时，先请求后端标记已读；如果这一步失败，后续报告/用药/健康页面不会打开，也没有明确提示。
+
+位置：`health_app/lib/pages/notifications/notification_center_page.dart`。
+
+### 19. 用户端与医生端部分“今天/本月”按 UTC 计算
+
+中国时区的凌晨时段可能被算到上一天或上个月，影响问诊次数、今日随访和提醒归类。正式环境应统一明确业务时区。
+
+位置：问诊和医生工作台中使用 `DateTime.UtcNow.Date` 或 UTC 月份的逻辑。
+
+## 四、UI 与交互问题
+
+### 20. 用药和运动列表默认露出整片红色删除背景
+
+真机截图中，用药行和运动行在没有滑动时已经整行变红；运动行还出现“打卡”和“删除”重叠。用户会误以为数据异常或正处于危险删除状态。
+
+原因是通用滑动删除组件始终铺红色底层，而这些列表行本身透明。测试只验证滑动动作，没有验证未滑动时的最终视觉。
+
+证据：`05-medications.png`、`09-exercise.png`。  
+位置：`health_app/lib/widgets/common_widgets.dart`。
+
+### 21. 首页多个纯图标按钮缺少无障碍名称
+
+真机可访问性结构中，菜单、附件、输入框和发送按钮等多个可点击区域没有名称。普通用户能凭图标猜，读屏用户无法知道用途。
+
+证据：`01-current.xml`。
+
+### 22. 删除动作风格不统一
+
+报告、用药、运动使用滑动删除，通知使用整行侧滑，蓝牙设备直接显示红色垃圾桶，设置页则用大按钮。交互成本和误触风险不同。建议统一为“列表行滑动后显示删除 + 二次确认用于高价值数据”。
+
+### 23. 设置页的红色占比过重
+
+“删除账号”和“退出登录”两个大面积危险操作占据页面最强视觉层级，反而压过消息、隐私和服务协议。删除账号保持红色是合理的，但退出登录不必使用整块高饱和红色。
+
+证据：`12-settings.png`。
+
+### 24. 侧边栏健康仪表盘过于抢眼
+
+大面积蓝紫粉渐变和四个小框成为最强区域，与项目“克制、专业、模块色只做识别”的偏好有偏差；指标小字和透明边框的对比度也偏弱。
+
+证据：`02-drawer.png`。
+
+### 25. 空状态表达不统一
+
+复查随访使用居中图标和说明；饮食使用一条白色容器；其他页面可能只留空白。建议统一空状态的标题、原因和下一步操作，但不需要每页再套一张大卡片。
+
+证据：`06-diet-records.png`、`08-followups.png`。
+
+### 26. 部分图标按钮只有约 40dp
+
+例如蓝牙页顶部新增按钮使用固定 40×40，低于常见的 48dp 触控建议；对手部不便或视力较弱的健康类用户不够友好。
+
+### 27. 大字体、横屏、小屏和读屏尚无验证证据
+
+许多页面使用固定高度、固定行布局和多个并排信息块。当前只在一台 1440×3200 Android 真机、默认字体比例下检查，不能据此确认大字体和 iOS 横屏不会溢出。
+
+## 五、合规与发布准备问题
+
+### 28. 合规文档仍有主体和联系方式占位符
+
+隐私政策、服务协议、个人信息清单和 SDK 清单里仍有 `xxx`、待定短信服务商等内容，不能用于正式审核。
+
+### 29. App 内文档与 H5 文档存在多套日期和内容
+
+App 内隐私/协议日期为 6 月 29 日，个人信息与 SDK 清单为 7 月 9 日；H5 清单日期为 7 月 7 日。以后修改一处很容易漏另一处。建议确定单一内容源或至少增加一致性测试。
+
+### 30. “关于我们”写了并不存在的意见反馈入口
+
+文档提示“设置 → 意见反馈”，实际设置页没有该入口；版本还写成 `Build 20260101`，与当前 `1.0.0+1` 不一致。
+
+### 31. 用户同意协议没有服务端记录
+
+当前“同意”只是登录页内存中的一个布尔值，未保存同意时间、协议版本或政策更新后的重新同意记录。服务端接口也不要求同意状态，无法证明用户同意了哪一版条款。
+
+### 32. Android 权限声明偏多且缺少版本限制
+
+当前声明了蓝牙广播权限，但 App 主要是扫描/连接；旧版存储和蓝牙权限也没有按 Android 版本加 `maxSdkVersion`。正式个人信息清单应与实际最小权限保持一致。
+
+### 33. 本地 token 使用普通 SQLite 明文保存
+
+符合项目“不用 shared_preferences”的约定，但 access token 和 refresh token 没有系统级加密保护；同时 Android 也未显式关闭备份。正式版本需要决定是否改用系统安全存储或加密数据库，并限制备份。
+
+### 34. iOS 名称和方向仍是模板状态
+
+Info.plist 的显示名称还是 `Health App`，并允许 iPhone 横屏；当前页面主要按竖屏设计，尚未验证横屏。Bundle ID、签名和证书则仍按项目计划待配置。
+
+### 35. CORS 当前允许任意来源并携带凭据
+
+本地调试方便，但正式环境应只允许确定的 H5/管理端域名，不能继续接受任意 Origin。
+
+## 六、已确认正常或已有保护的部分
+
+- 当前 Flutter `analyze` 无错误。
+- Flutter 47 项测试全部通过。
+- 后端 44 项测试全部通过。
+- 报告、用药、饮食、运动、健康数据等主要删除接口都按当前用户筛选，不是只删前端显示。
+- 单独删除报告时会同时删除报告原文件。
+- AI 历史对话恢复后仍保留原 conversationId，可以继续发送新消息；历史确认卡只读是合理保护。
+- 管理员和医生普通 HTTP 端点已有角色过滤，问题主要集中在固定管理员验证码、医生数据同步和未鉴权 SignalR Hub。
+- 设置、通知、报告列表已经较接近“一行一行、文字区分隔线”的目标风格。
+- 隐私政策、服务协议、个人信息清单、SDK 清单和关于我们均已有 App 内入口与 H5 文件。
+
+## 七、真机流程健康度
+
+1. 首页与 AI 对话：可进入；视觉基本完整，但纯图标无障碍名称不足，AI SSE 鉴权有严重后端风险。
+2. 侧边栏：可打开；功能入口齐全，仪表盘色彩和层级偏重。
+3. 健康档案：可加载和编辑；固定保存区需要继续验证大字体遮挡。
+4. 报告管理：列表正常；文件公开访问是严重隐私风险。
+5. 用药管理：数据能加载；列表红底显示错误明显。
+6. 饮食记录：日期、空状态和趋势能显示；空状态样式与其他页不统一。
+7. 健康日历：日期和计划能显示；业务时区需要后端统一。
+8. 复查随访：空状态清楚；本次账号没有数据，未实测详情。
+9. 运动计划：数据能加载；红底和操作文字重叠明显。
+10. 蓝牙设备：绑定设备能显示；自动读取后的批量上传链路断开。
+11. 通知中心：历史和未读数能显示；未读通知在网络失败时可能打不开目的页。
+12. 设置与合规入口：入口齐全；危险操作权重过高，文档仍有占位和不一致。
+13. 个人信息：真机运行版本可进入；检查期间源代码刚加入新的基本资料编辑入口，当前运行包尚未热更新到这一版。
+14. 医生端：已完成代码与接口核对；没有医生测试账号，本次未做完整真机流程。
+15. 管理员端：已完成代码与接口核对；没有实际执行新增/停用/删除，避免改变真实数据。
+16. iOS：仅做配置与代码检查；没有证书、Mac 构建和 iPhone 实测，不能确认界面与权限流程。
+
+## 八、证据限制
+
+- 真机截图来自本次检查时设备上正在运行的调试包。检查过程中项目源代码仍在被更新，后加入的个人资料编辑和设备错误文案没有重新构建到该运行包，因此相关结论以当前代码为准、旧界面截图只用于对应未变化页面。
+- 没有执行真实删除、账号注销、医生管理、短信发送或蓝牙测量，避免改变现有数据；这些部分通过前后端代码和接口对应关系确认。
+- 没有正式域名、HTTPS、短信服务商、对象存储、iOS 签名和商店账号，因此只检查了当前准备缺口。

backend/.env.example

@@ -16,6 +16,14 @@ QWEN_BASE_URL=https://dashscope.aliyuncs.com/compatible-mode/v1
 QWEN_API_KEY=sk-your-key-here
 QWEN_VISION_MODEL=qwen-vl-max
 
+# 阿里云百炼实时语音输入（Fun-ASR）
+DASHSCOPE_ASR_API_KEY=sk-your-dashscope-key-here
+DASHSCOPE_ASR_WORKSPACE_ID=your-workspace-id
+DASHSCOPE_ASR_MODEL=fun-asr-realtime
+DASHSCOPE_ASR_MAX_DURATION_SECONDS=60
+# 可选；不填时按 Workspace ID 自动生成北京地域专属地址
+# DASHSCOPE_ASR_WEBSOCKET_URL=wss://your-workspace-id.cn-beijing.maas.aliyuncs.com/api-ws/v1/inference
+
 # MinIO
 MINIO_ENDPOINT=localhost:9000
 MINIO_ACCESS_KEY=minioadmin

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

@@ -35,7 +35,7 @@ public interface IAiConversationService
     Task<IReadOnlyList<AiConversationDto>> ListAsync(Guid userId, CancellationToken ct);
     Task<IReadOnlyList<AiConversationMessageDto>> GetMessagesAsync(Guid userId, Guid conversationId, CancellationToken ct);
     Task UpdateSummaryAsync(Guid conversationId, string summary, CancellationToken ct);
-    Task DeleteAsync(Guid userId, Guid conversationId, CancellationToken ct);
+    Task<bool> DeleteAsync(Guid userId, Guid conversationId, CancellationToken ct);
     Task<int> DeleteAllAsync(Guid userId, CancellationToken ct);
 }
 
@@ -48,6 +48,7 @@ public interface IAiConversationRepository
     Task<IReadOnlyList<ConversationMessage>> GetRecentMessagesAsync(Guid conversationId, int limit, CancellationToken ct);
     Task AddConversationAsync(Conversation conversation, CancellationToken ct);
     Task AddMessageAsync(ConversationMessage message, CancellationToken ct);
+    Task<int> DeleteLegacyDietCommentaryArtifactsAsync(Guid userId, string promptPrefix, CancellationToken ct);
     void Delete(Conversation conversation);
     Task SaveChangesAsync(CancellationToken ct);
 }

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

@@ -5,7 +5,7 @@ namespace Health.Application.AI;
 
 public sealed class AiConversationService(IAiConversationRepository conversations) : IAiConversationService
 {
-    private const int HistoryConversationLimit = 7;
+    private const int HistoryConversationLimit = 30;
     private readonly IAiConversationRepository _conversations = conversations;
 
     public async Task<OpenConversationResult> OpenAsync(
@@ -55,6 +55,10 @@ public sealed class AiConversationService(IAiConversationRepository conversation
 
     public async Task<IReadOnlyList<AiConversationDto>> ListAsync(Guid userId, CancellationToken ct)
     {
+        await _conversations.DeleteLegacyDietCommentaryArtifactsAsync(
+            userId,
+            DietCommentaryPolicy.LegacyPromptPrefix,
+            ct);
         var conversations = await _conversations.ListAsync(userId, ct);
         return conversations.Take(HistoryConversationLimit).Select(ToDto).ToList();
     }
@@ -79,13 +83,14 @@ public sealed class AiConversationService(IAiConversationRepository conversation
         await _conversations.SaveChangesAsync(ct);
     }
 
-    public async Task DeleteAsync(Guid userId, Guid conversationId, CancellationToken ct)
+    public async Task<bool> DeleteAsync(Guid userId, Guid conversationId, CancellationToken ct)
     {
         var conversation = await _conversations.GetOwnedAsync(userId, conversationId, ct);
-        if (conversation == null) return;
+        if (conversation == null) return false;
 
         _conversations.Delete(conversation);
         await _conversations.SaveChangesAsync(ct);
+        return true;
     }
 
     public async Task<int> DeleteAllAsync(Guid userId, CancellationToken ct)

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

@@ -0,0 +1,24 @@
+namespace Health.Application.AI;
+
+public sealed record AiEntryDraft(
+    Guid Id,
+    Guid UserId,
+    Guid ConversationId,
+    string EntryType,
+    string Payload,
+    string MissingFields,
+    DateTime ExpiresAt);
+
+public interface IAiEntryDraftStore
+{
+    Task<AiEntryDraft?> GetActiveAsync(Guid userId, Guid conversationId, string entryType, CancellationToken ct);
+    Task<AiEntryDraft> UpsertAsync(
+        Guid userId,
+        Guid conversationId,
+        string entryType,
+        string payload,
+        string missingFields,
+        TimeSpan lifetime,
+        CancellationToken ct);
+    Task CompleteAsync(Guid draftId, Guid userId, CancellationToken ct);
+}

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

@@ -16,5 +16,5 @@ public interface IAttachmentContextBuilder
     /// <summary>
     /// 根据 imageUrl 或 pdfUrl 构建附件上下文。两个都为空返回 null。
     /// </summary>
-    Task<AttachmentContext?> BuildAsync(string? imageUrl, string? pdfUrl, CancellationToken ct);
+    Task<AttachmentContext?> BuildAsync(Guid userId, string? imageUrl, string? pdfUrl, CancellationToken ct);
 }

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

@@ -0,0 +1,36 @@
+using Health.Domain.Entities;
+using Health.Domain.Enums;
+
+namespace Health.Application.AI;
+
+public sealed record DietCommentaryFood(string Name, string Portion, int Calories);
+
+public static class DietCommentaryPolicy
+{
+    public const string LegacyPromptPrefix = "饮食记录页需要展示本餐建议。";
+
+    public const string SystemPrompt = """
+        你是健康管理 App 中的饮食整理助手。根据用户本餐食物和健康档案，直接输出2到3条简短事实描述。
+        每条12到22个汉字，不要问候，不要说“好的”“当然”“建议如下”，不要编号，不要使用 Markdown。
+        优先围绕控盐控油、蔬菜和蛋白质搭配及份量控制描述客观事实（如“本餐盐分约5克”“蔬菜偏少”）。
+        不作诊断，不提供治疗、处方、停药或调药结论，不给饮食建议，不基于疾病推断。语言简洁、专业、面向普通用户。
+        如果输出了营养事实或饮食相关健康信息，末尾必须附上“参考来源”，使用固定医学来源目录中的 S-DIET-01 或 S-DIET-02。
+        """;
+
+    public static string BuildFoodDescription(IEnumerable<DietCommentaryFood> foods) =>
+        string.Join("、", foods.Select(food =>
+            $"{Normalize(food.Name, 40)}（{Normalize(food.Portion, 30)}，{Math.Clamp(food.Calories, 0, 10000)}千卡）"));
+
+    public static bool IsLegacyArtifact(IEnumerable<ConversationMessage> messages)
+    {
+        var userMessages = messages.Where(message => message.Role == MessageRole.User).ToList();
+        return userMessages.Count > 0 &&
+               userMessages.All(message => message.Content.TrimStart().StartsWith(LegacyPromptPrefix, StringComparison.Ordinal));
+    }
+
+    private static string Normalize(string value, int maxLength)
+    {
+        var normalized = string.Join(' ', value.Trim().Split((char[]?)null, StringSplitOptions.RemoveEmptyEntries));
+        return normalized.Length > maxLength ? normalized[..maxLength] : normalized;
+    }
+}

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

@@ -0,0 +1,91 @@
+namespace Health.Application.AI;
+
+/// <summary>
+/// iOS 审核版内置医学来源目录。
+/// 这是固定提示词资料，不依赖在线 RAG 检索。
+/// </summary>
+public static class MedicalCitationKnowledge
+{
+    public const string Prompt = """
+        固定医学参考来源目录（仅可引用下列来源，不得编造 PMID、DOI 或 URL）：
+
+        [S-BP-01] 2024 ESC Guidelines for the management of elevated blood pressure and hypertension
+        适用：血压记录、血压趋势、单次血压不能单独诊断、复测和就医提醒。
+        https://pubmed.ncbi.nlm.nih.gov/39210715/
+
+        [S-GLU-01] Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes—2025
+        适用：血糖记录、空腹或餐后状态、低血糖风险和血糖结果说明。
+        https://pubmed.ncbi.nlm.nih.gov/39651981/
+
+        [S-HR-01] All About Heart Rate, American Heart Association
+        适用：静息心率的客观说明和心率记录趋势。
+        https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/all-about-heart-rate-pulse
+
+        [S-OXY-01] Pulse Oximeter Basics, U.S. Food and Drug Administration
+        适用：血氧读数局限、复测、症状和血氧记录说明。
+        https://www.fda.gov/consumers/consumer-updates/pulse-oximeter-basics
+
+        [S-DIET-01] Popular Dietary Patterns: Alignment With American Heart Association 2021 Dietary Guidance
+        适用：一般饮食模式、食物营养特征、饮食图片估算局限。
+        https://pubmed.ncbi.nlm.nih.gov/37128940/
+
+        [S-DIET-02] Diet and nutrition in cardiovascular disease prevention
+        适用：一般心血管健康饮食信息，不用于个体化疾病饮食处方。
+        https://pubmed.ncbi.nlm.nih.gov/40504596/
+
+        [S-EX-01] Resistance Exercise Training in Individuals With and Without Cardiovascular Disease: 2023 Update
+        适用：一般运动计划记录和运动安全提醒，不用于疾病运动处方。
+        https://pubmed.ncbi.nlm.nih.gov/38059362/
+
+        [S-EX-02] Core Components of Cardiac Rehabilitation Programs: 2024 Update
+        适用：心脏康复相关安全边界，只能建议咨询专业人员，不能生成康复处方。
+        https://pubmed.ncbi.nlm.nih.gov/39315436/
+
+        [S-MED-01] Medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence
+        适用：用药计划记录、服药提醒和建议咨询医生或药师。
+        https://pubmed.ncbi.nlm.nih.gov/39480983/
+
+        [S-REPORT-01] Interpreting Normal Values and Reference Ranges for Laboratory Tests
+        适用：报告指标、参考范围和异常标记的客观说明。
+        https://pubmed.ncbi.nlm.nih.gov/40268322/
+
+        [S-REPORT-02] Verification of reference intervals in routine clinical laboratories: practical challenges and recommendations
+        适用：不同实验室参考范围差异和优先使用原报告参考范围。
+        https://pubmed.ncbi.nlm.nih.gov/29729142/
+
+        [S-EM-01] 2024 American Heart Association and American Red Cross Guidelines for First Aid
+        适用：危险症状安全提醒、及时联系当地急救服务和不要等待 AI 判断。
+        https://cpr.heart.org/en/resuscitation-science/2024-first-aid-guidelines
+
+        来源使用边界：
+        - 血压：单次记录不能单独诊断高血压；应结合多次记录、测量条件、症状和医生评估；不得建议自行加药、减药或停药。
+        - 血糖：必须关注空腹/餐后等测量时段和既往用药；不能把一个统一目标套用给所有人；不得据此诊断糖尿病或指导自行调药。
+        - 心率：静息心率的客观范围不能替代诊断；应结合是否安静、是否有不适和变化趋势说明。
+        - 血氧：读数是估计值，可能受手部温度、活动、循环、皮肤因素和设备影响；应结合症状和复测结果，不得仅凭单个数值诊断或指导吸氧/调药。
+        - 饮食：图片不能精确确定重量、份量、烹调油和调味料；盐、糖、脂肪和热量只能作一般估算；不得根据疾病档案生成个体化饮食处方。
+        - 运动：只能提供一般运动计划记录和安全提醒；不得针对心血管疾病制定运动处方；有胸痛、晕厥或明显呼吸困难时应先就医评估。
+        - 用药：只能记录计划、查询任务和提醒；开始、停止、更换或调整药物应由医生或药师决定。
+        - 报告：优先使用报告本身提供的参考范围；标记高/低不等于诊断；不同实验室参考范围不能直接互换；应由医生结合症状和病史解释。
+        - 危险症状：胸部不适、呼吸困难、单侧无力、语言障碍、意识异常等应立即联系当地急救服务，不要等待 AI 继续判断。
+        """;
+
+    public const string FixedDietCitation = """
+        参考来源：
+        [S-DIET-01] Popular Dietary Patterns: Alignment With American Heart Association 2021 Dietary Guidance
+        https://pubmed.ncbi.nlm.nih.gov/37128940/
+        """;
+
+    public const string FixedReportCitation = """
+        参考来源：
+        [S-REPORT-01] Interpreting Normal Values and Reference Ranges for Laboratory Tests
+        https://pubmed.ncbi.nlm.nih.gov/40268322/
+        [S-REPORT-02] Verification of reference intervals in routine clinical laboratories: practical challenges and recommendations
+        https://pubmed.ncbi.nlm.nih.gov/29729142/
+        """;
+
+    public const string EmergencyCitation = """
+        参考来源：
+        [S-EM-01] 2024 American Heart Association and American Red Cross Guidelines for First Aid
+        https://cpr.heart.org/en/resuscitation-science/2024-first-aid-guidelines
+        """;
+}

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

@@ -1,30 +1,28 @@
 using System.Text;
 using Health.Application.HealthArchives;
 using Health.Application.HealthRecords;
-using Health.Application.Medications;
 
 namespace Health.Application.AI;
 
 public sealed class PatientContextService(
     IHealthArchiveService archives,
-    IHealthRecordService healthRecords,
-    IMedicationService medications) : IPatientContextService
+    IHealthRecordService healthRecords) : IPatientContextService
 {
     private readonly IHealthArchiveService _archives = archives;
     private readonly IHealthRecordService _healthRecords = healthRecords;
-    private readonly IMedicationService _medications = medications;
 
     public async Task<string> BuildAsync(Guid userId, CancellationToken ct)
     {
         var archive = await _archives.GetAsync(userId, ct);
         var recentRecords = (await _healthRecords.GetRecordsAsync(userId, null, 30, ct)).Take(10).ToList();
-        var activeMedications = await _medications.ListActiveAsync(userId, ct);
 
         var sb = new StringBuilder();
         if (archive != null)
         {
             if (!string.IsNullOrEmpty(archive.Diagnosis)) sb.AppendLine($"诊断: {archive.Diagnosis}");
-            if (archive.Surgeries.Count > 0)
+            if (archive.SurgeryHistoryStatus == "无")
+                sb.AppendLine("手术史: 无");
+            else if (archive.Surgeries.Count > 0)
                 sb.AppendLine($"手术: {string.Join("；", archive.Surgeries.Select(s => $"{s.Type} ({s.Date})"))}");
             else if (!string.IsNullOrEmpty(archive.SurgeryType))
                 sb.AppendLine($"手术: {archive.SurgeryType} ({archive.SurgeryDate})");
@@ -34,23 +32,11 @@ public sealed class PatientContextService(
             if (archive.DietRestrictions.Count > 0) sb.AppendLine($"饮食限制: {string.Join(", ", archive.DietRestrictions)}");
         }
 
-        if (activeMedications.Count > 0)
-        {
-            sb.AppendLine("当前用药:");
-            foreach (var medication in activeMedications.Take(20))
-            {
-                var times = medication.TimeOfDay.Count > 0
-                    ? string.Join("/", medication.TimeOfDay.Select(t => t.ToString("HH:mm")))
-                    : "未设置时间";
-                sb.AppendLine($"  {medication.Name} {medication.Dosage ?? ""} {medication.Frequency} {times}");
-            }
-        }
-
         if (recentRecords.Count > 0)
         {
             sb.AppendLine("近期健康数据:");
             foreach (var record in recentRecords)
-                sb.AppendLine($"  {record.Type}: {RecordValue(record)} ({record.RecordedAt:MM-dd HH:mm})");
+                sb.AppendLine($"  {record.Type}: {RecordValue(record)} ({ToBeijing(record.RecordedAt):MM-dd HH:mm} 北京时间)");
         }
 
         return sb.ToString();
@@ -65,4 +51,15 @@ public sealed class PatientContextService(
         "Weight" => $"{record.Value}kg",
         _ => "—"
     };
+
+    private static DateTime ToBeijing(DateTime value)
+    {
+        var utc = value.Kind switch
+        {
+            DateTimeKind.Utc => value,
+            DateTimeKind.Local => value.ToUniversalTime(),
+            _ => DateTime.SpecifyKind(value, DateTimeKind.Utc),
+        };
+        return utc.AddHours(8);
+    }
 }

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

@@ -40,7 +40,7 @@ public sealed class CalendarService(ICalendarRepository calendar) : ICalendarSer
             .Select(i => new { type = i.ExerciseType, duration = i.DurationMinutes, isCompleted = i.IsCompleted, scheduledDate = i.ScheduledDate })
             .ToList();
         var followUps = snapshot.FollowUps
-            .Where(f => DateOnly.FromDateTime(f.ScheduledAt) == date)
+            .Where(f => BeijingDate(f.ScheduledAt) == date)
             .Select(f => new { f.Title, f.DoctorName, f.Department, status = f.Status.ToString() })
             .ToList();
 
@@ -67,7 +67,7 @@ public sealed class CalendarService(ICalendarRepository calendar) : ICalendarSer
                 entries.Add(new CalendarEntry("exercise", new { type = "exercise", name = item.ExerciseType, duration = item.DurationMinutes, isCompleted = item.IsCompleted, scheduledDate = item.ScheduledDate }));
         }
 
-        foreach (var followUp in snapshot.FollowUps.Where(f => DateOnly.FromDateTime(f.ScheduledAt) == date))
+        foreach (var followUp in snapshot.FollowUps.Where(f => BeijingDate(f.ScheduledAt) == date))
         {
             entries.Add(new CalendarEntry("followup", new
             {
@@ -88,5 +88,14 @@ public sealed class CalendarService(ICalendarRepository calendar) : ICalendarSer
         && (medication.StartDate == null || medication.StartDate <= date)
         && (medication.EndDate == null || medication.EndDate >= date);
 
+    private static DateOnly BeijingDate(DateTime value)
+    {
+        // EF 从 timestamptz 读取的是 UTC；单元测试及旧内存对象可能是 Unspecified。
+        var beijing = value.Kind == DateTimeKind.Unspecified
+            ? value
+            : value.ToUniversalTime().AddHours(8);
+        return DateOnly.FromDateTime(beijing);
+    }
+
     private sealed record CalendarEntry(string Type, object Value);
 }

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

@@ -42,19 +42,19 @@ public interface IExerciseService
     Task<ExercisePlanDto?> GetCurrentAsync(Guid userId, CancellationToken ct);
     Task<Guid> CreateAsync(Guid userId, ExercisePlanCreateRequest request, CancellationToken ct);
     Task<IReadOnlyList<ExercisePlanSummaryDto>> ListAsync(Guid userId, CancellationToken ct);
+    Task<IReadOnlyList<ExercisePlanSummaryDto>> ListAllAsync(Guid userId, CancellationToken ct);
     Task<ExercisePlanDto?> GetByIdAsync(Guid userId, Guid planId, CancellationToken ct);
     Task<bool> DeleteAsync(Guid userId, Guid planId, CancellationToken ct);
     Task<bool?> ToggleCheckInAsync(Guid userId, Guid itemId, CancellationToken ct);
     Task<bool> CheckInAsync(Guid userId, Guid itemId, CancellationToken ct);
-    Task<ExercisePlanDto?> GetLatestAsync(Guid userId, CancellationToken ct);
 }
 
 public interface IExerciseRepository
 {
     Task<IReadOnlyList<ExercisePlan>> ListActiveOnAsync(Guid userId, DateOnly date, CancellationToken ct);
     Task<IReadOnlyList<ExercisePlan>> ListAsync(Guid userId, int limit, CancellationToken ct);
+    Task<IReadOnlyList<ExercisePlan>> ListAllAsync(Guid userId, CancellationToken ct);
     Task<ExercisePlan?> GetOwnedPlanAsync(Guid userId, Guid planId, CancellationToken ct);
-    Task<ExercisePlan?> GetLatestAsync(Guid userId, CancellationToken ct);
     Task<ExercisePlanItem?> GetOwnedItemAsync(Guid userId, Guid itemId, CancellationToken ct);
     Task AddAsync(ExercisePlan plan, CancellationToken ct);
     void Delete(ExercisePlan plan);

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

@@ -33,8 +33,11 @@ public sealed class ExerciseService(IExerciseRepository exercises) : IExerciseSe
         {
             plan.Items.Add(new ExercisePlanItem
             {
-                Id = Guid.NewGuid(), ScheduledDate = date, ExerciseType = exerciseType,
-                DurationMinutes = duration, IsRestDay = false,
+                Id = Guid.NewGuid(),
+                ScheduledDate = date,
+                ExerciseType = exerciseType,
+                DurationMinutes = duration,
+                IsRestDay = false,
             });
         }
         await SaveNewAsync(plan, ct);
@@ -52,10 +55,13 @@ public sealed class ExerciseService(IExerciseRepository exercises) : IExerciseSe
     public async Task<IReadOnlyList<ExercisePlanSummaryDto>> ListAsync(Guid userId, CancellationToken ct)
     {
         var plans = await _exercises.ListAsync(userId, 20, ct);
-        return plans.Select(p => new ExercisePlanSummaryDto(
-            p.Id, p.StartDate, p.EndDate, p.ReminderTime, p.CreatedAt,
-            p.Items.Count, p.Items.Count(i => i.IsCompleted),
-            p.Items.OrderBy(i => i.ScheduledDate).Select(ToItemDto).ToList())).ToList();
+        return plans.Select(ToSummaryDto).ToList();
+    }
+
+    public async Task<IReadOnlyList<ExercisePlanSummaryDto>> ListAllAsync(Guid userId, CancellationToken ct)
+    {
+        var plans = await _exercises.ListAllAsync(userId, ct);
+        return plans.Select(ToSummaryDto).ToList();
     }
 
     public async Task<ExercisePlanDto?> GetByIdAsync(Guid userId, Guid planId, CancellationToken ct)
@@ -103,12 +109,6 @@ public sealed class ExerciseService(IExerciseRepository exercises) : IExerciseSe
         return true;
     }
 
-    public async Task<ExercisePlanDto?> GetLatestAsync(Guid userId, CancellationToken ct)
-    {
-        var plan = await _exercises.GetLatestAsync(userId, ct);
-        return plan == null ? null : ToDto(plan);
-    }
-
     private async Task SaveNewAsync(ExercisePlan plan, CancellationToken ct)
     {
         await _exercises.AddAsync(plan, ct);
@@ -117,15 +117,24 @@ public sealed class ExerciseService(IExerciseRepository exercises) : IExerciseSe
 
     private static ExercisePlan NewPlan(Guid userId, DateOnly startDate, DateOnly endDate, TimeOnly? reminderTime) => new()
     {
-        Id = Guid.NewGuid(), UserId = userId, StartDate = startDate, EndDate = endDate,
+        Id = Guid.NewGuid(),
+        UserId = userId,
+        StartDate = startDate,
+        EndDate = endDate,
         ReminderTime = reminderTime ?? DefaultReminderTime,
-        CreatedAt = DateTime.UtcNow, UpdatedAt = DateTime.UtcNow,
+        CreatedAt = DateTime.UtcNow,
+        UpdatedAt = DateTime.UtcNow,
     };
 
     private static ExercisePlanDto ToDto(ExercisePlan plan) => new(
         plan.Id, plan.StartDate, plan.EndDate, plan.ReminderTime, plan.CreatedAt, plan.UpdatedAt,
         plan.Items.OrderBy(i => i.ScheduledDate).Select(ToItemDto).ToList());
 
+    private static ExercisePlanSummaryDto ToSummaryDto(ExercisePlan plan) => new(
+        plan.Id, plan.StartDate, plan.EndDate, plan.ReminderTime, plan.CreatedAt,
+        plan.Items.Count, plan.Items.Count(i => i.IsCompleted),
+        plan.Items.OrderBy(i => i.ScheduledDate).Select(ToItemDto).ToList());
+
     private static ExercisePlanItemDto ToItemDto(ExercisePlanItem item) => new(
         item.Id, item.ScheduledDate, item.ExerciseType, item.DurationMinutes,
         item.IsCompleted, item.CompletedAt, item.IsRestDay);

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

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

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

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

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

@@ -27,6 +27,7 @@ public interface IHealthRecordService
 {
     Task<IReadOnlyList<HealthRecordDto>> GetRecordsAsync(Guid userId, string? type, int? days, CancellationToken ct);
     Task<Guid> CreateAsync(Guid userId, HealthRecordUpsertRequest request, CancellationToken ct);
+    Task<IReadOnlyList<Guid>> CreateManyAsync(Guid userId, IReadOnlyList<HealthRecordUpsertRequest> requests, CancellationToken ct);
     Task<bool> UpdateAsync(Guid userId, Guid id, HealthRecordUpsertRequest request, CancellationToken ct);
     Task<bool> DeleteAsync(Guid userId, Guid id, CancellationToken ct);
     Task<Dictionary<string, object?>> GetLatestAsync(Guid userId, CancellationToken ct);

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

@@ -9,7 +9,7 @@ public static class HealthRecordRules
     {
         HealthMetricType.BloodPressure => request.Systolic >= 140 || request.Diastolic >= 90 || request.Systolic <= 89 || request.Diastolic <= 59,
         HealthMetricType.HeartRate => request.Value > 100 || request.Value < 60,
-        HealthMetricType.Glucose => request.Value >= 7.0m || request.Value <= 3.8m,
+        HealthMetricType.Glucose => request.Value > 6.1m || request.Value < 3.9m,
         HealthMetricType.SpO2 => request.Value <= 94,
         HealthMetricType.Weight => false,
         _ => false
@@ -58,4 +58,3 @@ public static class HealthRecordRules
             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

@@ -49,6 +49,44 @@ public sealed class HealthRecordService(
         return record.Id;
     }
 
+    public async Task<IReadOnlyList<Guid>> CreateManyAsync(
+        Guid userId,
+        IReadOnlyList<HealthRecordUpsertRequest> requests,
+        CancellationToken ct)
+    {
+        if (requests.Count == 0)
+            throw new ArgumentException("至少需要一条健康记录", nameof(requests));
+
+        foreach (var request in requests)
+            HealthRecordRules.Validate(request);
+
+        var now = DateTime.UtcNow;
+        var records = requests.Select(request => new HealthRecord
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            MetricType = request.Type,
+            Systolic = request.Systolic,
+            Diastolic = request.Diastolic,
+            Value = request.Value,
+            Unit = request.Unit,
+            Source = request.Source,
+            RecordedAt = request.RecordedAt ?? now,
+            CreatedAt = now,
+            IsAbnormal = HealthRecordRules.CheckAbnormal(request),
+        }).ToList();
+
+        foreach (var record in records)
+            await _records.AddAsync(record, ct);
+
+        await _records.SaveChangesAsync(ct);
+
+        foreach (var record in records)
+            await EnqueueAbnormalNotificationAsync(record, ct);
+
+        return records.Select(record => record.Id).ToList();
+    }
+
     public async Task<bool> UpdateAsync(Guid userId, Guid id, HealthRecordUpsertRequest request, CancellationToken ct)
     {
         var record = await _records.GetOwnedAsync(userId, id, ct);
@@ -101,6 +139,7 @@ public sealed class HealthRecordService(
                 latest.Diastolic,
                 latest.Value,
                 latest.Unit,
+                latest.IsAbnormal,
                 latest.RecordedAt
             };
         }
@@ -140,7 +179,7 @@ public sealed class HealthRecordService(
                 ("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 =>
+            HealthMetricType.Glucose when record.Value > 6.1m =>
                 ("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"),
@@ -149,6 +188,16 @@ public sealed class HealthRecordService(
             _ => ("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 citation = record.MetricType switch
+        {
+            HealthMetricType.BloodPressure => "参考来源：\n[S-BP-01] 2024 ESC Guidelines for the management of elevated blood pressure and hypertension\nhttps://pubmed.ncbi.nlm.nih.gov/39210715/",
+            HealthMetricType.Glucose => "参考来源：\n[S-GLU-01] Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes—2025\nhttps://pubmed.ncbi.nlm.nih.gov/39651981/",
+            HealthMetricType.HeartRate => "参考来源：\n[S-HR-01] All About Heart Rate, American Heart Association\nhttps://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/all-about-heart-rate-pulse",
+            HealthMetricType.SpO2 => "参考来源：\n[S-OXY-01] Pulse Oximeter Basics, U.S. Food and Drug Administration\nhttps://www.fda.gov/consumers/consumer-updates/pulse-oximeter-basics",
+            _ => string.Empty,
+        };
+        if (!string.IsNullOrWhiteSpace(citation)) message = $"{message}\n\n{citation}";
+
         var window = DateTime.UtcNow.Ticks / TimeSpan.FromMinutes(30).Ticks;
         var sourceId = DeterministicGuid($"{record.UserId}:{record.MetricType}:{severity}:{window}");
         await _notifications.EnqueueAsync(

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

@@ -20,7 +20,8 @@ public sealed record MedicationPatchRequest(
     IReadOnlyList<TimeOnly>? TimeOfDay,
     DateOnly? StartDate,
     DateOnly? EndDate,
-    string? Notes);
+    string? Notes,
+    bool ClearEndDate = false);
 
 public sealed record MedicationDto(
     Guid Id,
@@ -44,6 +45,21 @@ public sealed record MedicationReminderDto(
     string ScheduledTime,
     string Status);
 
+public sealed record AiMedicationDoseDto(
+    string ScheduledTime,
+    string Status);
+
+public sealed record AiMedicationPlanDto(
+    Guid Id,
+    string Name,
+    string? Dosage,
+    string Frequency,
+    DateOnly? StartDate,
+    DateOnly? EndDate,
+    string Phase,
+    bool ScheduledOnDate,
+    IReadOnlyList<AiMedicationDoseDto> Doses);
+
 public sealed record MedicationReminderTask(
     Guid TaskId,
     Guid UserId,
@@ -59,12 +75,10 @@ public interface IMedicationService
     Task<Guid> CreateAsync(Guid userId, MedicationUpsertRequest request, CancellationToken ct);
     Task<bool> UpdateAsync(Guid userId, Guid medicationId, MedicationPatchRequest request, CancellationToken ct);
     Task<bool> DeleteAsync(Guid userId, Guid medicationId, CancellationToken ct);
-    Task<bool?> ToggleTodayTakenAsync(Guid userId, Guid medicationId, CancellationToken ct);
     Task<IReadOnlyList<MedicationReminderDto>> GetRemindersAsync(Guid userId, CancellationToken ct);
     Task<bool?> ConfirmDoseAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, MedicationLogStatus status, CancellationToken ct);
     Task<bool> CancelDoseAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, CancellationToken ct);
-    Task<IReadOnlyList<MedicationDto>> ListActiveAsync(Guid userId, CancellationToken ct);
-    Task<bool> ConfirmNowAsync(Guid userId, Guid medicationId, CancellationToken ct);
+    Task<IReadOnlyList<AiMedicationPlanDto>> GetAiOverviewAsync(Guid userId, DateOnly date, CancellationToken ct);
 }
 
 public interface IMedicationRepository
@@ -73,8 +87,6 @@ public interface IMedicationRepository
     Task<IReadOnlyList<Medication>> ListActiveForRemindersAsync(Guid userId, DateOnly today, CancellationToken ct);
     Task<IReadOnlyList<MedicationLog>> ListLogsInWindowAsync(Guid userId, DateTime startUtc, DateTime endUtc, CancellationToken ct);
     Task<Medication?> GetOwnedAsync(Guid userId, Guid medicationId, CancellationToken ct);
-    Task<bool> ExistsOwnedAsync(Guid userId, Guid medicationId, CancellationToken ct);
-    Task<MedicationLog?> GetTodayTakenLogAsync(Guid userId, Guid medicationId, DateTime startUtc, DateTime endUtc, CancellationToken ct);
     Task<bool> DoseLogExistsAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, DateTime startUtc, DateTime endUtc, CancellationToken ct);
     Task<MedicationLog?> GetDoseLogAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, DateTime startUtc, DateTime endUtc, CancellationToken ct);
     Task<IReadOnlyList<Medication>> ListActiveForReminderScanAsync(CancellationToken ct);

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

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

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

@@ -54,7 +54,8 @@ public sealed class MedicationService(IMedicationRepository medications) : IMedi
         if (request.Frequency.HasValue) med.Frequency = request.Frequency.Value;
         if (request.TimeOfDay != null) med.TimeOfDay = NormalizeTimes(request.TimeOfDay);
         if (request.StartDate.HasValue) med.StartDate = request.StartDate.Value;
-        if (request.EndDate.HasValue) med.EndDate = request.EndDate.Value;
+        if (request.ClearEndDate) med.EndDate = null;
+        else if (request.EndDate.HasValue) med.EndDate = request.EndDate.Value;
         ValidateDateRange(med.StartDate, med.EndDate);
         if (request.Notes != null) med.Notes = request.Notes;
         med.UpdatedAt = DateTime.UtcNow;
@@ -95,23 +96,6 @@ public sealed class MedicationService(IMedicationRepository medications) : IMedi
         return true;
     }
 
-    public async Task<bool?> ToggleTodayTakenAsync(Guid userId, Guid medicationId, CancellationToken ct)
-    {
-        if (!await _medications.ExistsOwnedAsync(userId, medicationId, ct)) return null;
-
-        var (todayStartUtc, todayEndUtc) = GetBeijingTodayUtcWindow();
-        var existing = await _medications.GetTodayTakenLogAsync(userId, medicationId, todayStartUtc, todayEndUtc, ct);
-        if (existing != null)
-        {
-            _medications.DeleteLog(existing);
-            await _medications.SaveChangesAsync(ct);
-            return false;
-        }
-
-        await AddLogAsync(userId, medicationId, MedicationLogStatus.Taken, TimeOnly.FromDateTime(DateTime.UtcNow.AddHours(8)), ct);
-        return true;
-    }
-
     public async Task<IReadOnlyList<MedicationReminderDto>> GetRemindersAsync(Guid userId, CancellationToken ct)
     {
         var beijingNow = DateTime.UtcNow.AddHours(8);
@@ -130,15 +114,10 @@ public sealed class MedicationService(IMedicationRepository medications) : IMedi
             foreach (var scheduledTime in med.TimeOfDay)
             {
                 var log = logs.FirstOrDefault(l => l.MedicationId == med.Id && l.ScheduledTime == scheduledTime);
-                string status;
-                if (log != null)
-                    status = log.Status == MedicationLogStatus.Taken ? "taken" : "skipped";
-                else if (scheduledTime <= now.AddMinutes(-30))
-                    status = "overdue";
-                else if (scheduledTime <= now.AddHours(3))
-                    status = "upcoming";
-                else
-                    continue;
+                var status = MedicationScheduleStatus.Resolve(
+                    scheduledTime,
+                    now,
+                    log?.Status);
 
                 reminders.Add(new MedicationReminderDto(med.Id, med.Name, med.Dosage, scheduledTime.ToString("HH:mm"), status));
             }
@@ -151,7 +130,14 @@ public sealed class MedicationService(IMedicationRepository medications) : IMedi
 
     public async Task<bool?> ConfirmDoseAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, MedicationLogStatus status, CancellationToken ct)
     {
-        if (!await _medications.ExistsOwnedAsync(userId, medicationId, ct)) return null;
+        var medication = await _medications.GetOwnedAsync(userId, medicationId, ct);
+        if (medication == null) return null;
+
+        var today = BeijingToday();
+        if (!IsActiveOn(medication, today) ||
+            !GetDosesForToday(medication, today) ||
+            !medication.TimeOfDay.Contains(scheduledTime))
+            return false;
 
         var (todayStartUtc, todayEndUtc) = GetBeijingTodayUtcWindow();
         var existing = await _medications.DoseLogExistsAsync(userId, medicationId, scheduledTime, todayStartUtc, todayEndUtc, ct);
@@ -172,18 +158,48 @@ public sealed class MedicationService(IMedicationRepository medications) : IMedi
         return true;
     }
 
-    public Task<IReadOnlyList<MedicationDto>> ListActiveAsync(Guid userId, CancellationToken ct) =>
-        ListAsync(userId, "active", ct);
-
-    public async Task<bool> ConfirmNowAsync(Guid userId, Guid medicationId, CancellationToken ct)
+    public async Task<IReadOnlyList<AiMedicationPlanDto>> GetAiOverviewAsync(
+        Guid userId,
+        DateOnly date,
+        CancellationToken ct)
     {
-        var result = await ConfirmDoseAsync(
-            userId,
-            medicationId,
-            TimeOnly.FromDateTime(DateTime.UtcNow.AddHours(8)),
-            MedicationLogStatus.Taken,
-            ct);
-        return result == true;
+        var medications = await _medications.ListAsync(userId, null, ct);
+        var (startUtc, endUtc) = GetBeijingDateUtcWindow(date);
+        var logs = await _medications.ListLogsInWindowAsync(userId, startUtc, endUtc, ct);
+        var today = BeijingToday();
+        var now = TimeOnly.FromDateTime(DateTime.UtcNow.AddHours(8));
+
+        return medications.Select(medication =>
+        {
+            var phase = ResolvePhase(medication, date);
+            var scheduled = phase == "active" && GetDosesForToday(medication, date);
+            var doses = scheduled
+                ? medication.TimeOfDay.OrderBy(time => time).Select(time =>
+                {
+                    var log = logs.FirstOrDefault(item =>
+                        item.MedicationId == medication.Id && item.ScheduledTime == time);
+                    var status = log != null
+                        ? log.Status.ToString().ToLowerInvariant()
+                        : date < today
+                            ? "missed"
+                            : date > today
+                                ? "scheduled"
+                                : MedicationScheduleStatus.Resolve(time, now, null);
+                    return new AiMedicationDoseDto(time.ToString("HH:mm"), status);
+                }).ToList()
+                : [];
+
+            return new AiMedicationPlanDto(
+                medication.Id,
+                medication.Name,
+                medication.Dosage,
+                medication.Frequency.ToString(),
+                medication.StartDate,
+                medication.EndDate,
+                phase,
+                scheduled,
+                doses);
+        }).ToList();
     }
 
     private async Task AddLogAsync(Guid userId, Guid medicationId, MedicationLogStatus status, TimeOnly scheduledTime, CancellationToken ct)
@@ -221,9 +237,28 @@ public sealed class MedicationService(IMedicationRepository medications) : IMedi
 
     private static (DateTime StartUtc, DateTime EndUtc) GetBeijingTodayUtcWindow()
     {
-        var beijingToday = DateTime.UtcNow.AddHours(8).Date;
-        var todayStartUtc = beijingToday.AddHours(-8);
-        return (todayStartUtc, todayStartUtc.AddDays(1));
+        return GetBeijingDateUtcWindow(BeijingToday());
+    }
+
+    private static (DateTime StartUtc, DateTime EndUtc) GetBeijingDateUtcWindow(DateOnly date)
+    {
+        var startUtc = DateTime.SpecifyKind(date.ToDateTime(TimeOnly.MinValue).AddHours(-8), DateTimeKind.Utc);
+        return (startUtc, startUtc.AddDays(1));
+    }
+
+    private static DateOnly BeijingToday() => DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8));
+
+    private static bool IsActiveOn(Medication medication, DateOnly date) =>
+        medication.IsActive &&
+        (!medication.StartDate.HasValue || medication.StartDate.Value <= date) &&
+        (!medication.EndDate.HasValue || medication.EndDate.Value >= date);
+
+    private static string ResolvePhase(Medication medication, DateOnly date)
+    {
+        if (!medication.IsActive) return "inactive";
+        if (medication.StartDate.HasValue && medication.StartDate.Value > date) return "upcoming";
+        if (medication.EndDate.HasValue && medication.EndDate.Value < date) return "ended";
+        return "active";
     }
 
     private static bool GetDosesForToday(Medication med, DateOnly today)

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

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

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

@@ -94,7 +94,7 @@ public sealed class ReportService(
     public static ReportDto ToDto(Report report) => new(
         report.Id,
         report.UserId,
-        report.FileUrl,
+        $"/api/reports/{report.Id}/file",
         report.FileType.ToString(),
         report.Category.ToString(),
         report.Status.ToString(),

backend/src/Health.Application/Speech/realtime_speech_contracts.cs

@@ -0,0 +1,10 @@
+using System.Net.WebSockets;
+
+namespace Health.Application.Speech;
+
+public interface IRealtimeSpeechRecognitionProxy
+{
+    bool IsConfigured { get; }
+
+    Task ProxyAsync(WebSocket clientSocket, CancellationToken cancellationToken);
+}

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

@@ -14,7 +14,12 @@ public sealed record UserProfileDto(
 public sealed record UserProfileUpdateRequest(
     string? Name,
     string? Gender,
-    DateOnly? BirthDate);
+    DateOnly? BirthDate,
+    string? AvatarUrl);
+
+public sealed record AccountFileReferences(
+    IReadOnlyList<string> FileUrls,
+    IReadOnlyList<string> ConversationMetadataJson);
 
 public interface IUserService
 {
@@ -26,6 +31,12 @@ public interface IUserService
 public interface IUserRepository
 {
     Task<User?> GetAsync(Guid userId, CancellationToken ct);
+    Task<AccountFileReferences> GetAccountFileReferencesAsync(Guid userId, CancellationToken ct);
     Task SaveChangesAsync(CancellationToken ct);
     Task DeleteAccountDataAsync(Guid userId, CancellationToken ct);
 }
+
+public interface IAccountFileCleanup
+{
+    Task DeleteAsync(Guid userId, AccountFileReferences references, CancellationToken ct);
+}

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

@@ -1,8 +1,11 @@
 namespace Health.Application.Users;
 
-public sealed class UserService(IUserRepository users) : IUserService
+public sealed class UserService(
+    IUserRepository users,
+    IAccountFileCleanup fileCleanup) : IUserService
 {
     private readonly IUserRepository _users = users;
+    private readonly IAccountFileCleanup _fileCleanup = fileCleanup;
 
     public async Task<UserProfileDto?> GetProfileAsync(Guid userId, CancellationToken ct)
     {
@@ -25,11 +28,16 @@ public sealed class UserService(IUserRepository users) : IUserService
         if (request.Name != null) user.Name = request.Name;
         if (request.Gender != null) user.Gender = request.Gender;
         if (request.BirthDate.HasValue) user.BirthDate = request.BirthDate.Value;
+        if (request.AvatarUrl != null) user.AvatarUrl = request.AvatarUrl;
         user.UpdatedAt = DateTime.UtcNow;
         await _users.SaveChangesAsync(ct);
         return true;
     }
 
-    public Task DeleteAccountAsync(Guid userId, CancellationToken ct) =>
-        _users.DeleteAccountDataAsync(userId, ct);
+    public async Task DeleteAccountAsync(Guid userId, CancellationToken ct)
+    {
+        var references = await _users.GetAccountFileReferencesAsync(userId, ct);
+        await _fileCleanup.DeleteAsync(userId, references, ct);
+        await _users.DeleteAccountDataAsync(userId, ct);
+    }
 }

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

@@ -35,6 +35,7 @@ public sealed class HealthArchive
     public List<string> DietRestrictions { get; set; } = [];    // 饮食限制
     public List<string> ChronicDiseases { get; set; } = [];     // 慢病史
     public string? FamilyHistory { get; set; }       // 家族病史
+    public string? SurgeryHistoryStatus { get; set; } // 无/有，区分未填写与无手术史
     public DateTime UpdatedAt { get; set; } = DateTime.UtcNow;
 
     public User User { get; set; } = null!;
@@ -89,6 +90,10 @@ public sealed class NotificationPreference
     public bool FollowUpReminder { get; set; } = true;
     public bool DoctorReply { get; set; } = true;
     public bool AbnormalAlert { get; set; } = true;
+    public bool PushEnabled { get; set; } = true;
+    public bool DndEnabled { get; set; }
+    public int DndStartMinutes { get; set; } = 22 * 60;
+    public int DndEndMinutes { get; set; } = 8 * 60;
     // 健康录入提醒——总开关 + 5 子项
     public bool HealthRecordReminder { get; set; } = true;
     public bool HealthRecordReminderBloodPressure { get; set; } = true;

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

@@ -136,10 +136,10 @@ public enum FollowUpStatus
 public enum AgentType
 {
     Default,      // 默认对话
-    Consultation, // AI 问诊
+    Consultation, // AI 对话
     Health,       // 记数据
     Diet,         // 拍饮食
-    Medication,   // 药管家
+    Medication,   // 药提醒
     Report,       // 看报告
     Exercise,     // 运动计划
     Unified       // 统一入口（自动路由）

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

@@ -0,0 +1,49 @@
+using System.Globalization;
+using System.Text.RegularExpressions;
+
+namespace Health.Infrastructure.AI.AgentHandlers;
+
+internal static partial class AiDateTime
+{
+    public static DateTime BeijingNow => DateTime.UtcNow.AddHours(8);
+    public static DateOnly BeijingToday => DateOnly.FromDateTime(BeijingNow);
+
+    public static (DateTime StartUtc, DateTime EndUtc) BeijingDateWindowUtc(DateOnly date)
+    {
+        var startUtc = DateTime.SpecifyKind(date.ToDateTime(TimeOnly.MinValue).AddHours(-8), DateTimeKind.Utc);
+        return (startUtc, startUtc.AddDays(1));
+    }
+
+    public static DateTime ToUtc(DateTime value) => value.Kind switch
+    {
+        DateTimeKind.Utc => value,
+        DateTimeKind.Local => value.ToUniversalTime(),
+        _ => DateTime.SpecifyKind(value, DateTimeKind.Utc),
+    };
+
+    public static string ToBeijingText(DateTime value) =>
+        ToUtc(value).AddHours(8).ToString("yyyy-MM-dd HH:mm:ss", CultureInfo.InvariantCulture);
+
+    public static bool TryParseUserDateTime(string? value, out DateTime utc)
+    {
+        utc = default;
+        if (string.IsNullOrWhiteSpace(value)) return false;
+
+        if ((value.EndsWith("Z", StringComparison.OrdinalIgnoreCase) || OffsetSuffix().IsMatch(value)) &&
+            DateTimeOffset.TryParse(value, CultureInfo.InvariantCulture, DateTimeStyles.AllowWhiteSpaces, out var offsetValue))
+        {
+            utc = offsetValue.UtcDateTime;
+            return true;
+        }
+
+        if (!DateTime.TryParse(value, CultureInfo.InvariantCulture, DateTimeStyles.AllowWhiteSpaces, out var beijingValue))
+            return false;
+
+        utc = DateTime.SpecifyKind(beijingValue, DateTimeKind.Unspecified).AddHours(-8);
+        utc = DateTime.SpecifyKind(utc, DateTimeKind.Utc);
+        return true;
+    }
+
+    [GeneratedRegex(@"[+-]\d{2}:?\d{2}$")]
+    private static partial Regex OffsetSuffix();
+}

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

@@ -8,12 +8,47 @@ namespace Health.Infrastructure.AI.AgentHandlers;
 /// </summary>
 public static class CommonAgentHandler
 {
+    public static readonly ToolDefinition SearchMedicalKnowledgeTool = new()
+    {
+        Function = new()
+        {
+            Name = "search_medical_knowledge",
+            Description = "按需检索医学知识库。仅用于症状分析、健康建议、疾病/药品/检查指标解释等需要医学资料支撑的回答；健康数据录入、用药或运动计划创建/查询/打卡、普通寒暄不得调用。",
+            Parameters = new
+            {
+                type = "object",
+                properties = new
+                {
+                    query = new
+                    {
+                        type = "string",
+                        description = "需要检索的医学问题，保留关键症状、疾病、药品或指标名称",
+                    },
+                },
+                required = new[] { "query" },
+            },
+        },
+    };
+
     public static readonly ToolDefinition QueryHealthRecordsTool = new()
     {
         Function = new()
         {
-            Name = "query_health_records", Description = "查询近期健康数据",
-            Parameters = new { type = "object", properties = new { type = new { type = "string" }, days = new { type = "integer" } } }
+            Name = "query_health_records",
+            Description = "查询近期健康数据",
+            Parameters = new
+            {
+                type = "object",
+                properties = new
+                {
+                    type = new { type = "string", @enum = new[] { "blood_pressure", "heart_rate", "glucose", "spo2", "weight", "all" }, description = "健康指标类型" },
+                    scope = new { type = "string", @enum = new[] { "today", "yesterday", "date", "recent_days", "range" }, description = "日期范围，默认 recent_days" },
+                    date = new { type = "string", description = "scope=date 时的北京时间日期 yyyy-MM-dd" },
+                    start_date = new { type = "string", description = "scope=range 时的北京时间开始日期 yyyy-MM-dd" },
+                    end_date = new { type = "string", description = "scope=range 时的北京时间结束日期 yyyy-MM-dd（包含）" },
+                    days = new { type = "integer", description = "scope=recent_days 时的天数，1到365" },
+                }
+            }
         }
     };
 
@@ -42,10 +77,67 @@ public static class CommonAgentHandler
 
     private static async Task<object> ExecuteQueryHealthRecords(IHealthRecordService healthRecords, Guid userId, JsonElement args, CancellationToken ct)
     {
-        var type = args.TryGetProperty("type", out var t) ? t.GetString() : null;
-        var days = args.TryGetProperty("days", out var d) ? d.GetInt32() : 7;
-        var records = await healthRecords.GetRecordsAsync(userId, type, days, ct);
-        return new { count = records.Count, records };
+        var rawType = args.TryGetProperty("type", out var t) ? t.GetString() : null;
+        if (!TryNormalizeMetricType(rawType, out var metricType))
+            return new { success = false, message = $"无法识别健康指标类型: {rawType}" };
+
+        var scope = args.TryGetProperty("scope", out var scopeValue)
+            ? scopeValue.GetString()?.ToLowerInvariant()
+            : "recent_days";
+        DateTime? startUtc = null;
+        DateTime? endUtc = null;
+        int days;
+
+        switch (scope)
+        {
+            case "today":
+                (startUtc, endUtc) = AiDateTime.BeijingDateWindowUtc(AiDateTime.BeijingToday);
+                days = 2;
+                break;
+            case "yesterday":
+                (startUtc, endUtc) = AiDateTime.BeijingDateWindowUtc(AiDateTime.BeijingToday.AddDays(-1));
+                days = 3;
+                break;
+            case "date":
+                if (!TryReadDate(args, "date", out var date))
+                    return new { success = false, message = "查询指定日期时必须提供有效的 date" };
+                (startUtc, endUtc) = AiDateTime.BeijingDateWindowUtc(date);
+                days = DaysSince(startUtc.Value);
+                break;
+            case "range":
+                if (!TryReadDate(args, "start_date", out var startDate) ||
+                    !TryReadDate(args, "end_date", out var endDate) || endDate < startDate)
+                    return new { success = false, message = "必须提供有效的 start_date 和 end_date，且结束日期不能早于开始日期" };
+                startUtc = AiDateTime.BeijingDateWindowUtc(startDate).StartUtc;
+                endUtc = AiDateTime.BeijingDateWindowUtc(endDate).EndUtc;
+                days = DaysSince(startUtc.Value);
+                break;
+            default:
+                days = args.TryGetProperty("days", out var d) && d.TryGetInt32(out var parsedDays)
+                    ? Math.Clamp(parsedDays, 1, 365)
+                    : 7;
+                scope = "recent_days";
+                break;
+        }
+
+        var records = await healthRecords.GetRecordsAsync(userId, metricType, days, ct);
+        var filtered = records
+            .Where(record => !startUtc.HasValue || AiDateTime.ToUtc(record.RecordedAt) >= startUtc.Value)
+            .Where(record => !endUtc.HasValue || AiDateTime.ToUtc(record.RecordedAt) < endUtc.Value)
+            .Select(record => new
+            {
+                record.Id,
+                record.Type,
+                record.Systolic,
+                record.Diastolic,
+                record.Value,
+                record.Unit,
+                record.Source,
+                record.IsAbnormal,
+                recorded_at_beijing = AiDateTime.ToBeijingText(record.RecordedAt),
+            })
+            .ToList();
+        return new { success = true, scope, count = filtered.Count, records = filtered };
     }
 
     private static async Task<object> ExecuteCheckArchive(IHealthArchiveService archives, Guid userId, CancellationToken ct)
@@ -54,55 +146,39 @@ public static class CommonAgentHandler
         if (archive == null) return new { found = false };
         return new
         {
-            found = true, archive.Diagnosis, archive.SurgeryType,
-            SurgeryDate = archive.SurgeryDate?.ToString("yyyy-MM-dd"), archive.Surgeries,
-            archive.Allergies, archive.DietRestrictions, archive.ChronicDiseases, archive.FamilyHistory,
+            found = true,
+            archive.Diagnosis,
+            archive.SurgeryType,
+            SurgeryDate = archive.SurgeryDate?.ToString("yyyy-MM-dd"),
+            archive.Surgeries,
+            archive.Allergies,
+            archive.DietRestrictions,
+            archive.ChronicDiseases,
+            archive.FamilyHistory,
         };
     }
 
-    public static readonly ToolDefinition ManageArchiveTool = new()
+    private static bool TryNormalizeMetricType(string? value, out string? normalized)
     {
-        Function = new()
+        normalized = value?.Trim().ToLowerInvariant() switch
         {
-            Name = "manage_archive", Description = "管理用户健康档案",
-            Parameters = new
-            {
-                type = "object",
-                properties = new
-                {
-                    action = new { type = "string", description = "update_diagnosis/update_surgery/update_allergies/update_chronic_diseases/update_diet_restrictions/query" },
-                    diagnosis = new { type = "string" },
-                    surgery_type = new { type = "string" },
-                    surgery_date = new { type = "string" },
-                    allergies = new { type = "array", items = new { type = "string" } },
-                    chronic_diseases = new { type = "array", items = new { type = "string" } },
-                    diet_restrictions = new { type = "array", items = new { type = "string" } },
-                },
-                required = new[] { "action" }
-            }
-        }
+            null or "" or "all" or "全部" => null,
+            "bloodpressure" or "blood_pressure" or "血压" => "BloodPressure",
+            "heartrate" or "heart_rate" or "心率" or "脉搏" => "HeartRate",
+            "glucose" or "blood_glucose" or "血糖" => "Glucose",
+            "spo2" or "blood_oxygen" or "血氧" or "血氧饱和度" => "SpO2",
+            "weight" or "体重" => "Weight",
+            _ => "__invalid__",
         };
-
-    public static Task<object> ExecuteManageArchive(
-        IHealthArchiveService archives,
-        Guid userId,
-        JsonElement args,
-        CancellationToken ct = default)
-    {
-        var action = args.TryGetProperty("action", out var a) ? a.GetString()! : "query";
-        var request = new HealthArchiveUpdateRequest(
-            args.TryGetProperty("diagnosis", out var diagnosis) ? diagnosis.GetString() : null,
-            args.TryGetProperty("surgery_type", out var surgeryType) ? surgeryType.GetString() : null,
-            args.TryGetProperty("surgery_date", out var surgeryDate) && DateOnly.TryParse(surgeryDate.GetString(), out var date) ? date : null,
-            ReadStringArray(args, "allergies"),
-            ReadStringArray(args, "diet_restrictions"),
-            ReadStringArray(args, "chronic_diseases"),
-            args.TryGetProperty("family_history", out var familyHistory) ? familyHistory.GetString() : null);
-        return archives.ExecuteAiActionAsync(userId, action, request, ct);
+        return normalized != "__invalid__";
     }
 
-    private static IReadOnlyList<string>? ReadStringArray(JsonElement args, string propertyName) =>
-        args.TryGetProperty(propertyName, out var value) && value.ValueKind == JsonValueKind.Array
-            ? value.EnumerateArray().Select(x => x.GetString()).Where(x => !string.IsNullOrWhiteSpace(x)).Cast<string>().ToList()
-            : null;
+    private static bool TryReadDate(JsonElement args, string name, out DateOnly date)
+    {
+        date = default;
+        return args.TryGetProperty(name, out var value) && DateOnly.TryParse(value.GetString(), out date);
+    }
+
+    private static int DaysSince(DateTime startUtc) =>
+        Math.Clamp((int)Math.Ceiling((DateTime.UtcNow - startUtc).TotalDays) + 1, 1, 3650);
 }

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

@@ -15,7 +15,9 @@ public static class ExerciseAgentHandler
                 type = "object",
                 properties = new
                 {
-                    action = new { type = "string", description = "create/query/checkin" },
+                    action = new { type = "string", @enum = new[] { "create", "query", "checkin" }, description = "create/query/checkin" },
+                    scope = new { type = "string", @enum = new[] { "today", "scheduled_date", "current_plans", "upcoming_plans", "ended_plans", "all_plans" }, description = "查询时必填：今日任务/指定日期任务/当前计划/即将开始/已结束/全部计划" },
+                    date = new { type = "string", description = "仅 scope=scheduled_date 时必填，使用北京时间日期 yyyy-MM-dd" },
                     start_date = new { type = "string", description = "开始日期 yyyy-MM-dd，默认今天" },
                     duration_days = new { type = "integer", description = "连续运动天数，如一周为7天" },
                     exercise_type = new { type = "string", description = "运动类型，如散步、慢跑、游泳" },
@@ -30,20 +32,50 @@ public static class ExerciseAgentHandler
 
     public static List<ToolDefinition> Tools => [ManageExerciseTool];
 
+    public static string? ValidateWriteArguments(JsonElement args)
+    {
+        var action = args.TryGetProperty("action", out var actionValue)
+            ? actionValue.GetString()?.ToLowerInvariant()
+            : null;
+        if (action != "create") return null;
+
+        if (!args.TryGetProperty("exercise_type", out var typeValue) ||
+            string.IsNullOrWhiteSpace(typeValue.GetString()))
+            return "创建运动计划前需要确认运动项目";
+        if (!args.TryGetProperty("duration_minutes", out var minutesValue) ||
+            !minutesValue.TryGetInt32(out var minutes) || minutes is <= 0 or > 300)
+            return "创建运动计划前需要确认合理的单次运动时长";
+        if (!args.TryGetProperty("duration_days", out var daysValue) ||
+            !daysValue.TryGetInt32(out var days) || days is <= 0 or > 366)
+            return "创建运动计划前需要确认计划持续天数";
+        if (!args.TryGetProperty("start_date", out var startValue) ||
+            !DateOnly.TryParse(startValue.GetString(), out _))
+            return "创建运动计划前需要确认开始日期";
+        if (!args.TryGetProperty("reminder_time", out var reminderValue) ||
+            !TimeOnly.TryParse(reminderValue.GetString(), out _))
+            return "创建运动计划前需要确认具体提醒时间";
+        return null;
+    }
+
     public static async Task<object> Execute(
         string toolName,
         JsonElement args,
-        AppDbContext db,
         Guid userId,
-        IExerciseService? exercises = null,
+        IExerciseService exercises,
         CancellationToken ct = default)
     {
-        if (toolName != "manage_exercise" || exercises == null)
+        if (toolName != "manage_exercise")
             return new { success = false, message = $"未知工具: {toolName}" };
 
-        var action = args.TryGetProperty("action", out var actionValue) ? actionValue.GetString() : "query";
+        var action = args.TryGetProperty("action", out var actionValue)
+            ? actionValue.GetString()?.ToLowerInvariant()
+            : null;
         if (action == "create")
         {
+            var validationError = ValidateWriteArguments(args);
+            if (validationError != null)
+                return new { success = false, message = validationError };
+
             var startDate = args.TryGetProperty("start_date", out var startValue) && DateOnly.TryParse(startValue.GetString(), out var parsedStart)
                 ? parsedStart
                 : DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8));
@@ -67,17 +99,111 @@ public static class ExerciseAgentHandler
             return success ? new { success = true } : new { success = false, message = "条目不存在" };
         }
 
-        var plan = await exercises.GetLatestAsync(userId, ct);
-        return plan == null
-            ? new { found = false }
-            : new
+        if (action != "query")
+            return new { success = false, message = $"未知操作: {action}" };
+
+        var scope = args.TryGetProperty("scope", out var scopeValue)
+            ? scopeValue.GetString()?.ToLowerInvariant()
+            : null;
+        if (scope is not ("today" or "scheduled_date" or "current_plans" or "upcoming_plans" or "ended_plans" or "all_plans"))
+            return new
+            {
+                success = false,
+                message = "查询运动计划时必须明确 scope：today、scheduled_date、current_plans、upcoming_plans、ended_plans 或 all_plans",
+            };
+        if (scope == "scheduled_date" &&
+            (!args.TryGetProperty("date", out var requestedDate) || !DateOnly.TryParse(requestedDate.GetString(), out _)))
+            return new { success = false, message = "查询指定日期的运动安排时必须提供有效的 date" };
+        var queryDate = scope == "scheduled_date"
+            ? DateOnly.Parse(args.GetProperty("date").GetString()!)
+            : AiDateTime.BeijingToday;
+        var isDateScope = scope is "today" or "scheduled_date";
+        var plans = await exercises.ListAllAsync(userId, ct);
+        var overview = plans.Select(plan => new
         {
-                found = true,
             plan_id = plan.Id,
             plan.StartDate,
             plan.EndDate,
+            phase = queryDate < plan.StartDate ? "upcoming" : queryDate > plan.EndDate ? "ended" : "active",
             plan.ReminderTime,
-                items = plan.Items.Select(i => new { i.Id, i.ScheduledDate, i.ExerciseType, i.DurationMinutes, i.IsCompleted }),
+            total_items = plan.Items.Count,
+            completed_items = plan.Items.Count(item => item.IsCompleted),
+            returned_items = isDateScope
+                ? plan.Items.Count(item => item.ScheduledDate == queryDate)
+                : Math.Min(plan.Items.Count, 14),
+            items_truncated = !isDateScope && plan.Items.Count > 14,
+            items = plan.Items
+                .Where(item => !isDateScope || item.ScheduledDate == queryDate)
+                .OrderBy(item => item.ScheduledDate)
+                .Take(isDateScope ? int.MaxValue : 14)
+                .Select(item => new
+                {
+                    item.Id,
+                    item.ScheduledDate,
+                    item.ExerciseType,
+                    item.DurationMinutes,
+                    item.IsCompleted,
+                    item.IsRestDay,
+                    completed_at_beijing = item.CompletedAt.HasValue ? AiDateTime.ToBeijingText(item.CompletedAt.Value) : null,
+                })
+                .ToList(),
+        });
+        var filtered = scope switch
+        {
+            "all_plans" => overview,
+            "current_plans" => overview.Where(plan => plan.phase == "active"),
+            "upcoming_plans" => overview
+                .Where(plan => plan.phase == "upcoming")
+                .OrderBy(plan => plan.StartDate),
+            "ended_plans" => overview
+                .Where(plan => plan.phase == "ended")
+                .OrderByDescending(plan => plan.EndDate),
+            _ => overview.Where(plan => plan.phase == "active" && plan.items.Count > 0),
+        };
+        var result = filtered.ToList();
+        var scheduledTasks = result.SelectMany(plan => plan.items).Where(item => !item.IsRestDay).ToList();
+        var nextPlan = plans.Where(plan => plan.StartDate > queryDate).OrderBy(plan => plan.StartDate).FirstOrDefault();
+        string authoritativeAnswer;
+        if (result.Count == 0)
+        {
+            authoritativeAnswer = isDateScope
+                ? $"没有查到 {queryDate:yyyy-MM-dd} 的运动安排。"
+                : "当前没有查到符合条件的运动计划。";
+        }
+        else if (isDateScope)
+        {
+            var taskLines = scheduledTasks.Select(item =>
+                $"- {item.ExerciseType}：{item.DurationMinutes} 分钟，{(item.IsCompleted ? "已完成" : "未完成")}");
+            authoritativeAnswer =
+                $"{queryDate:yyyy-MM-dd} 的运动安排：\n{string.Join('\n', taskLines)}";
+        }
+        else
+        {
+            var planLines = result.Select(plan =>
+            {
+                var representative = plan.items.FirstOrDefault(item => !item.IsRestDay);
+                var exerciseType = representative?.ExerciseType ?? "运动";
+                var durationMinutes = representative?.DurationMinutes ?? 0;
+                return $"- {exerciseType}：{plan.StartDate:yyyy-MM-dd} 至 {plan.EndDate:yyyy-MM-dd}，"
+                    + $"每天 {durationMinutes} 分钟，提醒时间 {plan.ReminderTime:HH:mm}";
+            });
+            authoritativeAnswer =
+                $"查到 {result.Count} 个符合条件的运动计划：\n{string.Join('\n', planLines)}";
+        }
+        return new
+        {
+            found = result.Count > 0,
+            query_date = queryDate.ToString("yyyy-MM-dd"),
+            scope,
+            count = result.Count,
+            all_tasks_completed = isDateScope
+                ? scheduledTasks.Count > 0 && scheduledTasks.All(item => item.IsCompleted)
+                : (bool?)null,
+            has_upcoming_plans = nextPlan != null,
+            next_start_date = nextPlan?.StartDate.ToString("yyyy-MM-dd"),
+            days_until_next_start = nextPlan == null ? (int?)null : nextPlan.StartDate.DayNumber - queryDate.DayNumber,
+            plans = result,
+            authoritative_answer = authoritativeAnswer,
         };
     }
 }

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

@@ -7,35 +7,162 @@ namespace Health.Infrastructure.AI.AgentHandlers;
 /// </summary>
 public static class HealthDataAgentHandler
 {
+    private static readonly string[] MetricTypes = ["blood_pressure", "heart_rate", "glucose", "spo2", "weight"];
+
     public static readonly ToolDefinition RecordHealthDataTool = new()
     {
         Function = new()
         {
-            Name = "record_health_data", Description = "记录健康数据（血压/心率/血糖/血氧/体重）",
-            Parameters = new { type = "object", properties = new { type = new { type = "string" }, systolic = new { type = "integer" }, diastolic = new { type = "integer" }, heart_rate = new { type = "number" }, glucose = new { type = "number" }, spo2 = new { type = "number" }, weight = new { type = "number" } }, required = new[] { "type" } }
+            Name = "record_health_data",
+            Description = "记录健康数据（血压/心率/血糖/血氧/体重）。用户说“脉搏”时按“心率”处理，type 使用 heart_rate，数值写入 heart_rate。",
+            Parameters = new { type = "object", properties = new { type = new { type = "string", @enum = new[] { "blood_pressure", "heart_rate", "glucose", "spo2", "weight" } }, systolic = new { type = "integer" }, diastolic = new { type = "integer" }, heart_rate = new { type = "number" }, glucose = new { type = "number" }, spo2 = new { type = "number" }, weight = new { type = "number" }, recorded_at = new { type = "string", description = "测量时间；不带时区时按北京时间解释" } }, required = new[] { "type" } }
         }
     };
 
-    public static List<ToolDefinition> Tools => [RecordHealthDataTool, CommonAgentHandler.QueryHealthRecordsTool];
+    public static readonly ToolDefinition RecordHealthDataBatchTool = new()
+    {
+        Function = new()
+        {
+            Name = "record_health_data_batch",
+            Description = "提交当前这一轮要录入的全部健康指标。一次只调用一次；即使只有一个指标也放入 metrics。血压可先只提供已知的一侧，脉搏按心率 heart_rate 处理。后端会整批校验、追问或生成一张确认卡。",
+            Parameters = new
+            {
+                type = "object",
+                properties = new
+                {
+                    metrics = new
+                    {
+                        type = "array",
+                        minItems = 1,
+                        description = "当前录入批次的全部指标，不得遗漏；不要带入普通历史对话或上一张已生成卡片的数据",
+                        items = new
+                        {
+                            type = "object",
+                            properties = new
+                            {
+                                type = new { type = "string", @enum = MetricTypes },
+                                systolic = new { type = "integer" },
+                                diastolic = new { type = "integer" },
+                                heart_rate = new { type = "number" },
+                                glucose = new { type = "number" },
+                                spo2 = new { type = "number" },
+                                weight = new { type = "number" },
+                                recorded_at = new { type = "string", description = "测量时间；不带时区时按北京时间解释" },
+                            },
+                            required = new[] { "type" },
+                        },
+                    },
+                },
+                required = new[] { "metrics" },
+            },
+        },
+    };
 
-    public static async Task<object> Execute(string toolName, JsonElement args, Guid userId, IHealthRecordService healthRecords)
+    public static List<ToolDefinition> Tools => [RecordHealthDataBatchTool, CommonAgentHandler.QueryHealthRecordsTool];
+
+    public static string? ValidateWriteArguments(JsonElement args)
+    {
+        var type = args.TryGetProperty("type", out var typeValue) ? typeValue.GetString() : null;
+        return type switch
+        {
+            "blood_pressure" => ValidateBloodPressure(args),
+            "heart_rate" => ValidateValue(args, "heart_rate", "心率", 1m, 250m),
+            "glucose" => ValidateValue(args, "glucose", "血糖", 0.1m, 50m),
+            "spo2" => ValidateValue(args, "spo2", "血氧", 1m, 100m),
+            "weight" => ValidateValue(args, "weight", "体重", 1m, 500m),
+            _ => "缺少有效的健康指标类型",
+        };
+    }
+
+    public static string? GetUrgentWarning(JsonElement args)
+    {
+        var type = args.TryGetProperty("type", out var typeValue) ? typeValue.GetString() : null;
+        return type switch
+        {
+            "blood_pressure"
+                when args.TryGetProperty("systolic", out var systolic) &&
+                     systolic.TryGetInt32(out var systolicValue) &&
+                     args.TryGetProperty("diastolic", out var diastolic) &&
+                     diastolic.TryGetInt32(out var diastolicValue) &&
+                     (systolicValue >= 180 || diastolicValue >= 120)
+                => "这次血压数值已达到明显危险范围，请不要继续等待录入，尽快联系医生或前往急诊评估。",
+            "heart_rate" when IsValueOutside(args, "heart_rate", 45m, 130m)
+                => "这次心率数值明显异常，请尽快联系医生评估；如伴有胸痛、晕厥或呼吸困难，请立即就医。",
+            "glucose" when IsValueOutside(args, "glucose", 3.0m, 16.7m)
+                => "这次血糖数值属于需要尽快处理的危险范围，请立即联系医生或前往医疗机构评估。",
+            "spo2"
+                when args.TryGetProperty("spo2", out var spo2) &&
+                     spo2.TryGetDecimal(out var spo2Value) &&
+                     spo2Value <= 90m
+                => "这次血氧数值明显偏低，请尽快就医评估；如有呼吸困难、胸闷或意识异常，请立即拨打当地急救电话。",
+            _ => null,
+        };
+    }
+
+    public static IReadOnlyList<JsonElement> GetBatchMetrics(JsonElement args) =>
+        args.TryGetProperty("metrics", out var metrics) && metrics.ValueKind == JsonValueKind.Array
+            ? metrics.EnumerateArray().Select(metric => metric.Clone()).ToList()
+            : [];
+
+    public static Dictionary<string, object?> CreatePreview(JsonElement args)
+    {
+        var type = args.TryGetProperty("type", out var typeValue) ? typeValue.GetString() ?? "" : "";
+        var (metricType, value, unit, systolic, diastolic) = ParseMetric(type, args);
+        if (metricType == null)
+            return [];
+
+        var request = new HealthRecordUpsertRequest(
+            metricType.Value,
+            systolic,
+            diastolic,
+            value,
+            unit,
+            HealthRecordSource.AiEntry,
+            null);
+        return new Dictionary<string, object?>
+        {
+            ["type"] = metricType.Value.ToString(),
+            ["value"] = metricType == HealthMetricType.BloodPressure
+                ? $"{systolic}/{diastolic}"
+                : value?.ToString() ?? "",
+            ["unit"] = unit,
+            ["abnormal"] = HealthRecordRules.CheckAbnormal(request),
+        };
+    }
+
+    public static async Task<object> Execute(
+        string toolName,
+        JsonElement args,
+        Guid userId,
+        IHealthRecordService healthRecords,
+        CancellationToken ct)
     {
         return toolName switch
         {
-            "record_health_data" => await ExecuteRecordHealthData(healthRecords, userId, args),
+            "record_health_data" => await ExecuteRecordHealthData(healthRecords, userId, args, ct),
+            "record_health_data_batch" => await ExecuteRecordHealthDataBatch(healthRecords, userId, args, ct),
             _ => new { success = false, message = $"未知工具: {toolName}" }
         };
     }
 
-    private static async Task<object> ExecuteRecordHealthData(IHealthRecordService healthRecords, Guid userId, JsonElement args)
+    private static async Task<object> ExecuteRecordHealthData(
+        IHealthRecordService healthRecords,
+        Guid userId,
+        JsonElement args,
+        CancellationToken ct)
     {
+        var validationError = ValidateWriteArguments(args);
+        if (validationError != null)
+            return new { success = false, message = validationError };
+
         var type = args.TryGetProperty("type", out var t) ? t.GetString()! : "";
         var (metricType, value, unit, systolic, diastolic) = ParseMetric(type, args);
         if (metricType == null)
             return new { success = false, message = $"未知指标类型: {type}" };
 
-        var recordedAt = args.TryGetProperty("recorded_at", out var ra) && ra.TryGetDateTime(out var dt)
-            ? dt
+        var recordedAt = args.TryGetProperty("recorded_at", out var ra) &&
+                         AiDateTime.TryParseUserDateTime(ra.GetString(), out var parsedRecordedAt)
+            ? parsedRecordedAt
             : DateTime.UtcNow;
 
         var request = new HealthRecordUpsertRequest(
@@ -47,7 +174,7 @@ public static class HealthDataAgentHandler
             HealthRecordSource.AiEntry,
             recordedAt);
 
-        var id = await healthRecords.CreateAsync(userId, request, CancellationToken.None);
+        var id = await healthRecords.CreateAsync(userId, request, ct);
         var valStr = metricType == HealthMetricType.BloodPressure ? $"{systolic}/{diastolic}" : value?.ToString() ?? "";
         return new
         {
@@ -60,6 +187,75 @@ public static class HealthDataAgentHandler
         };
     }
 
+    private static async Task<object> ExecuteRecordHealthDataBatch(
+        IHealthRecordService healthRecords,
+        Guid userId,
+        JsonElement args,
+        CancellationToken ct)
+    {
+        var metrics = GetBatchMetrics(args);
+        if (metrics.Count == 0)
+            return new { success = false, message = "当前录入批次没有健康指标" };
+
+        var requests = new List<HealthRecordUpsertRequest>(metrics.Count);
+        var previews = new List<Dictionary<string, object?>>(metrics.Count);
+        foreach (var metric in metrics)
+        {
+            var validationError = ValidateWriteArguments(metric);
+            if (validationError != null)
+                return new { success = false, message = validationError };
+
+            var type = metric.GetProperty("type").GetString()!;
+            var (metricType, value, unit, systolic, diastolic) = ParseMetric(type, metric);
+            if (metricType == null)
+                return new { success = false, message = $"未知指标类型: {type}" };
+
+            var recordedAt = metric.TryGetProperty("recorded_at", out var recordedAtValue) &&
+                             AiDateTime.TryParseUserDateTime(recordedAtValue.GetString(), out var parsedRecordedAt)
+                ? parsedRecordedAt
+                : DateTime.UtcNow;
+            requests.Add(new HealthRecordUpsertRequest(
+                metricType.Value,
+                systolic,
+                diastolic,
+                value,
+                unit,
+                HealthRecordSource.AiEntry,
+                recordedAt));
+            previews.Add(CreatePreview(metric));
+        }
+
+        var ids = await healthRecords.CreateManyAsync(userId, requests, ct);
+        return new
+        {
+            success = true,
+            record_ids = ids,
+            items = previews,
+        };
+    }
+
+    private static string? ValidateBloodPressure(JsonElement args)
+    {
+        if (!args.TryGetProperty("systolic", out var systolicValue) || !systolicValue.TryGetInt32(out var systolic) ||
+            !args.TryGetProperty("diastolic", out var diastolicValue) || !diastolicValue.TryGetInt32(out var diastolic))
+            return "录入血压前需要同时提供收缩压和舒张压";
+        if (systolic is <= 0 or > 260 || diastolic is <= 0 or > 160 || systolic <= diastolic)
+            return "血压数值明显无效，请核对收缩压和舒张压后重新提供";
+        return null;
+    }
+
+    private static string? ValidateValue(JsonElement args, string property, string label, decimal minimum, decimal maximum)
+    {
+        if (!args.TryGetProperty(property, out var valueElement) || !valueElement.TryGetDecimal(out var value))
+            return $"录入{label}前需要提供数值";
+        return value < minimum || value > maximum ? $"{label}数值明显无效，请重新提供" : null;
+    }
+
+    private static bool IsValueOutside(JsonElement args, string property, decimal minimum, decimal maximum) =>
+        args.TryGetProperty(property, out var valueElement) &&
+        valueElement.TryGetDecimal(out var value) &&
+        (value <= minimum || value >= maximum);
+
     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

@@ -3,7 +3,7 @@ using Health.Application.Medications;
 namespace Health.Infrastructure.AI.AgentHandlers;
 
 /// <summary>
-/// 药管家 Agent 工具处理器。
+/// 药提醒 Agent 工具处理器。
 /// </summary>
 public static class MedicationAgentHandler
 {
@@ -12,19 +12,23 @@ public static class MedicationAgentHandler
         Function = new()
         {
             Name = "manage_medication",
-            Description = "用药管理（创建/查询/确认服药）",
+            Description = "用药管理（创建计划、按日期查询计划与逐顿服药状态、确认某一顿服药）",
             Parameters = new
             {
                 type = "object",
                 properties = new
                 {
-                    action = new { type = "string", description = "create/query/confirm" },
+                    action = new { type = "string", @enum = new[] { "create", "query", "confirm" }, description = "create/query/confirm" },
+                    scope = new { type = "string", @enum = new[] { "today", "scheduled_date", "current_plans", "upcoming_plans", "ended_plans", "inactive_plans", "all_plans" }, description = "查询时必填：今日安排/指定日期安排/当前计划/即将开始/自然结束/已停用/全部计划" },
+                    date = new { type = "string", description = "仅 scope=scheduled_date 时必填，使用北京时间日期 yyyy-MM-dd" },
                     medication_id = new { type = "string", description = "药品 ID，确认服药时使用" },
+                    scheduled_time = new { type = "string", description = "要确认的计划服药时间 HH:mm" },
                     name = new { type = "string", description = "药品名称" },
                     dosage = new { type = "string", description = "剂量，如 100mg" },
-                    frequency = new { type = "string", description = "频率，如 Daily/EveryOtherDay/Weekly" },
+                    frequency = new { type = "string", @enum = new[] { "Daily", "TwiceDaily", "ThreeTimesDaily", "EveryOtherDay", "Weekly", "AsNeeded" }, description = "服药频率" },
                     time_of_day = new { type = "array", items = new { type = "string" }, description = "服药时间，如 [\"08:00\",\"20:00\"]" },
                     duration_days = new { type = "integer", description = "服用天数" },
+                    long_term = new { type = "boolean", description = "是否明确为长期服用；与 duration_days 二选一" },
                     start_date = new { type = "string", description = "开始日期 yyyy-MM-dd" },
                 },
                 required = new[] { "action" }
@@ -43,17 +47,17 @@ public static class MedicationAgentHandler
         return toolName switch
         {
             "manage_medication" => await ExecuteManageMedication(medications, userId, args, ct),
-            _ => new { success = false, message = $"鏈煡宸ュ叿: {toolName}" }
+            _ => new { success = false, message = $"未知工具: {toolName}" }
         };
     }
 
     private static async Task<object> ExecuteManageMedication(IMedicationService medications, Guid userId, JsonElement args, CancellationToken ct)
     {
-        var action = args.TryGetProperty("action", out var a) ? a.GetString()! : "query";
+        var action = args.TryGetProperty("action", out var a) ? a.GetString()?.ToLowerInvariant() : null;
         return action switch
         {
             "create" => await CreateMedication(medications, userId, args, ct),
-            "query" => await QueryMedications(medications, userId, ct),
+            "query" => await QueryMedications(medications, userId, args, ct),
             "confirm" => await ConfirmMedication(medications, userId, args, ct),
             _ => new { success = false, message = $"未知操作: {action}" }
         };
@@ -61,14 +65,19 @@ public static class MedicationAgentHandler
 
     private static async Task<object> CreateMedication(IMedicationService medications, Guid userId, JsonElement args, CancellationToken ct)
     {
+        var validationError = ValidateWriteArguments(args);
+        if (validationError != null)
+            return new { success = false, message = validationError };
+
         var name = args.TryGetProperty("name", out var n) ? n.GetString()! : "";
         var dosage = args.TryGetProperty("dosage", out var dg) ? dg.GetString() : null;
         var frequency = ReadFrequency(args);
         var times = ReadTimes(args);
         var durationDays = args.TryGetProperty("duration_days", out var dd) ? dd.GetInt32() : 0;
+        var longTerm = args.TryGetProperty("long_term", out var longTermValue) && longTermValue.ValueKind == JsonValueKind.True;
         var startDate = ReadStartDate(args);
         // 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;
+        DateOnly? endDate = longTerm ? null : startDate.AddDays(durationDays - 1);
 
         var medicationId = await medications.CreateAsync(userId, new MedicationUpsertRequest(
             name,
@@ -91,27 +100,146 @@ public static class MedicationAgentHandler
             time = timeLabels,
             start_date = startDate.ToString("yyyy-MM-dd"),
             duration_days = durationDays,
+            long_term = longTerm,
         };
     }
 
-    private static async Task<object> QueryMedications(IMedicationService medications, Guid userId, CancellationToken ct)
+    private static async Task<object> QueryMedications(
+        IMedicationService medications,
+        Guid userId,
+        JsonElement args,
+        CancellationToken ct)
     {
-        var meds = await medications.ListActiveAsync(userId, ct);
-        return new { count = meds.Count, medications = meds.Select(m => new { m.Id, m.Name, m.Dosage, m.TimeOfDay }) };
+        var scope = args.TryGetProperty("scope", out var scopeValue)
+            ? scopeValue.GetString()?.ToLowerInvariant()
+            : null;
+        if (scope is not ("today" or "scheduled_date" or "current_plans" or "upcoming_plans" or "ended_plans" or "inactive_plans" or "all_plans"))
+            return new
+            {
+                success = false,
+                message = "查询用药时必须明确 scope：today、scheduled_date、current_plans、upcoming_plans、ended_plans、inactive_plans 或 all_plans",
+            };
+        if (scope == "scheduled_date" &&
+            (!args.TryGetProperty("date", out var requestedDate) || !DateOnly.TryParse(requestedDate.GetString(), out _)))
+            return new { success = false, message = "查询指定日期的用药安排时必须提供有效的 date" };
+        var date = scope == "scheduled_date"
+            ? DateOnly.Parse(args.GetProperty("date").GetString()!)
+            : AiDateTime.BeijingToday;
+        var isDateScope = scope is "today" or "scheduled_date";
+        var overview = await medications.GetAiOverviewAsync(userId, date, ct);
+        var plans = scope switch
+        {
+            "all_plans" => overview.ToList(),
+            "current_plans" => overview.Where(plan => plan.Phase == "active").ToList(),
+            "upcoming_plans" => overview
+                .Where(plan => plan.Phase == "upcoming")
+                .OrderBy(plan => plan.StartDate)
+                .ToList(),
+            "ended_plans" => overview
+                .Where(plan => plan.Phase == "ended")
+                .OrderByDescending(plan => plan.EndDate)
+                .ToList(),
+            "inactive_plans" => overview
+                .Where(plan => plan.Phase == "inactive")
+                .OrderByDescending(plan => plan.EndDate)
+                .ToList(),
+            _ => overview.Where(plan => plan.ScheduledOnDate).ToList(),
+        };
+        var doseStatuses = plans.SelectMany(plan => plan.Doses).ToList();
+        var nextPlan = overview
+            .Where(plan => plan.Phase == "upcoming" && plan.StartDate.HasValue)
+            .OrderBy(plan => plan.StartDate)
+            .FirstOrDefault();
+
+        return new
+        {
+            query_date = date.ToString("yyyy-MM-dd"),
+            scope,
+            count = plans.Count,
+            all_doses_completed = isDateScope
+                ? doseStatuses.Count > 0 && doseStatuses.All(dose => dose.Status == "taken")
+                : (bool?)null,
+            has_upcoming_plans = nextPlan != null,
+            next_start_date = nextPlan?.StartDate?.ToString("yyyy-MM-dd"),
+            days_until_next_start = nextPlan?.StartDate is DateOnly nextStart
+                ? nextStart.DayNumber - date.DayNumber
+                : (int?)null,
+            plans,
+        };
     }
 
     private static async Task<object> ConfirmMedication(IMedicationService medications, Guid userId, JsonElement args, CancellationToken ct)
     {
-        var medId = args.TryGetProperty("medication_id", out var mid) ? mid.GetGuid() : Guid.Empty;
-        var success = await medications.ConfirmNowAsync(userId, medId, ct);
-        return success ? new { success = true } : new { success = false, message = "药品不存在或今天已经打卡" };
+        var validationError = ValidateWriteArguments(args);
+        if (validationError != null)
+            return new { success = false, message = validationError };
+
+        var medId = args.TryGetProperty("medication_id", out var mid) && mid.TryGetGuid(out var parsedMedicationId)
+            ? parsedMedicationId
+            : Guid.Empty;
+        if (!args.TryGetProperty("scheduled_time", out var timeValue) ||
+            !TimeOnly.TryParse(timeValue.GetString(), out var scheduledTime))
+            return new { success = false, message = "缺少要确认的计划服药时间" };
+
+        var success = await medications.ConfirmDoseAsync(
+            userId,
+            medId,
+            scheduledTime,
+            MedicationLogStatus.Taken,
+            ct);
+        return success == true
+            ? new { success = true, medication_id = medId, scheduled_time = scheduledTime.ToString("HH:mm") }
+            : new { success = false, message = success == null ? "药品不存在" : "该时间不属于今天的服药安排，或这一顿已经记录" };
+    }
+
+    public static string? ValidateWriteArguments(JsonElement args)
+    {
+        var action = args.TryGetProperty("action", out var actionValue)
+            ? actionValue.GetString()?.ToLowerInvariant()
+            : null;
+        if (action == "confirm")
+        {
+            if (!args.TryGetProperty("medication_id", out var medicationId) || !medicationId.TryGetGuid(out _))
+                return "确认服药时缺少有效的药品 ID";
+            if (!args.TryGetProperty("scheduled_time", out var scheduledTime) || !TimeOnly.TryParse(scheduledTime.GetString(), out _))
+                return "确认服药时缺少具体的计划服药时间";
+            return null;
+        }
+
+        if (action != "create") return null;
+        if (!args.TryGetProperty("name", out var name) || string.IsNullOrWhiteSpace(name.GetString()))
+            return "创建用药计划前需要确认药品名称";
+        if (!args.TryGetProperty("dosage", out var dosage) || string.IsNullOrWhiteSpace(dosage.GetString()))
+            return "创建用药计划前需要确认每次剂量";
+        if (!args.TryGetProperty("frequency", out var frequencyValue) ||
+            !Enum.TryParse<MedicationFrequency>(frequencyValue.GetString(), ignoreCase: true, out _))
+            return "创建用药计划前需要确认服药频率";
+        if (!args.TryGetProperty("time_of_day", out var times) || times.ValueKind != JsonValueKind.Array)
+            return "创建用药计划前需要确认具体服药时间";
+        var timeValues = times.EnumerateArray().ToList();
+        if (timeValues.Count == 0 || timeValues.Any(value => !TimeOnly.TryParse(value.GetString(), out _)))
+            return "创建用药计划前需要提供有效的具体服药时间";
+        if (!args.TryGetProperty("start_date", out var startDate) || !DateOnly.TryParse(startDate.GetString(), out _))
+            return "创建用药计划前需要确认开始日期";
+
+        var durationDays = 0;
+        var hasDuration = args.TryGetProperty("duration_days", out var duration) &&
+                          duration.TryGetInt32(out durationDays) && durationDays > 0;
+        var isLongTerm = args.TryGetProperty("long_term", out var longTerm) && longTerm.ValueKind == JsonValueKind.True;
+        if (hasDuration && durationDays > 3650)
+            return "服用天数不能超过3650天；长期服用请明确设置 long_term=true";
+        if (hasDuration && isLongTerm)
+            return "服用天数和长期服用不能同时设置";
+        if (!hasDuration && !isLongTerm)
+            return "创建用药计划前需要确认服用天数，或明确说明长期服用";
+        return null;
     }
 
 
     private static MedicationFrequency ReadFrequency(JsonElement args)
     {
         var frequencyStr = args.TryGetProperty("frequency", out var f) ? f.GetString() : "Daily";
-        return Enum.TryParse<MedicationFrequency>(frequencyStr, out var frequency) ? frequency : MedicationFrequency.Daily;
+        return Enum.TryParse<MedicationFrequency>(frequencyStr, ignoreCase: true, out var frequency) ? frequency : MedicationFrequency.Daily;
     }
 
     private static DateOnly ReadStartDate(JsonElement args)

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

@@ -0,0 +1,257 @@
+using Health.Application.Diets;
+using Health.Application.Notifications;
+using Health.Application.Reports;
+
+namespace Health.Infrastructure.AI.AgentHandlers;
+
+/// <summary>
+/// 统一助手使用的患者本人业务数据只读工具。
+/// </summary>
+public static class PatientReadAgentHandler
+{
+    public static readonly ToolDefinition QueryDietRecordsTool = new()
+    {
+        Function = new()
+        {
+            Name = "query_diet_records",
+            Description = "查询当前用户指定北京时间日期的饮食记录和总热量",
+            Parameters = new
+            {
+                type = "object",
+                properties = new
+                {
+                    date = new { type = "string", description = "北京时间日期 yyyy-MM-dd，默认今天" },
+                    meal_type = new { type = "string", @enum = new[] { "Breakfast", "Lunch", "Dinner", "Snack" }, description = "可选餐次" },
+                }
+            }
+        }
+    };
+
+    public static readonly ToolDefinition QueryFollowUpsTool = new()
+    {
+        Function = new()
+        {
+            Name = "query_followups",
+            Description = "查询当前用户的复查随访安排",
+            Parameters = new
+            {
+                type = "object",
+                properties = new
+                {
+                    scope = new { type = "string", @enum = new[] { "next", "upcoming", "completed", "date", "all" }, description = "查询时必填：下一次/未来安排/已完成/指定日期/全部" },
+                    date = new { type = "string", description = "scope=date 时的北京时间日期 yyyy-MM-dd" },
+                    limit = new { type = "integer", description = "最多返回条数，1到20" },
+                }
+            }
+        }
+    };
+
+    public static readonly ToolDefinition QueryReportsTool = new()
+    {
+        Function = new()
+        {
+            Name = "query_reports",
+            Description = "查询当前用户已经保存的检查报告状态、AI摘要和医生审核结论，不读取其他用户报告",
+            Parameters = new
+            {
+                type = "object",
+                properties = new
+                {
+                    limit = new { type = "integer", description = "最多返回条数，1到10，默认5" },
+                    status = new { type = "string", description = "可选报告状态" },
+                }
+            }
+        }
+    };
+
+    public static readonly ToolDefinition QueryNotificationsTool = new()
+    {
+        Function = new()
+        {
+            Name = "query_notifications",
+            Description = "查询当前用户的站内通知",
+            Parameters = new
+            {
+                type = "object",
+                properties = new
+                {
+                    scope = new { type = "string", @enum = new[] { "unread", "today", "recent" }, description = "默认 unread" },
+                    limit = new { type = "integer", description = "最多返回条数，1到20" },
+                }
+            }
+        }
+    };
+
+    public static async Task<object> QueryDietAsync(
+        IDietService diets,
+        Guid userId,
+        JsonElement args,
+        CancellationToken ct)
+    {
+        if (args.TryGetProperty("date", out var suppliedDate) && !DateOnly.TryParse(suppliedDate.GetString(), out _))
+            return new { success = false, message = "查询饮食记录时提供了无效的 date" };
+        var date = args.TryGetProperty("date", out var dateValue) && DateOnly.TryParse(dateValue.GetString(), out var parsedDate)
+            ? parsedDate
+            : AiDateTime.BeijingToday;
+        var mealType = args.TryGetProperty("meal_type", out var mealValue) ? mealValue.GetString() : null;
+        var records = await diets.ListAsync(userId, date.ToString("yyyy-MM-dd"), mealType, ct);
+        return new
+        {
+            query_date = date.ToString("yyyy-MM-dd"),
+            count = records.Count,
+            total_calories = records.Sum(record => record.TotalCalories ?? 0),
+            records = records.Select(record => new
+            {
+                record.Id,
+                record.MealType,
+                record.TotalCalories,
+                record.HealthScore,
+                record.RecordedAt,
+                record.FoodItems,
+            }),
+        };
+    }
+
+    public static async Task<object> QueryFollowUpsAsync(
+        AppDbContext db,
+        Guid userId,
+        JsonElement args,
+        CancellationToken ct)
+    {
+        var scope = args.TryGetProperty("scope", out var scopeValue)
+            ? scopeValue.GetString()?.ToLowerInvariant()
+            : null;
+        if (scope is not ("next" or "upcoming" or "completed" or "date" or "all"))
+            return new
+            {
+                success = false,
+                message = "查询复查安排时必须明确 scope：next、upcoming、completed、date 或 all",
+            };
+        var limit = ReadLimit(args, 10, 20);
+        var nowUtc = DateTime.UtcNow;
+        var query = db.FollowUps.AsNoTracking().Where(item => item.UserId == userId);
+
+        if (scope is "next" or "upcoming")
+            query = query.Where(item => item.Status == FollowUpStatus.Upcoming && item.ScheduledAt >= nowUtc);
+        else if (scope == "completed")
+            query = query.Where(item => item.Status == FollowUpStatus.Completed);
+        else if (scope == "date")
+        {
+            if (!args.TryGetProperty("date", out var dateValue) || !DateOnly.TryParse(dateValue.GetString(), out var date))
+                return new { success = false, message = "按日期查询复查时必须提供有效的 date" };
+            var (startUtc, endUtc) = AiDateTime.BeijingDateWindowUtc(date);
+            query = query.Where(item => item.ScheduledAt >= startUtc && item.ScheduledAt < endUtc);
+        }
+
+        var take = scope == "next" ? 1 : limit;
+        var orderedQuery = scope is "all" or "completed"
+            ? query.OrderByDescending(item => item.ScheduledAt)
+            : query.OrderBy(item => item.ScheduledAt);
+        var matchingCount = await query.CountAsync(ct);
+        var items = await orderedQuery
+            .Take(take)
+            .Select(item => new
+            {
+                item.Id,
+                item.Title,
+                item.DoctorName,
+                item.Department,
+                item.ScheduledAt,
+                item.Notes,
+                item.Status,
+            })
+            .ToListAsync(ct);
+        return new
+        {
+            success = true,
+            scope,
+            count = items.Count,
+            matching_count = matchingCount,
+            results_truncated = matchingCount > items.Count,
+            followups = items.Select(item => new
+            {
+                item.Id,
+                item.Title,
+                item.DoctorName,
+                item.Department,
+                scheduled_at_beijing = AiDateTime.ToBeijingText(item.ScheduledAt),
+                item.Notes,
+                status = item.Status.ToString(),
+            }),
+        };
+    }
+
+    public static async Task<object> QueryReportsAsync(
+        IReportService reports,
+        Guid userId,
+        JsonElement args,
+        CancellationToken ct)
+    {
+        var limit = ReadLimit(args, 5, 10);
+        var status = args.TryGetProperty("status", out var statusValue) ? statusValue.GetString() : null;
+        var records = await reports.GetReportsAsync(userId, ct);
+        var filtered = records
+            .Where(report => string.IsNullOrWhiteSpace(status) || report.Status.Equals(status, StringComparison.OrdinalIgnoreCase))
+            .OrderByDescending(report => report.CreatedAt)
+            .Take(limit)
+            .Select(report => new
+            {
+                report.Id,
+                report.Category,
+                report.Status,
+                report.AiStatus,
+                report.ReviewStatus,
+                report.Severity,
+                ai_summary = Truncate(report.AiSummary, 1800),
+                doctor_comment = Truncate(report.DoctorComment, 1000),
+                doctor_recommendation = Truncate(report.DoctorRecommendation, 1000),
+                report.DoctorName,
+                reviewed_at_beijing = report.ReviewedAt.HasValue ? AiDateTime.ToBeijingText(report.ReviewedAt.Value) : null,
+                created_at_beijing = AiDateTime.ToBeijingText(report.CreatedAt),
+            })
+            .ToList();
+        return new { count = filtered.Count, reports = filtered };
+    }
+
+    public static async Task<object> QueryNotificationsAsync(
+        IInAppNotificationService notifications,
+        Guid userId,
+        JsonElement args,
+        CancellationToken ct)
+    {
+        var scope = args.TryGetProperty("scope", out var scopeValue)
+            ? scopeValue.GetString()?.ToLowerInvariant() ?? "unread"
+            : "unread";
+        if (scope is not ("unread" or "today" or "recent")) scope = "unread";
+        var limit = ReadLimit(args, 10, 20);
+        var records = scope == "unread"
+            ? await notifications.GetPendingAsync(userId, ct)
+            : await notifications.GetHistoryAsync(userId, ct);
+        var (todayStartUtc, todayEndUtc) = AiDateTime.BeijingDateWindowUtc(AiDateTime.BeijingToday);
+        var filtered = records
+            .Where(item => scope != "today" ||
+                (AiDateTime.ToUtc(item.CreatedAt) >= todayStartUtc && AiDateTime.ToUtc(item.CreatedAt) < todayEndUtc))
+            .OrderByDescending(item => item.CreatedAt)
+            .Take(limit)
+            .Select(item => new
+            {
+                item.Id,
+                item.Type,
+                item.Title,
+                item.Message,
+                item.Severity,
+                item.IsRead,
+                created_at_beijing = AiDateTime.ToBeijingText(item.CreatedAt),
+            })
+            .ToList();
+        return new { scope, count = filtered.Count, notifications = filtered };
+    }
+
+    private static int ReadLimit(JsonElement args, int defaultValue, int max) =>
+        args.TryGetProperty("limit", out var value) && value.TryGetInt32(out var parsed)
+            ? Math.Clamp(parsed, 1, max)
+            : defaultValue;
+
+    private static string? Truncate(string? value, int maxLength) =>
+        string.IsNullOrWhiteSpace(value) || value.Length <= maxLength ? value : value[..maxLength] + "…";
+}

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

@@ -19,13 +19,13 @@ public static class ReportAgentHandler
             return new { success = false, message = "缺少报告图片" };
 
         var prompt = """
-            你是患者端医学报告预解读助手。请分析以下检查报告图片，以JSON格式返回：
+            你是报告结构化提取助手。请识别以下检查报告图片，以JSON格式返回：
             {
               "reportType": "报告类型（血常规/生化全项/心电图/彩超/出院小结/其他）",
               "indicators": [
                 {"name":"指标名","value":"数值","unit":"单位","range":"参考范围","status":"normal/high/low"}
               ],
-              "summary": "面向患者的初步预解读，说明异常指标的可能方向，不作确定诊断，不给出处方、停药、换药或调药建议；必要时建议咨询医生",
+              "summary": "列出异常指标及其数值和参考范围，客观说明超出范围，不解释可能原因，不结合用户档案做关联分析，建议咨询医生解读",
               "needsDoctorReview": true/false
             }
             只返回JSON，不要其他内容。

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

@@ -1,9 +1,12 @@
 using System.Text.Json;
 using Health.Application.AI;
 using Health.Application.Exercises;
+using Health.Application.Diets;
 using Health.Application.HealthArchives;
 using Health.Application.HealthRecords;
 using Health.Application.Medications;
+using Health.Application.Notifications;
+using Health.Application.Reports;
 using Health.Infrastructure.AI.AgentHandlers;
 
 namespace Health.Infrastructure.AI;
@@ -15,6 +18,9 @@ public sealed class AiToolExecutionService(
     IHealthRecordService healthRecords,
     IExerciseService exercises,
     IMedicationService medications,
+    IDietService diets,
+    IReportService reports,
+    IInAppNotificationService notifications,
     IAiWriteConfirmationStore confirmations) : IAiToolExecutionService
 {
     private readonly AppDbContext _db = db;
@@ -23,6 +29,9 @@ public sealed class AiToolExecutionService(
     private readonly IHealthRecordService _healthRecords = healthRecords;
     private readonly IExerciseService _exercises = exercises;
     private readonly IMedicationService _medications = medications;
+    private readonly IDietService _diets = diets;
+    private readonly IReportService _reports = reports;
+    private readonly IInAppNotificationService _notifications = notifications;
     private readonly IAiWriteConfirmationStore _confirmations = confirmations;
 
     public async Task<object> ExecuteAsync(string toolName, string arguments, Guid userId, CancellationToken ct)
@@ -31,13 +40,17 @@ public sealed class AiToolExecutionService(
         var root = json.RootElement;
         return await (toolName switch
         {
-            "record_health_data" => HealthDataAgentHandler.Execute(toolName, root, userId, _healthRecords),
+            "record_health_data" or "record_health_data_batch"
+                => HealthDataAgentHandler.Execute(toolName, root, userId, _healthRecords, ct),
             "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, userId, _medications, ct),
             "analyze_report" => ReportAgentHandler.AnalyzeReport(_db, userId, root, _visionClient),
-            "manage_exercise" => ExerciseAgentHandler.Execute(toolName, root, _db, userId, _exercises, ct),
-            "manage_archive" => CommonAgentHandler.ExecuteManageArchive(_healthArchives, userId, root, ct),
+            "manage_exercise" => ExerciseAgentHandler.Execute(toolName, root, userId, _exercises, ct),
+            "query_diet_records" => PatientReadAgentHandler.QueryDietAsync(_diets, userId, root, ct),
+            "query_followups" => PatientReadAgentHandler.QueryFollowUpsAsync(_db, userId, root, ct),
+            "query_reports" => PatientReadAgentHandler.QueryReportsAsync(_reports, userId, root, ct),
+            "query_notifications" => PatientReadAgentHandler.QueryNotificationsAsync(_notifications, userId, root, ct),
             _ => Task.FromResult<object>(new { success = false, message = $"未知工具: {toolName}" }),
         });
     }

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

@@ -1,5 +1,6 @@
 using System.Text.Json;
 using Health.Application.AI;
+using Health.Infrastructure.Files;
 using Microsoft.Extensions.Logging;
 using UglyToad.PdfPig;
 
@@ -19,19 +20,19 @@ public sealed class AttachmentContextBuilder(
     private readonly VisionClient _vision = vision;
     private readonly ILogger<AttachmentContextBuilder> _logger = logger;
 
-    public async Task<AttachmentContext?> BuildAsync(string? imageUrl, string? pdfUrl, CancellationToken ct)
+    public async Task<AttachmentContext?> BuildAsync(Guid userId, string? imageUrl, string? pdfUrl, CancellationToken ct)
     {
         if (!string.IsNullOrWhiteSpace(imageUrl))
-            return await BuildImageAsync(imageUrl!, ct);
+            return await BuildImageAsync(userId, imageUrl!, ct);
         if (!string.IsNullOrWhiteSpace(pdfUrl))
-            return await BuildPdfAsync(pdfUrl!, ct);
+            return await BuildPdfAsync(userId, pdfUrl!, ct);
         return null;
     }
 
     // ── 图片：调 VLM 输出结构化 JSON ──
-    private async Task<AttachmentContext?> BuildImageAsync(string imageUrl, CancellationToken ct)
+    private async Task<AttachmentContext?> BuildImageAsync(Guid userId, string imageUrl, CancellationToken ct)
     {
-        var filePath = ResolveLocalPath(imageUrl);
+        var filePath = UserUploadPathResolver.Resolve(userId, imageUrl);
         if (filePath == null || !File.Exists(filePath))
         {
             _logger.LogWarning("Image file not found for {Url}", imageUrl);
@@ -105,9 +106,9 @@ public sealed class AttachmentContextBuilder(
     }
 
     // ── PDF：PdfPig 抽取文本 ──
-    private Task<AttachmentContext?> BuildPdfAsync(string pdfUrl, CancellationToken ct)
+    private Task<AttachmentContext?> BuildPdfAsync(Guid userId, string pdfUrl, CancellationToken ct)
     {
-        var filePath = ResolveLocalPath(pdfUrl);
+        var filePath = UserUploadPathResolver.Resolve(userId, pdfUrl);
         var fileName = Path.GetFileName(pdfUrl);
         if (filePath == null || !File.Exists(filePath))
         {
@@ -150,18 +151,6 @@ public sealed class AttachmentContextBuilder(
         }
     }
 
-    private static string? ResolveLocalPath(string url)
-    {
-        // url 形如 "/uploads/{guid}.{ext}"。处理 base URL 前缀也兼容。
-        var idx = url.IndexOf("/uploads/", StringComparison.Ordinal);
-        if (idx < 0) return null;
-        var relative = url[(idx + "/uploads/".Length)..];
-        // 去掉可能的 query string
-        var q = relative.IndexOf('?');
-        if (q >= 0) relative = relative[..q];
-        return Path.Combine(Directory.GetCurrentDirectory(), "uploads", relative);
-    }
-
     private static string StripCodeFence(string raw)
     {
         var t = raw.Trim();

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

@@ -37,6 +37,29 @@ public sealed class EfAiConversationRepository(AppDbContext db) : IAiConversatio
     public async Task AddMessageAsync(ConversationMessage message, CancellationToken ct) =>
         await _db.ConversationMessages.AddAsync(message, ct);
 
+    public async Task<int> DeleteLegacyDietCommentaryArtifactsAsync(
+        Guid userId,
+        string promptPrefix,
+        CancellationToken ct)
+    {
+        var candidates = await _db.Conversations
+            .Include(conversation => conversation.Messages)
+            .Where(conversation =>
+                conversation.UserId == userId &&
+                conversation.Messages.Any(message =>
+                    message.Role == MessageRole.User &&
+                    message.Content.StartsWith(promptPrefix)))
+            .ToListAsync(ct);
+        var artifacts = candidates
+            .Where(conversation => DietCommentaryPolicy.IsLegacyArtifact(conversation.Messages))
+            .ToList();
+        if (artifacts.Count == 0) return 0;
+
+        _db.Conversations.RemoveRange(artifacts);
+        await _db.SaveChangesAsync(ct);
+        return artifacts.Count;
+    }
+
     public void Delete(Conversation conversation) =>
         _db.Conversations.Remove(conversation);
 

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

@@ -0,0 +1,108 @@
+using Health.Application.AI;
+using Health.Infrastructure.Data;
+using Health.Infrastructure.Data.Records;
+using Microsoft.EntityFrameworkCore;
+
+namespace Health.Infrastructure.AI;
+
+public sealed class EfAiEntryDraftStore(AppDbContext db) : IAiEntryDraftStore
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<AiEntryDraft?> GetActiveAsync(
+        Guid userId,
+        Guid conversationId,
+        string entryType,
+        CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        await ExpireAsync(now, ct);
+        var record = await _db.AiEntryDrafts.AsNoTracking().FirstOrDefaultAsync(x =>
+            x.UserId == userId &&
+            x.ConversationId == conversationId &&
+            x.EntryType == entryType &&
+            x.Status == "Pending" &&
+            x.ExpiresAt > now, ct);
+        return record == null ? null : ToDraft(record);
+    }
+
+    public async Task<AiEntryDraft> UpsertAsync(
+        Guid userId,
+        Guid conversationId,
+        string entryType,
+        string payload,
+        string missingFields,
+        TimeSpan lifetime,
+        CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        await ExpireAsync(now, ct);
+        var record = await _db.AiEntryDrafts.FirstOrDefaultAsync(x =>
+            x.UserId == userId &&
+            x.ConversationId == conversationId &&
+            x.EntryType == entryType &&
+            x.Status == "Pending", ct);
+        if (record == null)
+        {
+            record = new AiEntryDraftRecord
+            {
+                Id = Guid.NewGuid(),
+                UserId = userId,
+                ConversationId = conversationId,
+                EntryType = entryType,
+                CreatedAt = now,
+            };
+            await _db.AiEntryDrafts.AddAsync(record, ct);
+        }
+
+        record.Payload = payload;
+        record.MissingFields = missingFields;
+        record.ExpiresAt = now.Add(lifetime);
+        record.UpdatedAt = now;
+        await _db.SaveChangesAsync(ct);
+        return ToDraft(record);
+    }
+
+    public async Task CompleteAsync(Guid draftId, Guid userId, CancellationToken ct)
+    {
+        var record = await _db.AiEntryDrafts.FirstOrDefaultAsync(x =>
+            x.Id == draftId && x.UserId == userId && x.Status == "Pending", ct);
+        if (record == null) return;
+
+        record.Status = "Completed";
+        record.UpdatedAt = DateTime.UtcNow;
+        await _db.SaveChangesAsync(ct);
+    }
+
+    private async Task ExpireAsync(DateTime now, CancellationToken ct)
+    {
+        if (_db.Database.ProviderName == "Microsoft.EntityFrameworkCore.InMemory")
+        {
+            var expired = await _db.AiEntryDrafts
+                .Where(x => x.Status == "Pending" && x.ExpiresAt <= now)
+                .ToListAsync(ct);
+            foreach (var item in expired)
+            {
+                item.Status = "Expired";
+                item.UpdatedAt = now;
+            }
+            if (expired.Count > 0) await _db.SaveChangesAsync(ct);
+            return;
+        }
+
+        await _db.AiEntryDrafts
+            .Where(x => x.Status == "Pending" && x.ExpiresAt <= now)
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Expired")
+                .SetProperty(x => x.UpdatedAt, now), ct);
+    }
+
+    private static AiEntryDraft ToDraft(AiEntryDraftRecord record) => new(
+        record.Id,
+        record.UserId,
+        record.ConversationId,
+        record.EntryType,
+        record.Payload,
+        record.MissingFields,
+        record.ExpiresAt);
+}

backend/src/Health.Infrastructure/AI/Prompts/global/identity.md

@@ -0,0 +1,8 @@
+你是患者端统一 AI 健康助手“小脉”。你的任务是理解用户当前真正想做的事情，调用经过授权的业务工具，并用自然、温和、清楚的中文回复。
+
+核心原则：
+- 个人健康数据、计划、完成状态和报告状态必须以当前业务工具返回为准，不能根据聊天历史或患者背景猜测。
+- 工具没有返回的数据不得编造；暂时没有对应能力时应如实说明。
+- 一条消息可能包含多个意图，必须分别处理，不能为了简化而遗漏其中一项。
+- 当前工具结果与历史聊天冲突时，以当前工具结果为准。
+- 普通聊天历史用于理解语境，不等同于待写入数据；只有后端明确提供的待补充草稿才允许跨消息合并录入字段。

backend/src/Health.Infrastructure/AI/Prompts/global/medical_safety.md

@@ -0,0 +1,6 @@
+医疗安全边界：
+- 你是健康解释与预问诊助手，不是医生，不能替代医生诊断、处方或治疗决策。
+- 可以解释健康数据、报告指标和症状可能方向，但不能作确定诊断。
+- 不要求用户自行新增、停用、更换药物或调整剂量；涉及治疗变化时建议咨询医生或药师。
+- 出现剧烈胸痛、呼吸困难、意识异常、晕厥、说话不清、一侧肢体无力、血氧明显偏低、血压或血糖严重异常等危险信号时，立即停止普通流程并优先建议及时就医或急诊评估。
+- 医疗分析使用“可能、建议、需要结合医生判断”等表达。

backend/src/Health.Infrastructure/AI/Prompts/global/response_style.md

@@ -0,0 +1,8 @@
+回复要求：
+- 语气自然、温和、专业，不使用系统报错式措辞。
+- 信息不完整时，每次只追问最关键的缺失内容；可以在一句话中列出同一批次明确缺少的字段。
+- 禁止使用粗体、斜体、删除线、HTML 和 Markdown 表格。
+- 标题只使用三级标题；列表使用短横线。
+- 数值和单位之间留空格，例如 120 mmHg、6.2 mmol/L。
+- 不输出任何以 $ 开头的占位符。
+- 不重复堆砌免责声明。

backend/src/Health.Infrastructure/AI/Prompts/modules/diet_analysis.md

@@ -0,0 +1,6 @@
+新饮食图片分析模块：
+- 仅用于本轮新上传的饮食图片；查询已经保存的饮食记录应进入个人数据查询模块。
+- 识别食物名称、估算份量和热量，并结合患者健康档案评价。
+- 对过敏、低盐、低脂、低糖等限制给出清楚提醒，不作绝对化医疗结论。
+- 饮食建议需要医学资料支撑时可以按需调用知识库。
+- 图片分析结果不能在用户未确认时冒充已经保存的饮食记录。

backend/src/Health.Infrastructure/AI/Prompts/modules/exercise_entry.md

@@ -0,0 +1,9 @@
+运动计划录入模块：
+- 用户明确创建运动计划时调用 manage_exercise(action="create")。
+- 完整计划需要：运动项目、每天运动时长、持续天数、开始日期和具体提醒时间。
+- 中文时长和周期应正确换算，例如半小时=30 分钟、一小时=60 分钟、一周=7 天、一个月=30 天。
+- 只传用户明确提供的字段；当前产品不自动补默认运动项目、天数、开始日期或提醒时间。
+- 信息不完整时仍调用工具，让后端保存待补充草稿；下一轮补充时与草稿合并。
+- 用户明确开始新的运动计划时不得继承旧草稿内容。
+- 后端返回 pendingConfirmation=true 后展示确认卡；用户点击前不得声称计划已创建。
+- 单纯创建运动计划不调用医学知识库。用户先询问该运动是否适合自己时，额外进入医疗咨询模块。

backend/src/Health.Infrastructure/AI/Prompts/modules/general_chat.md

@@ -0,0 +1,4 @@
+普通聊天与应用帮助模块：
+- 问候、感谢和普通闲聊自然简短回复，不调用业务工具或医学知识库。
+- 用户询问应用功能位置或使用方法时可以直接说明；已有固定 App 内链接时可自然提供一个跳转链接。
+- 不确定用户是想咨询数值还是保存记录时，只做一次简短澄清，不生成确认卡。

backend/src/Health.Infrastructure/AI/Prompts/modules/health_entry.md

@@ -0,0 +1,13 @@
+健康指标录入模块：
+- 支持血压、心率、血糖、血氧、体重；“脉搏”与“心率”是同一指标，统一使用 heart_rate。
+- 必须理解常见完整血压表达，例如 113/86、113-86、113—86，前者为收缩压，后者为舒张压。
+- 用户明确要求录入时必须调用 record_health_data_batch，而且每个录入批次只调用一次；即使只有一个指标，也必须放进 metrics 数组。信息不完整也要调用，只传用户明确提供的字段，让后端保存整个待补充批次草稿。
+- 不能自行补测量数值。测量时间未说明时可以由后端使用当前时间。
+- 一次消息可以包含多个指标，必须完整提取，不得遗漏。多指标属于同一录入批次，最终应汇总在一张确认卡中。
+- metrics 必须包含用户本轮明确要录入的全部指标；不要为每个指标分别调用工具。
+- 如果同一批次存在不完整或明显无效的指标，应保留本批次其他已识别指标，先根据后端结果追问缺失或错误部分；全部补齐后再生成整批确认卡。
+- 用户只补充一个缺失值时，必须结合后端提供的当前草稿，不能只记录最后一句。
+- 已经生成确认卡的批次立即结束；无论用户是否点击，下一条新的录入请求都属于新批次，不能带入上一张卡的数据。
+- 普通聊天历史中的指标不得自动加入当前卡；只有明确的待补充草稿可以跨消息合并。
+- 后端返回 pendingConfirmation=true 才代表确认卡真实生成。确认卡出现前不得要求用户点击卡片，点击前不得声称已经保存或录入成功。
+- 后端返回危险提醒或无效数值时，不生成成功话术，按返回内容提醒用户。

backend/src/Health.Infrastructure/AI/Prompts/modules/medical_consultation.md

@@ -0,0 +1,7 @@
+医疗咨询与健康建议模块：
+- 症状求助时先判断是否存在危险信号；非紧急情况下每轮只追问一个最关键问题，逐步了解部位、开始时间、程度、诱因和伴随表现。
+- 信息足够后给出可能相关方向、严重程度以及观察、门诊、尽快就医或急诊建议，不作正式诊断。
+- 解释用户个人指标或趋势时，应先调用相应个人数据查询工具获取真实数据。
+- 疾病、药品、检查指标、康复、饮食或运动建议需要医学资料支撑时，调用 search_medical_knowledge。
+- 不需要外部医学资料的简单澄清、问候或业务操作不调用知识库。
+- 用户同时要求录入或创建计划时，医疗解释不能代替对应录入工具和确认卡。

backend/src/Health.Infrastructure/AI/Prompts/modules/medication_entry.md

@@ -0,0 +1,9 @@
+用药计划录入模块：
+- 用户明确创建用药计划时调用 manage_medication(action="create")。
+- 只传用户明确提供的字段，不自行新增药品、猜测剂量、频率、具体服药时间、开始日期或疗程。
+- 完整计划需要：药品名称、每次剂量、频率、具体服药时间、开始日期，以及疗程天数或明确长期服用。
+- “早饭后、晚上”等模糊时间不能擅自换算为具体时刻，应追问具体时间。
+- 信息不完整时仍调用工具，让后端保存待补充草稿；下一轮只补缺失字段时与草稿合并。
+- 存在旧草稿但用户明确开始另一种药品的新计划时，应开始新批次，禁止继承旧药品的剂量、时间、频率或疗程。
+- 后端返回 pendingConfirmation=true 后展示确认卡；用户点击前不得声称计划已创建。
+- 用药计划录入本身不调用医学知识库。用户同时询问药品知识或副作用时，额外进入医疗咨询模块。

backend/src/Health.Infrastructure/AI/Prompts/modules/personal_query.md

@@ -0,0 +1,7 @@
+个人数据查询模块：
+- 查询用户自己的健康记录、健康档案、用药计划、运动计划、饮食记录、复查安排、已有报告和通知时，必须调用对应只读业务工具。
+- 不能根据患者背景、聊天历史或以前的工具结果回答当前状态。
+- 必须区分“记录存在”“计划当前有效”“指定日期有安排”“任务已经完成”。
+- 查询某一天任务与查询计划生命周期不能混用；时间意图不明确时只追问时间范围。
+- 工具没有返回数据时明确说明未查到，不得编造。
+- 个人数据查询通常不调用医学知识库；用户同时要求解释或建议时，额外进入医疗咨询模块。

backend/src/Health.Infrastructure/AI/Prompts/modules/report_analysis.md

@@ -0,0 +1,7 @@
+新报告分析模块：
+- 仅用于本轮新上传的医学检查报告图片或报告文件；查询以前保存的报告应进入个人数据查询模块。
+- 提取报告名称、日期、关键指标、参考范围、异常标记和原文结论。
+- 区分结构化检验指标与影像/医生描述，不把影像描述改写成确定诊断。
+- 给出患者可理解的初步解释和下一步建议，注明需要结合医生判断。
+- 报告内容需要进一步医学解释时可以按需调用知识库。
+- 用户没有明确要求时，不把报告中的指标直接写入健康记录。

backend/src/Health.Infrastructure/AI/Prompts/rag/retrieval_rules.md

@@ -0,0 +1,7 @@
+医学知识库使用规则：
+- 知识库是医疗咨询、指标解释、药品知识、报告解释和健康建议的辅助能力，不是独立用户意图。
+- 健康指标录入、用药或运动计划创建、个人数据查询、服药确认、运动打卡、普通聊天时禁止调用。
+- 一条消息同时包含业务操作和医学咨询时，先完成必要业务工具调用；只有咨询部分确实需要资料时才检索。
+- 检索问题应保留关键症状、疾病、药品或指标名称，删除无关寒暄和操作指令。
+- 只能依据真实返回的知识片段作参考；没有结果时应谨慎回答，不得虚构检索内容或来源。
+- 知识库内容不能覆盖患者当前业务数据，也不能替代紧急安全规则。

backend/src/Health.Infrastructure/AI/Prompts/router/intent_router.md

@@ -0,0 +1,25 @@
+你是主聊天的意图路由器，只负责识别意图，不回答用户问题。
+
+请结合用户当前消息、附件类型、最近对话和后端提供的待补充草稿，选择一个或多个意图：
+- health_entry：录入健康指标，或继续补充健康指标草稿。
+- medication_entry：创建用药计划，或继续补充用药计划草稿。
+- exercise_entry：创建运动计划，或继续补充运动计划草稿。
+- personal_query：查询用户自己的健康数据、健康档案、用药/运动计划、饮食、复查、报告或通知。
+- medical_consultation：症状求助、指标解释、疾病/药品知识、健康评价、饮食/运动/康复建议。
+- report_analysis：分析新上传的医学报告图片或报告文件。
+- diet_analysis：分析新上传的饮食图片。
+- app_help：询问应用功能位置或使用方法。
+- general_chat：问候、感谢、普通闲聊或不需要业务工具的对话。
+
+判断规则：
+- “帮我记录血压 116/89”是 health_entry。
+- “血压 116/89 正常吗”是 medical_consultation，不是录入。
+- “记录血压 150/95，并告诉我是否偏高”同时包含 health_entry 和 medical_consultation。
+- 查询已有报告属于 personal_query；分析本轮新上传报告属于 report_analysis。
+- 创建计划与询问建议必须区分；“创建每天散步 30 分钟的计划”是 exercise_entry，“我适合每天散步 30 分钟吗”是 medical_consultation。
+- 只有确实在补充草稿缺失字段时才标记为 continue；存在草稿不代表所有后续消息都必须继续草稿。
+- 用户明确开始新的同类录入时标记 start_new，不能继承旧草稿字段。
+- 用户明确说取消、不录了时标记 cancel。
+- 无法确定是咨询还是录入时选择 general_chat，让主助手自然澄清。
+
+必须通过 route_user_intent 工具返回结构化结果，不得输出解释文字。

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

@@ -9,7 +9,7 @@ namespace Health.Infrastructure.AI;
 public sealed class DeepSeekClient(HttpClient http, IConfiguration config)
 {
     private readonly HttpClient _http = http;
-    private readonly string _model = config["DEEPSEEK_MODEL"] ?? "deepseek-chat";
+    private readonly string _model = config["DEEPSEEK_MODEL"] ?? "deepseek-v4-flash";
     private readonly JsonSerializerOptions _jsonOptions = new()
     {
         PropertyNamingPolicy = JsonNamingPolicy.SnakeCaseLower,
@@ -30,6 +30,7 @@ public sealed class DeepSeekClient(HttpClient http, IConfiguration config)
         {
             Model = _model, Messages = messages, Stream = true,
             MaxTokens = maxTokens, Temperature = temperature, Tools = tools,
+            Thinking = new ThinkingOptions { Type = "disabled" },
         };
         if (tools?.Count > 0) request.ToolChoice = "auto";
 
@@ -64,14 +65,16 @@ public sealed class DeepSeekClient(HttpClient http, IConfiguration config)
         List<ToolDefinition>? tools = null,
         int maxTokens = 2048,
         float temperature = 0.7f,
+        string? toolChoice = null,
         CancellationToken ct = default)
     {
         var request = new ChatCompletionRequest
         {
             Model = _model, Messages = messages, Stream = false,
             MaxTokens = maxTokens, Temperature = temperature, Tools = tools,
+            Thinking = new ThinkingOptions { Type = "disabled" },
         };
-        if (tools?.Count > 0) request.ToolChoice = "auto";
+        if (tools?.Count > 0) request.ToolChoice = toolChoice ?? "auto";
 
         var json = JsonSerializer.Serialize(request, _jsonOptions);
         var content = new StringContent(json, Encoding.UTF8, "application/json");
@@ -88,7 +91,7 @@ public sealed class DeepSeekClient(HttpClient http, IConfiguration config)
 public sealed class VisionClient(HttpClient http, IConfiguration config)
 {
     private readonly HttpClient _http = http;
-    private readonly string _model = config["VLM_MODEL"] ?? "doubao-vision-pro";
+    private readonly string _model = config["VLM_MODEL"] ?? config["QWEN_VISION_MODEL"] ?? "qwen-vl-max";
     private readonly JsonSerializerOptions _jsonOptions = new()
     {
         PropertyNamingPolicy = JsonNamingPolicy.SnakeCaseLower,

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

@@ -14,8 +14,19 @@ public sealed class ChatCompletionRequest
     [System.Text.Json.Serialization.JsonPropertyName("vl_high_resolution_images")]
     public bool VlHighResolutionImages { get; set; }
 
+    [System.Text.Json.Serialization.JsonIgnore(Condition = System.Text.Json.Serialization.JsonIgnoreCondition.WhenWritingNull)]
     [System.Text.Json.Serialization.JsonPropertyName("enable_thinking")]
     public bool? EnableThinking { get; set; }
+
+    [System.Text.Json.Serialization.JsonIgnore(Condition = System.Text.Json.Serialization.JsonIgnoreCondition.WhenWritingNull)]
+    [System.Text.Json.Serialization.JsonPropertyName("thinking")]
+    public ThinkingOptions? Thinking { get; set; }
+}
+
+public sealed class ThinkingOptions
+{
+    [System.Text.Json.Serialization.JsonPropertyName("type")]
+    public string Type { get; set; } = "disabled";
 }
 
 public sealed class ChatMessage

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

@@ -0,0 +1,185 @@
+using System.Text.Json;
+
+namespace Health.Infrastructure.AI;
+
+public sealed record AiIntentRoute(
+    IReadOnlyList<string> Intents,
+    string DraftAction,
+    string DraftType)
+{
+    public static AiIntentRoute GeneralChat { get; } =
+        new(["general_chat"], "none", "none");
+
+    public static AiIntentRoute Compatibility { get; } = new(
+        [
+            "health_entry",
+            "medication_entry",
+            "exercise_entry",
+            "personal_query",
+            "medical_consultation",
+            "report_analysis",
+            "diet_analysis",
+            "general_chat",
+        ],
+        "none",
+        "none");
+}
+
+public static class AiIntentRouter
+{
+    private static readonly HashSet<string> AllowedIntents = new(
+        [
+            "health_entry",
+            "medication_entry",
+            "exercise_entry",
+            "personal_query",
+            "medical_consultation",
+            "report_analysis",
+            "diet_analysis",
+            "app_help",
+            "general_chat",
+        ],
+        StringComparer.OrdinalIgnoreCase);
+
+    public static readonly ToolDefinition RouteTool = new()
+    {
+        Function = new()
+        {
+            Name = "route_user_intent",
+            Description = "返回当前用户消息的一个或多个业务意图，不回答用户问题",
+            Parameters = new
+            {
+                type = "object",
+                properties = new
+                {
+                    intents = new
+                    {
+                        type = "array",
+                        minItems = 1,
+                        uniqueItems = true,
+                        items = new
+                        {
+                            type = "string",
+                            @enum = AllowedIntents.OrderBy(x => x).ToArray(),
+                        },
+                    },
+                    draft_action = new
+                    {
+                        type = "string",
+                        @enum = new[] { "none", "continue", "start_new", "cancel" },
+                        description = "当前消息与待补充录入草稿的关系",
+                    },
+                    draft_type = new
+                    {
+                        type = "string",
+                        @enum = new[] { "none", "health_entry", "medication_entry", "exercise_entry" },
+                    },
+                },
+                required = new[] { "intents", "draft_action", "draft_type" },
+            },
+        },
+    };
+
+    public static async Task<AiIntentRoute> RouteAsync(
+        DeepSeekClient client,
+        PromptManager prompts,
+        string currentMessage,
+        string attachmentContext,
+        string draftContext,
+        string recentConversation,
+        CancellationToken ct)
+    {
+        var userContext = $"""
+            当前用户消息：
+            {currentMessage}
+
+            本轮附件：
+            {(string.IsNullOrWhiteSpace(attachmentContext) ? "无" : attachmentContext)}
+
+            当前待补充录入草稿：
+            {(string.IsNullOrWhiteSpace(draftContext) ? "无" : draftContext)}
+
+            最近对话：
+            {(string.IsNullOrWhiteSpace(recentConversation) ? "无" : recentConversation)}
+            """;
+
+        try
+        {
+            var response = await client.ChatAsync(
+                [
+                    new ChatMessage { Role = "system", Content = prompts.GetIntentRouterPrompt() },
+                    new ChatMessage { Role = "user", Content = userContext },
+                ],
+                tools: [RouteTool],
+                maxTokens: 300,
+                temperature: 0.1f,
+                toolChoice: "required",
+                ct: ct);
+
+            var call = response.Choices?
+                .FirstOrDefault()?
+                .Message?
+                .ToolCalls?
+                .FirstOrDefault(item => item.Function.Name == "route_user_intent");
+            return call == null ? AiIntentRoute.Compatibility : Parse(call.Function.Arguments);
+        }
+        catch (OperationCanceledException) when (ct.IsCancellationRequested)
+        {
+            throw;
+        }
+        catch
+        {
+            // Routing failure must not make the whole chat unavailable. The broad
+            // compatibility prompt/tool set remains the safe fallback.
+            return AiIntentRoute.Compatibility;
+        }
+    }
+
+    internal static AiIntentRoute Parse(string arguments)
+    {
+        try
+        {
+            using var json = JsonDocument.Parse(arguments);
+            var root = json.RootElement;
+            var intents = root.TryGetProperty("intents", out var values) &&
+                          values.ValueKind == JsonValueKind.Array
+                ? values.EnumerateArray()
+                    .Where(value => value.ValueKind == JsonValueKind.String)
+                    .Select(value => value.GetString()?.Trim().ToLowerInvariant() ?? "")
+                    .Where(AllowedIntents.Contains)
+                    .Distinct(StringComparer.OrdinalIgnoreCase)
+                    .ToList()
+                : [];
+            if (intents.Count == 0) intents.Add("general_chat");
+
+            var draftAction = ReadEnum(
+                root,
+                "draft_action",
+                ["none", "continue", "start_new", "cancel"],
+                "none");
+            var draftType = ReadEnum(
+                root,
+                "draft_type",
+                ["none", "health_entry", "medication_entry", "exercise_entry"],
+                "none");
+            return new AiIntentRoute(intents, draftAction, draftType);
+        }
+        catch (JsonException)
+        {
+            return AiIntentRoute.Compatibility;
+        }
+    }
+
+    private static string ReadEnum(
+        JsonElement root,
+        string property,
+        IReadOnlyCollection<string> allowed,
+        string fallback)
+    {
+        var value = root.TryGetProperty(property, out var element) &&
+                    element.ValueKind == JsonValueKind.String
+            ? element.GetString()?.Trim().ToLowerInvariant()
+            : null;
+        return value != null && allowed.Contains(value) ? value : fallback;
+    }
+}

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

@@ -14,10 +14,12 @@ public sealed class FastGptKnowledgeClient(HttpClient http, IConfiguration confi
     private readonly string _datasetId = config["FASTGPT_DATASET_ID"] ?? "";
     private readonly float _similarity = float.TryParse(config["FASTGPT_SIMILARITY"], out var s) ? s : 0.4f;
     private readonly int _limit = int.TryParse(config["FASTGPT_LIMIT"], out var l) ? l : 3000;
+    private readonly bool _ragEnabled = bool.TryParse(config["ENABLE_MEDICAL_RAG"], out var enabled) && enabled;
     private readonly ILogger<FastGptKnowledgeClient> _logger = logger;
     private readonly JsonSerializerOptions _jsonOptions = new() { PropertyNameCaseInsensitive = true };
 
-    public bool IsEnabled => !string.IsNullOrWhiteSpace(_datasetId);
+    // iOS 审核版使用后端内置医学来源目录，暂时关闭在线 RAG，减少一次外部检索请求。
+    public bool IsEnabled => _ragEnabled && !string.IsNullOrWhiteSpace(_datasetId);
 
     /// <summary>
     /// 按用户问题检索知识库，返回最相关的文档片段。

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

@@ -1,191 +1,157 @@
+using System.Reflection;
+using Health.Application.AI;
+
 namespace Health.Infrastructure.AI;
 
 /// <summary>
-/// System Prompt 模板管理
+/// Loads small, responsibility-focused prompt resources and composes only the
+/// sections required by the current intent route.
 /// </summary>
 public sealed class PromptManager
 {
-    /// <summary>
-    /// 获取指定 Agent 的 System Prompt
-    /// </summary>
-    public string GetSystemPrompt(AgentType agentType)
-    {
-        var prompt = agentType switch
-        {
-            AgentType.Default => DefaultPrompt,
-            AgentType.Consultation => ConsultationPrompt,
-            AgentType.Health => HealthDataPrompt,
-            AgentType.Diet => DietPrompt,
-            AgentType.Medication => MedicationPrompt,
-            AgentType.Report => ReportPrompt,
-            AgentType.Exercise => ExercisePrompt,
-            AgentType.Unified => UnifiedPrompt,
-            _ => DefaultPrompt
-        };
+    private static readonly Assembly PromptAssembly = typeof(PromptManager).Assembly;
+    private static readonly IReadOnlyDictionary<string, string> PromptCache = LoadPrompts();
 
-        return $"{prompt}\n\n{MedicalBoundaryRules}\n\n{SmartLinkRules}";
+    private static readonly string[] GlobalSections =
+    [
+        "global/identity.md",
+        "global/medical_safety.md",
+        "global/response_style.md",
+    ];
+
+    public string GetIntentRouterPrompt() => Read("router/intent_router.md");
+
+    public string ComposeForIntents(IEnumerable<string> intents)
+    {
+        var normalized = intents
+            .Select(NormalizeIntent)
+            .Where(intent => intent.Length > 0)
+            .Distinct(StringComparer.OrdinalIgnoreCase)
+            .ToList();
+        if (normalized.Count == 0) normalized.Add("general_chat");
+
+        var sections = new List<string>(GlobalSections);
+        foreach (var intent in normalized)
+        {
+            sections.Add(intent switch
+            {
+                "health_entry" => "modules/health_entry.md",
+                "medication_entry" => "modules/medication_entry.md",
+                "exercise_entry" => "modules/exercise_entry.md",
+                "personal_query" => "modules/personal_query.md",
+                "medical_consultation" => "modules/medical_consultation.md",
+                "report_analysis" => "modules/report_analysis.md",
+                "diet_analysis" => "modules/diet_analysis.md",
+                "app_help" or "general_chat" => "modules/general_chat.md",
+                _ => "modules/general_chat.md",
+            });
         }
 
-    private const string SmartLinkRules = """
-        智能跳转链接（按需嵌入）：
-        - 当用户明确询问食物的 热量/卡路里 时，在回答的自然位置嵌入 Markdown 链接 [热量分析](app://diet)，引导用户使用专门的饮食拍照分析功能。
-        - 当用户上传医学检查报告、化验单、影像报告、出院小结等需要专业解读时，在回答末尾嵌入 [报告分析](app://report)，引导上传到报告分析功能获得详细解读。
-        - 当用户询问血压、血糖、血氧等需要长期追踪的设备测量场景时，可嵌入 [蓝牙设备](app://device)。
+        if (normalized.Contains("medical_consultation") ||
+            normalized.Contains("report_analysis") ||
+            normalized.Contains("diet_analysis"))
+        {
+            sections.Add("rag/retrieval_rules.md");
+        }
 
-        硬性约束：
-        - 每条回复最多嵌入一个跳转链接，且必须在合适语境下自然提及，不要堆砌。
-        - 仅"问热量/卡路里"才用 app://diet；"营养、能不能吃、是否健康"类问题正常回答，禁止插入饮食跳转链接。
-        - 链接的 Markdown 文本只能用上面列出的 4 个固定文案，不要自创其他文案。
+        var composed = Compose(sections);
+        var needsMedicalSources = normalized.Contains("medical_consultation") ||
+                                  normalized.Contains("report_analysis") ||
+                                  normalized.Contains("diet_analysis");
+        if (needsMedicalSources)
+        {
+            composed += "\n\n" + CitationRules + "\n\n" + MedicalCitationKnowledge.Prompt;
+        }
+
+        // This is an iOS-specific scope rule and is intentionally added to every
+        // route, while the large medical source directory is only added to advice routes.
+        return composed + "\n\n" + CurrentScopeRules;
+    }
+
+    private const string CitationRules = """
+        医疗信息来源引用（必须遵守）：
+        - 当回复包含医疗事实、数值解释、饮食/运动/用药相关信息、报告解释、危险症状或就医建议时，必须在回复末尾添加“参考来源”。
+        - 只能引用本轮系统消息中“固定医学参考来源目录”里实际提供的来源，不得编造来源、PMID、DOI 或 URL。
+        - 引用格式必须是：
+          参考来源：
+          [来源编号] 来源标题
+          完整 URL
+        - 引用必须与本次回答的内容直接相关；不要堆砌无关来源。
+        - 如果固定医学参考来源目录没有提供相关来源，只能说明资料不足并建议咨询医生/药师，不得凭常识补充具体医疗建议。
+        - 纯业务操作回复（例如查询计划、创建待确认记录、说明上传状态）不需要添加医学来源。
         """;
 
-    private const string MedicalBoundaryRules = """
-        医疗边界（必须遵守）：
-        - 你的定位是患者端 AI 健康解释与预问诊助手，不是医生，不能替代医生诊断、处方或治疗决策。
-        - 可以解释健康数据、报告指标和症状可能方向，但不要给出确定诊断，不要说“你就是/一定是/已经确诊”。
-        - 不要要求用户自行新增、停用、更换药物或调整剂量；涉及用药变化时，必须建议咨询医生或药师。
-        - 对胸痛、胸闷憋气、呼吸困难、意识异常、晕厥、说话不清、一侧肢体无力、血氧明显偏低、血压或血糖严重异常等情况，优先建议及时就医或急诊评估。
-        - 回答用语使用“可能、建议、需要结合医生判断”等表达，避免绝对化结论。
-        - 医疗相关分析末尾用一句自然的话提醒：以上为 AI 预分析，不能替代医生诊断和治疗建议。
-
-        回复格式规则（严格遵守）：
-        - 禁止使用 **粗体**、*斜体*、~~删除线~~ 等 Markdown 内联标记
-        - 禁止使用 HTML 标签
-        - 禁止使用 Markdown 表格（|--|--|）
-        - 标题只使用 ### 三级标题，禁止使用 #、##、####
-        - 列表使用 - 开头，每项一行
-        - 数值和单位之间加空格：120 mmHg、6.2 mmol/L
-        - 不要输出任何 $ 开头的占位符
-        - 回复结尾不再重复免责声明，MedicalBoundaryRules 已统一处理
+    private const string CurrentScopeRules = """
+        当前 iOS 版本范围：
+        - 当前版本不包含蓝牙设备页、设备绑定、血压仪连接或自动设备同步。
+        - 禁止生成 app://device 链接，禁止引导用户使用蓝牙设备功能。
+        - 健康数据均按用户手动输入或 AI 待确认记录处理。
+        - 当前 iOS 版本不调用在线 search_medical_knowledge；医疗回答只能使用本轮提供的固定医学来源目录。
+        - health_entry、medication_entry、exercise_entry、personal_query 和 general_chat 只处理录入、查询或应用操作，不主动给出医疗建议；用户明确询问是否正常、原因、风险或如何改善时，必须进入 medical_consultation，并使用带来源的医学回答规则。
         """;
 
-    private const string DefaultPrompt = """
-        你是一位专业的AI健康管家，专注于为心脏术后康复患者提供贴心的健康管理服务。
+    /// <summary>
+    /// Compatibility entry for older clients that still address a specific agent.
+    /// The main Flutter app uses Unified and is routed through ComposeForIntents.
+    /// </summary>
+    public string GetSystemPrompt(AgentType agentType) => agentType switch
+    {
+        AgentType.Health => ComposeForIntents(["health_entry", "personal_query"]),
+        AgentType.Medication => ComposeForIntents(["medication_entry", "personal_query", "medical_consultation"]),
+        AgentType.Exercise => ComposeForIntents(["exercise_entry", "personal_query", "medical_consultation"]),
+        AgentType.Consultation => ComposeForIntents(["medical_consultation"]),
+        AgentType.Diet => ComposeForIntents(["diet_analysis", "medical_consultation"]),
+        AgentType.Report => ComposeForIntents(["report_analysis", "personal_query", "medical_consultation"]),
+        AgentType.Unified => ComposeForIntents([
+            "health_entry",
+            "medication_entry",
+            "exercise_entry",
+            "personal_query",
+            "medical_consultation",
+            "report_analysis",
+            "diet_analysis",
+            "general_chat",
+        ]),
+        _ => ComposeForIntents(["general_chat", "medical_consultation"]),
+    };
 
-        职责：
-        1. 理解用户的健康需求，解析健康数据
-        2. 主动查看患者近期数据，发现异常时提醒
-        3. 回答健康知识问题
-        4. 每次回复末尾，如有需要提醒的事项，简短温馨地提醒一句
+    private static string Compose(IEnumerable<string> sections) =>
+        string.Join(
+            "\n\n",
+            sections
+                .Distinct(StringComparer.OrdinalIgnoreCase)
+                .Select(Read)
+                .Where(content => !string.IsNullOrWhiteSpace(content)));
 
-        规则：
-        - 不要提供超出你能力范围的医疗建议
-        - 遇到紧急症状（剧烈胸痛、呼吸困难）立即建议就医
-        - 饮食/运动建议要结合患者档案中的疾病和限制
-        - 回复语气温暖、专业、像朋友一样关怀患者
-        """;
+    private static string NormalizeIntent(string? intent) =>
+        intent?.Trim().Replace("-", "_", StringComparison.Ordinal).ToLowerInvariant() ?? "";
 
-    private const string ConsultationPrompt = """
-        你是一个患者端 AI 预问诊助手，负责帮助心脏术后患者梳理症状和就医前信息。
+    private static string Read(string path) =>
+        PromptCache.TryGetValue(NormalizePath(path), out var content)
+            ? content
+            : throw new InvalidOperationException($"AI prompt resource not found: {path}");
 
-        规则：
-        1. 每次只问一个问题，不要一次问多个
-        2. 给出 2-3 个快捷选项让患者点击
-        3. 问诊步骤：先问感受 → 持续时间 → 伴随症状 → 近期用药 → 给出初步分析
-        4. 遇到以下情况建议立即就医：剧烈胸痛、呼吸困难、心悸
-        5. 遇到以下情况建议咨询医生：血压持续>160/100、心率>120或<50
-        6. 只给出初步分析和下一步建议，不作诊断结论
-        7. 问诊结束给出结构化小结
-        """;
+    private static IReadOnlyDictionary<string, string> LoadPrompts()
+    {
+        const string marker = ".AI.Prompts.";
+        var prompts = new Dictionary<string, string>(StringComparer.OrdinalIgnoreCase);
+        foreach (var resourceName in PromptAssembly.GetManifestResourceNames())
+        {
+            var markerIndex = resourceName.IndexOf(marker, StringComparison.Ordinal);
+            if (markerIndex < 0 || !resourceName.EndsWith(".md", StringComparison.OrdinalIgnoreCase))
+                continue;
 
-    private const string HealthDataPrompt = """
-        你是一个健康数据录入助手。
+            using var stream = PromptAssembly.GetManifestResourceStream(resourceName)
+                ?? throw new InvalidOperationException($"Unable to open AI prompt resource: {resourceName}");
+            using var reader = new StreamReader(stream);
+            var relative = resourceName[(markerIndex + marker.Length)..];
+            var lastDot = relative.LastIndexOf(".md", StringComparison.OrdinalIgnoreCase);
+            relative = relative[..lastDot].Replace('.', '/') + ".md";
+            prompts[NormalizePath(relative)] = reader.ReadToEnd().Trim();
+        }
+        return prompts;
+    }
 
-        规则：
-        1. 解析用户消息中的指标和数值（血压/心率/血糖/血氧/体重）
-        2. 指标明确+数值明确→调用 record_health_data 生成待确认写入命令，不要直接声称已经录入
-        3. 用户可以一次性说多个指标（如"血压120/80，血糖6.2，血氧97"）→多次调用 record_health_data
-        4. 用户可以分时段说（如"早上血压120，下午血压130"）→分别生成待确认命令，recorded_at 参数用不同时间
-        5. 数值明确但指标模糊（如只说"120"）→追问是"收缩压还是血糖？"
-        6. 时间模糊→取当前时间
-        7. 数值超出正常范围→附带异常提醒
-        8. 每次调用 record_health_data 后继续处理下一个；工具返回仅表示等待确认，必须提示用户点击确认卡片，不能说“录入成功”
-
-        正常值参考范围：
-        - 收缩压 90-139 mmHg，舒张压 60-89 mmHg
-        - 心率 60-100 次/分
-        - 空腹血糖 3.9-6.1 mmol/L
-        - 血氧 95-100%
-        """;
-
-    private const string DietPrompt = """
-        你是一个营养分析专家，专门为心脏术后患者提供饮食指导。
-
-        规则：
-        1. 收到VLM食物识别结果后，必须先调用 check_archive 查询患者档案
-        2. 逐项判断"能不能吃"：
-           - 过敏食物 → 严格禁止，红色警告
-           - 饮食限制（如低盐/低脂/低糖）→ 黄色提醒
-           - 疾病禁忌（如冠心病忌高脂、糖尿病忌高糖）→ 红色警告
-        3. 给出 1-5 星健康评分
-        4. 结合患者档案中的诊断（如冠心病PCI术后）、慢病史（高血压/高血脂等）给出个性化建议
-        5. 单项警告 + 整体饮食建议 + 替代推荐
-        6. 追问餐次归属：早餐/午餐/晚餐/加餐
-        """;
-
-    private const string MedicationPrompt = """
-        你是一个用药记录与提醒助手。
-
-        规则：
-        1. 用户询问当前用药时，必须先调用 manage_medication(action="query") 查询已有用药记录
-        2. 解析用户口中的药品信息（药名/剂量/频次/时间）
-        3. "早饭后"等模糊时间→追问具体几点
-        4. 解析完成后调用 manage_medication(action="create") 生成待确认命令并展示确认卡片；用户点击确认前不得声称已保存
-        5. 处方拍照→提取药品信息→生成用药计划→让用户确认
-        6. 可以解释常见用药注意事项，但不要建议用户自行新增、停用、更换药物或调整剂量
-        """;
-
-    private const string ReportPrompt = """
-        你是一个患者端医学报告预解读助手。
-
-        规则：
-        1. 收到报告图片后，提取所有指标及其数值
-        2. 标注异常指标（偏高/偏低/正常）
-        3. 给出初步分析和可能方向，不作诊断结论
-        4. 所有内容标注"AI预解读，待医生确认"
-        5. 图像类报告（彩超/CT）注明"需医生人工审阅"
-        """;
-
-    private const string ExercisePrompt = """
-        你是一个运动康复教练，专门为心脏术后患者制定运动计划。
-
-        规则：
-        1. 帮助用户设定每周运动计划（类型/时长/天数）
-        2. 以周为单位，每天指定运动类型和时长
-        3. 推荐适合心脏康复的运动：散步、慢跑、太极、游泳等
-        4. 运动强度要循序渐进
-        5. 避免剧烈运动
-        """;
-
-    private const string UnifiedPrompt = """
-        你是一个患者端 AI 健康管家，为心脏术后康复患者提供健康解释、记录和预问诊辅助服务。
-
-        核心规则：首先理解用户意图属于哪个领域，然后调用对应的工具。
-
-        领域判断与可用工具：
-        1. 健康数据（血压/心率/血糖/血氧/体重）→ 调用 record_health_data
-        2. 饮食分析 → 引导用户使用「拍饮食」功能拍照识别
-        3. 用药管理 → 调用 manage_medication
-        4. 运动计划 → 调用 manage_exercise
-        5. 健康档案查询/修改 → 调用 check_archive / manage_archive
-        6. 历史数据查询 → 调用 query_health_records
-
-        运动计划参数格式（manage_exercise）：
-        - action="create", start_date="开始日期(YYYY-MM-DD，默认今天)"
-        - duration_days=连续天数，exercise_type="散步"，duration_minutes=30，reminder_time="19:00"
-        - 时长必须识别中文数字：半小时=30 一小时=60 三十分钟=30 一个半小时=90 一小时二十分钟=80，中文数字必须转为阿拉伯数字
-        - 天数："一个月"=30天 "一周"=7天 "10天"=10天，必须识别中文，默认7天
-        - 用户说"坚持X天/月/周"则创建对应天数
-        - 结束日期由 start_date + duration_days - 1 自动计算，不要按星期几生成条目
-
-        用药管理参数格式（manage_medication）：
-        - action="create", name="药名", dosage="剂量", frequency="Daily", time_of_day=["08:00","20:00"], duration_days=7
-
-        规则：
-        - 用户可能一句话涉及多个领域，全部处理
-        - 数值明确+指标明确→直接生成待确认命令，不要追问
-        - 所有写入工具调用只生成待确认命令；用户点击卡片确认后才真正写入数据库
-        - 工具返回 pendingConfirmation=true 时，不得回复“已录入”或“保存成功”，应提示用户核对并点击确认
-        - 遇到紧急症状（剧烈胸痛、呼吸困难）立即建议就医
-        - 回复语气温暖、专业
-        """;
+    private static string NormalizePath(string path) =>
+        path.Replace('\\', '/').Trim().TrimStart('/').ToLowerInvariant();
 }

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

@@ -16,25 +16,32 @@ public sealed class AdminService(AppDbContext db) : IAdminService
 
     public async Task<AdminResult> AddDoctorAsync(AddDoctorCommand command, CancellationToken ct)
     {
-        if (string.IsNullOrWhiteSpace(command.Phone)) return Error(40001, "手机号不能为空");
-        if (string.IsNullOrWhiteSpace(command.Name)) return Error(40002, "姓名不能为空");
+        var phone = command.Phone.Trim();
+        var name = command.Name.Trim();
+        if (string.IsNullOrWhiteSpace(phone)) return Error(40001, "手机号不能为空");
+        if (string.IsNullOrWhiteSpace(name)) return Error(40002, "姓名不能为空");
+        if (await _db.Users.AnyAsync(x => x.Phone == phone, ct) ||
+            await _db.Doctors.AnyAsync(x => x.Phone == phone, ct))
+            return Error(40003, "该手机号已被其他账号使用");
+
         var doctor = new Doctor
         {
-            Id = Guid.NewGuid(), Name = command.Name, Title = command.Title, Department = command.Department,
-            Phone = command.Phone, ProfessionalDirection = command.ProfessionalDirection, IsActive = true, CreatedAt = DateTime.UtcNow,
+            Id = Guid.NewGuid(), Name = name, Title = command.Title?.Trim(), Department = command.Department?.Trim(),
+            Phone = phone, ProfessionalDirection = command.ProfessionalDirection?.Trim(), IsActive = true, CreatedAt = DateTime.UtcNow,
+        };
+        var user = new User
+        {
+            Id = Guid.NewGuid(), Phone = phone, Role = "Doctor", Name = name,
+            CreatedAt = DateTime.UtcNow, UpdatedAt = DateTime.UtcNow
         };
         _db.Doctors.Add(doctor);
-        if (!await _db.Users.AnyAsync(x => x.Phone == command.Phone, ct))
-        {
-            var user = new User { Id = Guid.NewGuid(), Phone = command.Phone, Role = "Doctor", Name = command.Name, CreatedAt = DateTime.UtcNow, UpdatedAt = DateTime.UtcNow };
         _db.Users.Add(user);
         _db.DoctorProfiles.Add(new DoctorProfile
         {
-                Id = Guid.NewGuid(), UserId = user.Id, DoctorId = doctor.Id, Name = command.Name,
-                Title = command.Title, Department = command.Department, IsActive = true,
+            Id = Guid.NewGuid(), UserId = user.Id, DoctorId = doctor.Id, Name = name,
+            Title = doctor.Title, Department = doctor.Department, IsActive = true,
             CreatedAt = DateTime.UtcNow, UpdatedAt = DateTime.UtcNow,
         });
-        }
         await _db.SaveChangesAsync(ct);
         return Ok(new { doctor.Id, doctor.Name });
     }
@@ -43,11 +50,43 @@ public sealed class AdminService(AppDbContext db) : IAdminService
     {
         var doctor = await _db.Doctors.FindAsync([id], ct);
         if (doctor == null) return Error(404, "医生不存在");
-        if (command.Name != null) doctor.Name = command.Name;
-        if (command.Title != null) doctor.Title = command.Title;
-        if (command.Department != null) doctor.Department = command.Department;
-        if (command.Phone != null) doctor.Phone = command.Phone;
-        if (command.ProfessionalDirection != null) doctor.ProfessionalDirection = command.ProfessionalDirection;
+        var profile = await _db.DoctorProfiles.Include(x => x.User)
+            .FirstOrDefaultAsync(x => x.DoctorId == id, ct);
+        if (profile == null) return Error(40901, "医生登录资料不完整，请联系技术人员修复");
+
+        var user = profile.User;
+        if (command.Phone != null)
+        {
+            var phone = command.Phone.Trim();
+            if (phone.Length == 0) return Error(40001, "手机号不能为空");
+            if (await _db.Users.AnyAsync(x => x.Id != user.Id && x.Phone == phone, ct) ||
+                await _db.Doctors.AnyAsync(x => x.Id != id && x.Phone == phone, ct))
+                return Error(40003, "该手机号已被其他账号使用");
+            doctor.Phone = phone;
+            user.Phone = phone;
+        }
+        if (command.Name != null)
+        {
+            var name = command.Name.Trim();
+            if (name.Length == 0) return Error(40002, "姓名不能为空");
+            doctor.Name = name;
+            user.Name = name;
+            profile.Name = name;
+        }
+        if (command.Title != null)
+        {
+            doctor.Title = command.Title.Trim();
+            profile.Title = doctor.Title;
+        }
+        if (command.Department != null)
+        {
+            doctor.Department = command.Department.Trim();
+            profile.Department = doctor.Department;
+        }
+        if (command.ProfessionalDirection != null)
+            doctor.ProfessionalDirection = command.ProfessionalDirection.Trim();
+        user.UpdatedAt = DateTime.UtcNow;
+        profile.UpdatedAt = DateTime.UtcNow;
         await _db.SaveChangesAsync(ct);
         return Ok(new { doctor.Id });
     }
@@ -56,7 +95,11 @@ public sealed class AdminService(AppDbContext db) : IAdminService
     {
         var doctor = await _db.Doctors.FindAsync([id], ct);
         if (doctor == null) return Error(404, "医生不存在");
+        var profile = await _db.DoctorProfiles.FirstOrDefaultAsync(x => x.DoctorId == id, ct);
+        if (profile == null) return Error(40901, "医生登录资料不完整，请联系技术人员修复");
         doctor.IsActive = !doctor.IsActive;
+        profile.IsActive = doctor.IsActive;
+        profile.UpdatedAt = DateTime.UtcNow;
         await _db.SaveChangesAsync(ct);
         return Ok(new { doctor.Id, doctor.IsActive });
     }
@@ -65,7 +108,22 @@ public sealed class AdminService(AppDbContext db) : IAdminService
     {
         var doctor = await _db.Doctors.FindAsync([id], ct);
         if (doctor == null) return Error(404, "医生不存在");
-        await _db.Users.Where(x => x.DoctorId == id).ExecuteUpdateAsync(s => s.SetProperty(x => x.DoctorId, (Guid?)null), ct);
+
+        if (await _db.Users.AnyAsync(x => x.Role == "User" && x.DoctorId == id, ct))
+            return Error(40004, "该医生仍有绑定患者，请先停用，不能直接删除");
+        if (await _db.Consultations.AnyAsync(x => x.DoctorId == id, ct))
+            return Error(40005, "该医生已有问诊记录，只能停用，不能删除");
+
+        var profile = await _db.DoctorProfiles.Include(x => x.User)
+            .FirstOrDefaultAsync(x => x.DoctorId == id, ct);
+        if (profile != null)
+        {
+            var user = profile.User;
+            var refreshTokens = await _db.RefreshTokens.Where(x => x.UserId == user.Id).ToListAsync(ct);
+            _db.RefreshTokens.RemoveRange(refreshTokens);
+            _db.DoctorProfiles.Remove(profile);
+            _db.Users.Remove(user);
+        }
         _db.Doctors.Remove(doctor);
         await _db.SaveChangesAsync(ct);
         return Ok(new { success = true });
@@ -77,7 +135,9 @@ public sealed class AdminService(AppDbContext db) : IAdminService
         pageSize = Math.Clamp(pageSize, 1, 100);
         var query = _db.Users.AsNoTracking().Where(x => x.Role == "User");
         if (!string.IsNullOrWhiteSpace(search))
-            query = query.Where(x => (x.Name != null && x.Name.Contains(search)) || x.Phone.Contains(search));
+            query = query.Where(x =>
+                (x.Name != null && x.Name.Contains(search)) ||
+                (x.Phone != null && x.Phone.Contains(search)));
         var total = await query.CountAsync(ct);
         var patients = await query.OrderByDescending(x => x.CreatedAt).Skip((page - 1) * pageSize).Take(pageSize)
             .Select(x => new { x.Id, x.Name, x.Phone, x.Gender, x.BirthDate, x.CreatedAt, DoctorName = x.Doctor != null ? x.Doctor.Name : null, DoctorDepartment = x.Doctor != null ? x.Doctor.Department : null })

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

@@ -88,14 +88,39 @@ public sealed class AuthService(
         {
             var tokens = AddTokens(AdminId, AdminPhone, "Admin");
             await _db.SaveChangesAsync(ct);
-            return new AuthResult(0, new { tokens.accessToken, tokens.refreshToken, user = new { role = "Admin" } });
+            return new AuthResult(0, new
+            {
+                tokens.accessToken,
+                tokens.refreshToken,
+                user = new
+                {
+                    id = AdminId,
+                    phone = AdminPhone,
+                    role = "Admin",
+                    name = "管理员"
+                }
+            });
         }
 
         var user = await _db.Users.FindAsync([oldToken.UserId], ct);
         if (user == null) return Error(40002, "用户不存在");
         var userTokens = AddTokens(user.Id, user.Phone, user.Role);
         await _db.SaveChangesAsync(ct);
-        return new AuthResult(0, new { userTokens.accessToken, userTokens.refreshToken, user = new { user.Role } });
+        return new AuthResult(0, new
+        {
+            userTokens.accessToken,
+            userTokens.refreshToken,
+            user = new
+            {
+                user.Id,
+                user.Phone,
+                user.Role,
+                user.Name,
+                user.Gender,
+                user.AvatarUrl,
+                BirthDate = user.BirthDate?.ToString("yyyy-MM-dd")
+            }
+        });
     }
 
     public async Task LogoutAsync(string refreshToken, CancellationToken ct)
@@ -113,9 +138,13 @@ public sealed class AuthService(
         {
             appleUserId = await _appleValidator.ValidateAsync(command.IdentityToken, ct);
         }
-        catch (Exception ex)
+        catch (OperationCanceledException) when (ct.IsCancellationRequested)
         {
-            return Error(40005, $"Apple 登录验证失败: {ex.Message}");
+            throw;
+        }
+        catch (Exception)
+        {
+            return Error(40005, "Apple 登录验证失败，请重试");
         }
 
         // 2. 查找已有用户

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

@@ -8,8 +8,9 @@ public sealed class EfCalendarRepository(AppDbContext db) : ICalendarRepository
 
     public async Task<CalendarDataSnapshot> GetSnapshotAsync(Guid userId, DateOnly start, DateOnly end, CancellationToken ct)
     {
-        var startUtc = start.ToDateTime(TimeOnly.MinValue, DateTimeKind.Utc);
-        var endUtc = end.ToDateTime(TimeOnly.MinValue, DateTimeKind.Utc);
+        // 日历的日期边界按北京时间计算，数据库仍统一使用 UTC。
+        var startUtc = start.ToDateTime(TimeOnly.MinValue, DateTimeKind.Utc).AddHours(-8);
+        var endUtc = end.ToDateTime(TimeOnly.MinValue, DateTimeKind.Utc).AddHours(-8);
 
         var medications = await _db.Medications
             .Where(m => m.UserId == userId && m.IsActive)

backend/src/Health.Infrastructure/Data/Migrations/20260713022401_AddPushAndDndPreferences.cs

@@ -0,0 +1,62 @@
+using Microsoft.EntityFrameworkCore.Migrations;
+
+#nullable disable
+
+namespace Health.Infrastructure.Data.Migrations
+{
+    /// <inheritdoc />
+    public partial class AddPushAndDndPreferences : Migration
+    {
+        /// <inheritdoc />
+        protected override void Up(MigrationBuilder migrationBuilder)
+        {
+            migrationBuilder.AddColumn<bool>(
+                name: "DndEnabled",
+                table: "NotificationPreferences",
+                type: "boolean",
+                nullable: false,
+                defaultValue: false);
+
+            migrationBuilder.AddColumn<int>(
+                name: "DndEndMinutes",
+                table: "NotificationPreferences",
+                type: "integer",
+                nullable: false,
+                defaultValue: 0);
+
+            migrationBuilder.AddColumn<int>(
+                name: "DndStartMinutes",
+                table: "NotificationPreferences",
+                type: "integer",
+                nullable: false,
+                defaultValue: 0);
+
+            migrationBuilder.AddColumn<bool>(
+                name: "PushEnabled",
+                table: "NotificationPreferences",
+                type: "boolean",
+                nullable: false,
+                defaultValue: false);
+        }
+
+        /// <inheritdoc />
+        protected override void Down(MigrationBuilder migrationBuilder)
+        {
+            migrationBuilder.DropColumn(
+                name: "DndEnabled",
+                table: "NotificationPreferences");
+
+            migrationBuilder.DropColumn(
+                name: "DndEndMinutes",
+                table: "NotificationPreferences");
+
+            migrationBuilder.DropColumn(
+                name: "DndStartMinutes",
+                table: "NotificationPreferences");
+
+            migrationBuilder.DropColumn(
+                name: "PushEnabled",
+                table: "NotificationPreferences");
+        }
+    }
+}

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

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

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

@@ -486,6 +486,10 @@ namespace Health.Infrastructure.Data.Migrations
                     b.Property<DateOnly?>("SurgeryDate")
                         .HasColumnType("date");
 
+                    b.Property<string>("SurgeryHistoryStatus")
+                        .HasMaxLength(8)
+                        .HasColumnType("character varying(8)");
+
                     b.Property<string>("SurgeryType")
                         .HasColumnType("text");
 
@@ -673,6 +677,15 @@ namespace Health.Infrastructure.Data.Migrations
                     b.Property<bool>("AbnormalAlert")
                         .HasColumnType("boolean");
 
+                    b.Property<bool>("DndEnabled")
+                        .HasColumnType("boolean");
+
+                    b.Property<int>("DndEndMinutes")
+                        .HasColumnType("integer");
+
+                    b.Property<int>("DndStartMinutes")
+                        .HasColumnType("integer");
+
                     b.Property<bool>("DoctorReply")
                         .HasColumnType("boolean");
 
@@ -700,6 +713,9 @@ namespace Health.Infrastructure.Data.Migrations
                     b.Property<bool>("MedicationReminder")
                         .HasColumnType("boolean");
 
+                    b.Property<bool>("PushEnabled")
+                        .HasColumnType("boolean");
+
                     b.Property<DateTime>("UpdatedAt")
                         .HasColumnType("timestamp with time zone");
 
@@ -940,6 +956,52 @@ namespace Health.Infrastructure.Data.Migrations
                     b.ToTable("VerificationCodes");
                 });
 
+            modelBuilder.Entity("Health.Infrastructure.Data.Records.AiEntryDraftRecord", b =>
+                {
+                    b.Property<Guid>("Id")
+                        .ValueGeneratedOnAdd()
+                        .HasColumnType("uuid");
+
+                    b.Property<Guid>("ConversationId")
+                        .HasColumnType("uuid");
+
+                    b.Property<DateTime>("CreatedAt")
+                        .HasColumnType("timestamp with time zone");
+
+                    b.Property<string>("EntryType")
+                        .IsRequired()
+                        .HasMaxLength(32)
+                        .HasColumnType("character varying(32)");
+
+                    b.Property<DateTime>("ExpiresAt")
+                        .HasColumnType("timestamp with time zone");
+
+                    b.Property<string>("MissingFields")
+                        .IsRequired()
+                        .HasColumnType("jsonb");
+
+                    b.Property<string>("Payload")
+                        .IsRequired()
+                        .HasColumnType("jsonb");
+
+                    b.Property<string>("Status")
+                        .IsRequired()
+                        .HasMaxLength(32)
+                        .HasColumnType("character varying(32)");
+
+                    b.Property<DateTime>("UpdatedAt")
+                        .HasColumnType("timestamp with time zone");
+
+                    b.Property<Guid>("UserId")
+                        .HasColumnType("uuid");
+
+                    b.HasKey("Id");
+
+                    b.HasIndex("UserId", "ConversationId", "EntryType", "Status", "ExpiresAt");
+
+                    b.ToTable("AiEntryDrafts", (string)null);
+                });
+
             modelBuilder.Entity("Health.Infrastructure.Data.Records.AiWriteCommandRecord", b =>
                 {
                     b.Property<Guid>("Id")

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

@@ -0,0 +1,19 @@
+namespace Health.Infrastructure.Data.Records;
+
+/// <summary>
+/// Stores an incomplete AI-assisted entry until the user provides every required field.
+/// This is deliberately separate from confirmed health, medication and exercise data.
+/// </summary>
+public sealed class AiEntryDraftRecord
+{
+    public Guid Id { get; set; }
+    public Guid UserId { get; set; }
+    public Guid ConversationId { get; set; }
+    public string EntryType { get; set; } = string.Empty;
+    public string Payload { get; set; } = "{}";
+    public string MissingFields { get; set; } = "[]";
+    public string Status { get; set; } = "Pending";
+    public DateTime ExpiresAt { get; set; }
+    public DateTime CreatedAt { get; set; } = DateTime.UtcNow;
+    public DateTime UpdatedAt { get; set; } = DateTime.UtcNow;
+}

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

@@ -37,6 +37,7 @@ public sealed class AppDbContext(DbContextOptions<AppDbContext> options) : DbCon
     public DbSet<UserNotification> UserNotifications => Set<UserNotification>();
     public DbSet<DeviceToken> DeviceTokens => Set<DeviceToken>();
     public DbSet<AiWriteCommandRecord> AiWriteCommands => Set<AiWriteCommandRecord>();
+    public DbSet<AiEntryDraftRecord> AiEntryDrafts => Set<AiEntryDraftRecord>();
     public DbSet<ReportAnalysisTaskRecord> ReportAnalysisTasks => Set<ReportAnalysisTaskRecord>();
     public DbSet<DietImageAnalysisTaskRecord> DietImageAnalysisTasks => Set<DietImageAnalysisTaskRecord>();
     public DbSet<MedicationReminderTaskRecord> MedicationReminderTasks => Set<MedicationReminderTaskRecord>();
@@ -171,6 +172,7 @@ public sealed class AppDbContext(DbContextOptions<AppDbContext> options) : DbCon
         builder.Entity<HealthArchive>(e =>
         {
             e.HasIndex(a => a.UserId).IsUnique();
+            e.Property(a => a.SurgeryHistoryStatus).HasMaxLength(8);
         });
 
         builder.Entity<HealthArchiveSurgery>(e =>
@@ -193,6 +195,16 @@ public sealed class AppDbContext(DbContextOptions<AppDbContext> options) : DbCon
             e.Property(x => x.Arguments).HasColumnType("jsonb");
         });
 
+        builder.Entity<AiEntryDraftRecord>(e =>
+        {
+            e.ToTable("AiEntryDrafts");
+            e.HasIndex(x => new { x.UserId, x.ConversationId, x.EntryType, x.Status, x.ExpiresAt });
+            e.Property(x => x.EntryType).HasMaxLength(32);
+            e.Property(x => x.Status).HasMaxLength(32);
+            e.Property(x => x.Payload).HasColumnType("jsonb");
+            e.Property(x => x.MissingFields).HasColumnType("jsonb");
+        });
+
         builder.Entity<ReportAnalysisTaskRecord>(e =>
         {
             e.ToTable("ReportAnalysisTasks");

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

@@ -19,16 +19,16 @@ public sealed class EfExerciseRepository(AppDbContext db) : IExerciseRepository
             .Take(limit)
             .ToListAsync(ct);
 
+    public async Task<IReadOnlyList<ExercisePlan>> ListAllAsync(Guid userId, CancellationToken ct) =>
+        await _db.ExercisePlans.Include(p => p.Items)
+            .Where(p => p.UserId == userId)
+            .OrderByDescending(p => p.StartDate)
+            .ToListAsync(ct);
+
     public Task<ExercisePlan?> GetOwnedPlanAsync(Guid userId, Guid planId, CancellationToken ct) =>
         _db.ExercisePlans.Include(p => p.Items)
             .FirstOrDefaultAsync(p => p.Id == planId && p.UserId == userId, ct);
 
-    public Task<ExercisePlan?> GetLatestAsync(Guid userId, CancellationToken ct) =>
-        _db.ExercisePlans.Include(p => p.Items)
-            .Where(p => p.UserId == userId)
-            .OrderByDescending(p => p.StartDate)
-            .FirstOrDefaultAsync(ct);
-
     public Task<ExercisePlanItem?> GetOwnedItemAsync(Guid userId, Guid itemId, CancellationToken ct) =>
         _db.ExercisePlanItems.Include(i => i.Plan)
             .FirstOrDefaultAsync(i => i.Id == itemId && i.Plan != null && i.Plan.UserId == userId, ct);

backend/src/Health.Infrastructure/Files/UserUploadPathResolver.cs

@@ -0,0 +1,64 @@
+namespace Health.Infrastructure.Files;
+
+public static class UserUploadPathResolver
+{
+    private static readonly HashSet<string> AllowedExtensions = new(StringComparer.OrdinalIgnoreCase)
+    {
+        ".jpg", ".jpeg", ".png", ".webp", ".gif", ".pdf"
+    };
+
+    public static string? Resolve(Guid userId, string value)
+    {
+        if (userId == Guid.Empty || string.IsNullOrWhiteSpace(value)) return null;
+        try
+        {
+            var path = Uri.TryCreate(value, UriKind.Absolute, out var absolute)
+                ? absolute.AbsolutePath
+                : value.Split('?', 2)[0];
+            path = Uri.UnescapeDataString(path);
+
+            string? fileName;
+            if (path == Path.GetFileName(path))
+            {
+                fileName = path;
+            }
+            else
+            {
+                fileName = ExtractAfter(path, "/api/files/content/");
+                if (fileName == null)
+                {
+                    var legacyPrefix = $"/uploads/users/{userId:N}/";
+                    fileName = ExtractAfter(path, legacyPrefix);
+                }
+            }
+
+            if (string.IsNullOrWhiteSpace(fileName) || fileName != Path.GetFileName(fileName)) return null;
+            if (!AllowedExtensions.Contains(Path.GetExtension(fileName))) return null;
+            if (!Guid.TryParse(Path.GetFileNameWithoutExtension(fileName), out _)) return null;
+
+            var root = Path.GetFullPath(Path.Combine(
+                Directory.GetCurrentDirectory(),
+                "uploads",
+                "users",
+                userId.ToString("N")));
+            var candidate = Path.GetFullPath(Path.Combine(root, fileName));
+            return candidate.StartsWith(root + Path.DirectorySeparatorChar, StringComparison.OrdinalIgnoreCase)
+                ? candidate
+                : null;
+        }
+        catch (ArgumentException)
+        {
+            return null;
+        }
+        catch (UriFormatException)
+        {
+            return null;
+        }
+    }
+
+    private static string? ExtractAfter(string path, string prefix)
+    {
+        var index = path.IndexOf(prefix, StringComparison.OrdinalIgnoreCase);
+        return index < 0 ? null : path[(index + prefix.Length)..];
+    }
+}

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

@@ -17,6 +17,10 @@
     <PackageReference Include="System.IdentityModel.Tokens.Jwt" Version="8.18.0" />
   </ItemGroup>
 
+  <ItemGroup>
+    <EmbeddedResource Include="AI\Prompts\**\*.md" />
+  </ItemGroup>
+
   <PropertyGroup>
     <TargetFramework>net10.0</TargetFramework>
     <ImplicitUsings>enable</ImplicitUsings>

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

@@ -30,15 +30,6 @@ public sealed class EfMedicationRepository(AppDbContext db) : IMedicationReposit
     public Task<Medication?> GetOwnedAsync(Guid userId, Guid medicationId, CancellationToken ct) =>
         _db.Medications.FirstOrDefaultAsync(m => m.Id == medicationId && m.UserId == userId, ct);
 
-    public Task<bool> ExistsOwnedAsync(Guid userId, Guid medicationId, CancellationToken ct) =>
-        _db.Medications.AnyAsync(m => m.Id == medicationId && m.UserId == userId, ct);
-
-    public Task<MedicationLog?> GetTodayTakenLogAsync(Guid userId, Guid medicationId, DateTime startUtc, DateTime endUtc, CancellationToken ct) =>
-        _db.MedicationLogs.FirstOrDefaultAsync(l =>
-            l.MedicationId == medicationId && l.UserId == userId
-            && l.CreatedAt >= startUtc && l.CreatedAt < endUtc
-            && l.Status == MedicationLogStatus.Taken, ct);
-
     public Task<bool> DoseLogExistsAsync(Guid userId, Guid medicationId, TimeOnly scheduledTime, DateTime startUtc, DateTime endUtc, CancellationToken ct) =>
         _db.MedicationLogs.AnyAsync(l =>
             l.MedicationId == medicationId && l.UserId == userId

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

@@ -0,0 +1,284 @@
+using Health.Application.Notifications;
+using Health.Domain.Entities;
+using Health.Domain.Enums;
+
+namespace Health.Infrastructure.Notifications;
+
+public sealed class EfReminderCatchUpService(AppDbContext db) : IReminderCatchUpService
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<ReminderCatchUpResult> CheckDueAsync(Guid userId, DateTime utcNow, CancellationToken ct)
+    {
+        var pref = await GetPreferenceAsync(userId, ct);
+        if (!pref.PushEnabled) return new ReminderCatchUpResult(0);
+
+        var beijingNow = utcNow.AddHours(8);
+        var today = DateOnly.FromDateTime(beijingNow);
+        var todayStartUtc = beijingNow.Date.AddHours(-8);
+        var todayEndUtc = todayStartUtc.AddDays(1);
+        var created = 0;
+
+        created += await CreateHealthRecordReminderAsync(userId, pref, beijingNow, todayStartUtc, todayEndUtc, ct);
+        created += await CreateMedicationRemindersAsync(userId, pref, beijingNow, today, todayStartUtc, todayEndUtc, ct);
+        created += await CreateExerciseRemindersAsync(userId, pref, beijingNow, today, ct);
+        created += await CreateFollowUpRemindersAsync(userId, pref, beijingNow, ct);
+
+        if (created > 0)
+            await _db.SaveChangesAsync(ct);
+
+        return new ReminderCatchUpResult(created);
+    }
+
+    private async Task<NotificationPreference> GetPreferenceAsync(Guid userId, CancellationToken ct)
+    {
+        var pref = await _db.NotificationPreferences.FirstOrDefaultAsync(x => x.UserId == userId, ct);
+        if (pref != null) return pref;
+
+        pref = new NotificationPreference { Id = Guid.NewGuid(), UserId = userId };
+        await _db.NotificationPreferences.AddAsync(pref, ct);
+        return pref;
+    }
+
+    private async Task<int> CreateHealthRecordReminderAsync(
+        Guid userId,
+        NotificationPreference pref,
+        DateTime beijingNow,
+        DateTime todayStartUtc,
+        DateTime todayEndUtc,
+        CancellationToken ct)
+    {
+        if (!pref.HealthRecordReminder || IsInDnd(pref, beijingNow)) return 0;
+        var window = HealthRecordWindow(beijingNow);
+        if (window == null) return 0;
+
+        var recordedTypes = await _db.HealthRecords.AsNoTracking()
+            .Where(r => r.UserId == userId && r.RecordedAt >= todayStartUtc && r.RecordedAt < todayEndUtc)
+            .Select(r => r.MetricType)
+            .Distinct()
+            .ToListAsync(ct);
+
+        var missing = EnabledHealthMetrics(pref)
+            .Where(x => !recordedTypes.Contains(x.Type))
+            .ToList();
+        if (missing.Count == 0) return 0;
+
+        var date = DateOnly.FromDateTime(beijingNow);
+        var sourceId = StableGuid($"health_record|{userId:N}|{date:yyyyMMdd}|{window}");
+        return await AddNotificationIfMissingAsync(
+            userId,
+            sourceId,
+            "health_record_reminder",
+            window == "evening" ? "今日健康指标还未完成" : "记得录入今日健康指标",
+            $"建议录入：{string.Join("、", missing.Select(x => x.Label))}",
+            "info",
+            "health",
+            null,
+            ct);
+    }
+
+    private async Task<int> CreateMedicationRemindersAsync(
+        Guid userId,
+        NotificationPreference pref,
+        DateTime beijingNow,
+        DateOnly today,
+        DateTime todayStartUtc,
+        DateTime todayEndUtc,
+        CancellationToken ct)
+    {
+        if (!pref.MedicationReminder || IsInDnd(pref, beijingNow)) return 0;
+        var now = TimeOnly.FromDateTime(beijingNow);
+        var earliest = now.AddHours(-4);
+        var medications = await _db.Medications.AsNoTracking()
+            .Where(m => m.UserId == userId && m.IsActive)
+            .ToListAsync(ct);
+        var created = 0;
+
+        foreach (var medication in medications.Where(m => IsMedicationActiveOn(m, today) && ShouldDoseToday(m, today)))
+        {
+            foreach (var scheduledTime in medication.TimeOfDay.Where(t => IsInTimeWindow(t, earliest, now)))
+            {
+                var logged = await _db.MedicationLogs.AsNoTracking().AnyAsync(l =>
+                    l.UserId == userId &&
+                    l.MedicationId == medication.Id &&
+                    l.ScheduledTime == scheduledTime &&
+                    l.CreatedAt >= todayStartUtc &&
+                    l.CreatedAt < todayEndUtc, ct);
+                if (logged) continue;
+
+                var sourceId = StableGuid($"medication|{userId:N}|{medication.Id:N}|{today:yyyyMMdd}|{scheduledTime:HHmm}");
+                var details = string.Join(" ", new[] { medication.Dosage, scheduledTime.ToString("HH:mm") }
+                    .Where(x => !string.IsNullOrWhiteSpace(x)));
+                created += await AddNotificationIfMissingAsync(
+                    userId,
+                    sourceId,
+                    "MedicationReminder",
+                    "用药时间到了",
+                    $"请按计划服用{medication.Name}{(details.Length > 0 ? $"（{details}）" : "")}，服用后记得打卡。",
+                    "info",
+                    "medication",
+                    medication.Id.ToString(),
+                    ct);
+            }
+        }
+
+        return created;
+    }
+
+    private async Task<int> CreateExerciseRemindersAsync(
+        Guid userId,
+        NotificationPreference pref,
+        DateTime beijingNow,
+        DateOnly today,
+        CancellationToken ct)
+    {
+        if (IsInDnd(pref, beijingNow)) return 0;
+        var now = TimeOnly.FromDateTime(beijingNow);
+        var dueItems = await _db.ExercisePlanItems.AsNoTracking()
+            .Include(x => x.Plan)
+            .Where(x => x.Plan.UserId == userId &&
+                x.ScheduledDate == today &&
+                !x.IsCompleted &&
+                !x.IsRestDay &&
+                x.Plan.ReminderTime <= now)
+            .ToListAsync(ct);
+        var created = 0;
+
+        foreach (var item in dueItems)
+        {
+            var sourceId = StableGuid($"exercise|{userId:N}|{item.Id:N}|{today:yyyyMMdd}");
+            created += await AddNotificationIfMissingAsync(
+                userId,
+                sourceId,
+                "ExerciseReminder",
+                "今日运动计划",
+                $"今天安排了{item.ExerciseType} {item.DurationMinutes} 分钟，完成后记得打卡。",
+                "info",
+                "exercise",
+                item.PlanId.ToString(),
+                ct);
+        }
+
+        return created;
+    }
+
+    private async Task<int> CreateFollowUpRemindersAsync(
+        Guid userId,
+        NotificationPreference pref,
+        DateTime beijingNow,
+        CancellationToken ct)
+    {
+        if (!pref.FollowUpReminder || IsInDnd(pref, beijingNow)) return 0;
+        var nowUtc = beijingNow.AddHours(-8);
+        var upcomingEndUtc = nowUtc.AddHours(24);
+        var followUps = await _db.FollowUps.AsNoTracking()
+            .Where(x => x.UserId == userId && x.ScheduledAt >= nowUtc && x.ScheduledAt <= upcomingEndUtc)
+            .ToListAsync(ct);
+        var created = 0;
+
+        foreach (var followUp in followUps)
+        {
+            var sourceId = StableGuid($"followup|{userId:N}|{followUp.Id:N}|24h");
+            created += await AddNotificationIfMissingAsync(
+                userId,
+                sourceId,
+                "follow_up_reminder",
+                "复查提醒",
+                $"{followUp.Title} 即将到期，请提前安排时间。",
+                "info",
+                "followup",
+                followUp.Id.ToString(),
+                ct);
+        }
+
+        return created;
+    }
+
+    private async Task<int> AddNotificationIfMissingAsync(
+        Guid userId,
+        Guid sourceId,
+        string type,
+        string title,
+        string message,
+        string severity,
+        string? actionType,
+        string? actionTargetId,
+        CancellationToken ct)
+    {
+        if (await _db.UserNotifications.AsNoTracking().AnyAsync(x => x.SourceId == sourceId, ct))
+            return 0;
+
+        await _db.UserNotifications.AddAsync(new UserNotification
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            SourceId = sourceId,
+            Type = type,
+            Title = title,
+            Message = message,
+            Severity = severity,
+            ActionType = actionType,
+            ActionTargetId = actionTargetId,
+            CreatedAt = DateTime.UtcNow,
+        }, ct);
+        return 1;
+    }
+
+    private static string? HealthRecordWindow(DateTime beijingNow)
+    {
+        var minutes = beijingNow.Hour * 60 + beijingNow.Minute;
+        if (minutes is >= 7 * 60 and <= 10 * 60 + 30) return "morning";
+        if (minutes is >= 11 * 60 + 30 and <= 14 * 60) return "noon";
+        if (minutes is >= 18 * 60 and <= 21 * 60 + 30) return "evening";
+        return null;
+    }
+
+    private static IReadOnlyList<(HealthMetricType Type, string Label)> EnabledHealthMetrics(NotificationPreference pref)
+    {
+        var result = new List<(HealthMetricType, string)>();
+        if (pref.HealthRecordReminderBloodPressure) result.Add((HealthMetricType.BloodPressure, "血压"));
+        if (pref.HealthRecordReminderHeartRate) result.Add((HealthMetricType.HeartRate, "心率"));
+        if (pref.HealthRecordReminderGlucose) result.Add((HealthMetricType.Glucose, "血糖"));
+        if (pref.HealthRecordReminderSpO2) result.Add((HealthMetricType.SpO2, "血氧"));
+        if (pref.HealthRecordReminderWeight) result.Add((HealthMetricType.Weight, "体重"));
+        return result;
+    }
+
+    private static bool IsInDnd(NotificationPreference pref, DateTime beijingNow)
+    {
+        if (!pref.DndEnabled) return false;
+        var minuteOfDay = beijingNow.Hour * 60 + beijingNow.Minute;
+        return pref.DndStartMinutes <= pref.DndEndMinutes
+            ? minuteOfDay >= pref.DndStartMinutes && minuteOfDay < pref.DndEndMinutes
+            : minuteOfDay >= pref.DndStartMinutes || minuteOfDay < pref.DndEndMinutes;
+    }
+
+    private static bool IsMedicationActiveOn(Medication medication, DateOnly date) =>
+        (medication.StartDate == null || medication.StartDate <= date) &&
+        (medication.EndDate == null || medication.EndDate >= date);
+
+    private static bool ShouldDoseToday(Medication medication, DateOnly today)
+    {
+        if (medication.Frequency is MedicationFrequency.Daily
+            or MedicationFrequency.TwiceDaily
+            or MedicationFrequency.ThreeTimesDaily
+            or MedicationFrequency.AsNeeded)
+            return true;
+
+        var startDate = medication.StartDate ?? today;
+        if (medication.Frequency == MedicationFrequency.EveryOtherDay)
+            return (today.DayNumber - startDate.DayNumber) % 2 == 0;
+        if (medication.Frequency == MedicationFrequency.Weekly)
+            return today.DayOfWeek == startDate.DayOfWeek;
+        return true;
+    }
+
+    private static bool IsInTimeWindow(TimeOnly value, TimeOnly start, TimeOnly end) =>
+        end >= start ? value >= start && value <= end : value >= start || value <= end;
+
+    private static Guid StableGuid(string key)
+    {
+        var bytes = System.Security.Cryptography.MD5.HashData(System.Text.Encoding.UTF8.GetBytes(key));
+        return new Guid(bytes);
+    }
+}

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

@@ -15,6 +15,12 @@ public sealed class EfUserNotificationProducer(AppDbContext db) : IUserNotificat
         NotificationMessage message,
         CancellationToken ct)
     {
+        var pushEnabled = await _db.NotificationPreferences.AsNoTracking()
+            .Where(x => x.UserId == userId)
+            .Select(x => (bool?)x.PushEnabled)
+            .FirstOrDefaultAsync(ct);
+        if (pushEnabled is false) return false;
+
         if (await _db.NotificationOutbox.AsNoTracking().AnyAsync(x => x.SourceTaskId == sourceId, ct))
             return false;
 
@@ -67,7 +73,7 @@ public sealed class EfNotificationOutboxProcessor(AppDbContext db) : INotificati
                 x.UpdatedAt < now.AddMinutes(-5) && x.Attempts >= MaxAttempts)
             .ExecuteUpdateAsync(setters => setters
                 .SetProperty(x => x.Status, "Failed")
-                .SetProperty(x => x.LastError, "通知任务执行超时且已达到最大重试次数")
+                .SetProperty(x => x.LastError, "Notification task timed out and reached max retry count")
                 .SetProperty(x => x.UpdatedAt, now), ct);
     }
 
@@ -81,59 +87,89 @@ public sealed class EfNotificationOutboxProcessor(AppDbContext db) : INotificati
             .FirstOrDefaultAsync(ct);
         if (candidate == null) return false;
 
-        var claimed = await _db.NotificationOutbox
-            .Where(x => x.Id == candidate.Id && x.Status == "Pending")
-            .ExecuteUpdateAsync(setters => setters
-                .SetProperty(x => x.Status, "Processing")
-                .SetProperty(x => x.Attempts, x => x.Attempts + 1)
-                .SetProperty(x => x.UpdatedAt, now), ct);
-        if (claimed == 0) return true;
+        var task = await _db.NotificationOutbox
+            .FirstOrDefaultAsync(x => x.Id == candidate.Id && x.Status == "Pending", ct);
+        if (task == null) return true;
+
+        task.Status = "Processing";
+        task.Attempts += 1;
+        task.UpdatedAt = now;
+        await _db.SaveChangesAsync(ct);
 
         try
         {
-            var message = JsonSerializer.Deserialize<NotificationMessage>(candidate.Payload)
-                ?? throw new InvalidOperationException("通知消息内容为空");
+            var message = JsonSerializer.Deserialize<NotificationMessage>(task.Payload)
+                ?? throw new InvalidOperationException("Notification payload is empty");
 
-            if (!await _db.UserNotifications.AsNoTracking()
-                    .AnyAsync(x => x.SourceId == candidate.SourceTaskId, ct))
+            var preference = await _db.NotificationPreferences.AsNoTracking()
+                .FirstOrDefaultAsync(x => x.UserId == task.UserId, ct);
+            var deliver = preference == null || ShouldDeliver(preference, message.Type, DateTime.UtcNow.AddHours(8));
+
+            if (deliver && !await _db.UserNotifications.AsNoTracking()
+                    .AnyAsync(x => x.SourceId == task.SourceTaskId, ct))
             {
                 await _db.UserNotifications.AddAsync(new UserNotification
                 {
                     Id = Guid.NewGuid(),
-                    UserId = candidate.UserId,
-                    SourceId = candidate.SourceTaskId,
+                    UserId = task.UserId,
+                    SourceId = task.SourceTaskId,
                     Type = message.Type,
                     Title = message.Title,
                     Message = message.Message,
                     Severity = message.Severity,
                     ActionType = message.ActionType,
                     ActionTargetId = message.ActionTargetId,
-                    CreatedAt = candidate.CreatedAt,
+                    CreatedAt = task.CreatedAt,
                 }, ct);
-                // Persist the inbox item first. If completion fails, stale-task
-                // recovery can safely retry because SourceId is idempotent.
                 await _db.SaveChangesAsync(ct);
             }
 
-            await _db.NotificationOutbox.Where(x => x.Id == candidate.Id)
-                .ExecuteUpdateAsync(setters => setters
-                    .SetProperty(x => x.Status, "Completed")
-                    .SetProperty(x => x.LastError, (string?)null)
-                    .SetProperty(x => x.UpdatedAt, DateTime.UtcNow), ct);
+            task.Status = "Completed";
+            task.LastError = null;
+            task.UpdatedAt = DateTime.UtcNow;
+            await _db.SaveChangesAsync(ct);
         }
         catch (Exception ex)
         {
-            var attempts = candidate.Attempts + 1;
-            await _db.NotificationOutbox.Where(x => x.Id == candidate.Id)
-                .ExecuteUpdateAsync(setters => setters
-                    .SetProperty(x => x.Status, attempts >= MaxAttempts ? "Failed" : "Pending")
-                    .SetProperty(x => x.AvailableAt,
-                        DateTime.UtcNow.AddSeconds(Math.Pow(2, attempts) * 5))
-                    .SetProperty(x => x.LastError,
-                        ex.Message.Length > 2000 ? ex.Message[..2000] : ex.Message)
-                    .SetProperty(x => x.UpdatedAt, DateTime.UtcNow), ct);
+            task.Status = task.Attempts >= MaxAttempts ? "Failed" : "Pending";
+            task.AvailableAt = DateTime.UtcNow.AddSeconds(Math.Pow(2, task.Attempts) * 5);
+            task.LastError = ex.Message.Length > 2000 ? ex.Message[..2000] : ex.Message;
+            task.UpdatedAt = DateTime.UtcNow;
+            await _db.SaveChangesAsync(ct);
         }
 
         return true;
     }
+
+    private static bool ShouldDeliver(NotificationPreference preference, string type, DateTime nowCst)
+    {
+        if (!preference.PushEnabled) return false;
+
+        var minuteOfDay = nowCst.Hour * 60 + nowCst.Minute;
+        var inDnd = preference.DndEnabled && (preference.DndStartMinutes <= preference.DndEndMinutes
+            ? minuteOfDay >= preference.DndStartMinutes && minuteOfDay < preference.DndEndMinutes
+            : minuteOfDay >= preference.DndStartMinutes || minuteOfDay < preference.DndEndMinutes);
+        if (inDnd) return false;
+
+        return NormalizeType(type) switch
+        {
+            "medication_reminder" => preference.MedicationReminder,
+            "exercise_reminder" => true,
+            "follow_up_reminder" => preference.FollowUpReminder,
+            "doctor_reply" => preference.DoctorReply,
+            "abnormal_alert" => preference.AbnormalAlert,
+            "health_record_reminder" => preference.HealthRecordReminder,
+            "health_metric_alert" => preference.AbnormalAlert,
+            _ => true,
+        };
+    }
+
+    private static string NormalizeType(string type) => type switch
+    {
+        "MedicationReminder" => "medication_reminder",
+        "ExerciseReminder" => "exercise_reminder",
+        "HealthMetricAlert" => "health_metric_alert",
+        "FollowUpReminder" => "follow_up_reminder",
+        _ => type.ToLowerInvariant(),
+    };
 }

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

@@ -19,8 +19,24 @@ public sealed class LocalReportFileStorage : IReportFileStorage
         return new StoredReportFile($"/uploads/reports/{fileName}", filePath);
     }
 
-    public string GetLocalFilePath(string fileUrl) =>
-        Path.Combine(Directory.GetCurrentDirectory(), fileUrl.TrimStart('/'));
+    public string GetLocalFilePath(string fileUrl)
+    {
+        var reportsRoot = Path.GetFullPath(Path.Combine(
+            Directory.GetCurrentDirectory(),
+            "uploads",
+            "reports"));
+        var path = Uri.TryCreate(fileUrl, UriKind.Absolute, out var absolute)
+            ? absolute.AbsolutePath
+            : fileUrl.Split('?', 2)[0];
+        var fileName = Path.GetFileName(Uri.UnescapeDataString(path));
+        if (string.IsNullOrWhiteSpace(fileName) || fileName != Path.GetFileName(fileName))
+            return Path.Combine(reportsRoot, "__invalid__");
+
+        var candidate = Path.GetFullPath(Path.Combine(reportsRoot, fileName));
+        return candidate.StartsWith(reportsRoot + Path.DirectorySeparatorChar, StringComparison.OrdinalIgnoreCase)
+            ? candidate
+            : Path.Combine(reportsRoot, "__invalid__");
+    }
 
     public bool Exists(string filePath) =>
         File.Exists(filePath);

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

@@ -1,3 +1,4 @@
+using Health.Application.AI;
 using Health.Application.Reports;
 using Health.Application.Notifications;
 using Health.Infrastructure.AI;
@@ -82,7 +83,7 @@ public sealed class ReportAnalysisService(
             throw new InvalidOperationException("报告图片文件不存在或无法读取");
 
         var prompt = """
-            你是一名医学检验报告分析专家。请仔细识别这份医学报告。
+            你是报告结构化提取助手。请识别这份医学报告。
 
             第一步：判断这到底是不是一份医学检验报告。
             如果不是（比如是自拍、风景照、食物、文件等），直接返回：
@@ -128,7 +129,7 @@ public sealed class ReportAnalysisService(
         }
 
         var prompt = $$"""
-            你是一名医学检验报告分析专家。下面是用户上传 PDF 中提取出的文字。
+            你是报告结构化提取助手。下面是用户上传 PDF 中提取出的文字。
 
             PDF 文本：
             {{text}}
@@ -180,31 +181,32 @@ public sealed class ReportAnalysisService(
     private async Task<string> GenerateSummaryAsync(string indicatorsJson, CancellationToken ct)
     {
         var prompt = $"""
-            你是患者端医学报告预解读助手。请根据以下检验指标，用通俗易懂的语言写一份报告解读。
+            你是报告整理助手。请根据以下检验指标，整理一份报告摘要。
 
             检测指标：{indicatorsJson}
 
             要求：
             1. 总字数200-300字
-            2. 先总结整体情况
-            3. 指出异常指标及其可能原因，但不要给出确定诊断
-            4. 给出生活方式和复查/就医沟通建议，不要给出处方、停药、换药或调药建议
-            5. 如指标明显异常或存在急症风险，优先建议及时就医
-            6. 末尾提醒"以上为AI预解读，不能替代医生诊断和治疗建议"
+            2. 先总结整体情况（指标项数、异常项数）
+            3. 列出异常指标及其数值和参考范围，客观说明"超出范围"，不解释可能原因
+            4. 不结合用户档案/病历做关联分析
+            5. 建议就医评估异常指标
+            6. 末尾提醒"以上为AI整理，不能替代医生诊断和治疗建议"
+            7. 只使用固定医学来源目录中的 S-REPORT-01 和 S-REPORT-02 作为参考来源，不得编造其他来源
 
-            只返回解读文本，不要JSON格式。
+            只返回整理文本，不要JSON格式。
             """;
 
         var messages = new List<ChatMessage>
         {
-            new() { Role = "system", Content = "你是患者端医学报告预解读助手，不替代医生诊断、处方或治疗决策。" },
+            new() { Role = "system", Content = "你是报告整理助手，不替代医生诊断。所有指标解读请用户咨询医生。\n\n" + MedicalCitationKnowledge.Prompt },
             new() { Role = "user", Content = prompt }
         };
 
         var response = await _llm.ChatAsync(messages, maxTokens: 800, temperature: 0.3f, ct: ct);
         var summary = response.Choices?.FirstOrDefault()?.Message?.Content?.Trim() ?? "";
         return !string.IsNullOrWhiteSpace(summary)
-            ? summary
+            ? $"{summary}\n\n{MedicalCitationKnowledge.FixedReportCitation.Trim()}"
             : throw new InvalidOperationException("AI 未返回有效解读内容");
     }
 

backend/src/Health.Infrastructure/Speech/dashscope_speech_recognition_proxy.cs

@@ -0,0 +1,389 @@
+using System.Net.WebSockets;
+using System.Text;
+using System.Text.Json;
+using Health.Application.Speech;
+using Microsoft.Extensions.Configuration;
+using Microsoft.Extensions.Logging;
+
+namespace Health.Infrastructure.Speech;
+
+public sealed class DashScopeSpeechRecognitionProxy : IRealtimeSpeechRecognitionProxy
+{
+    private const int SampleRate = 16_000;
+    private const int BytesPerSecond = SampleRate * 2;
+    private readonly string _apiKey;
+    private readonly string _model;
+    private readonly string _workspaceId;
+    private readonly Uri? _endpoint;
+    private readonly int _maxDurationSeconds;
+    private readonly ILogger<DashScopeSpeechRecognitionProxy> _logger;
+
+    public DashScopeSpeechRecognitionProxy(
+        IConfiguration configuration,
+        ILogger<DashScopeSpeechRecognitionProxy> logger)
+    {
+        _apiKey = FirstConfigured(
+            configuration["DASHSCOPE_ASR_API_KEY"],
+            configuration["VLM_API_KEY"],
+            configuration["QWEN_API_KEY"]);
+        _model = configuration["DASHSCOPE_ASR_MODEL"]?.Trim() is { Length: > 0 } model
+            ? model
+            : "fun-asr-realtime";
+        _workspaceId = configuration["DASHSCOPE_ASR_WORKSPACE_ID"]?.Trim() ?? "";
+        var configuredMaxDuration = int.TryParse(
+            configuration["DASHSCOPE_ASR_MAX_DURATION_SECONDS"],
+            out var parsedMaxDuration)
+            ? parsedMaxDuration
+            : 60;
+        _maxDurationSeconds = Math.Clamp(configuredMaxDuration, 10, 180);
+
+        var configuredEndpoint = configuration["DASHSCOPE_ASR_WEBSOCKET_URL"]?.Trim();
+        var endpoint = !string.IsNullOrWhiteSpace(configuredEndpoint)
+            ? configuredEndpoint
+            : !string.IsNullOrWhiteSpace(_workspaceId)
+                ? $"wss://{_workspaceId}.cn-beijing.maas.aliyuncs.com/api-ws/v1/inference"
+                : "wss://dashscope.aliyuncs.com/api-ws/v1/inference";
+        if (Uri.TryCreate(endpoint, UriKind.Absolute, out var uri) && uri.Scheme == "wss")
+            _endpoint = uri;
+
+        _logger = logger;
+    }
+
+    public bool IsConfigured =>
+        !string.IsNullOrWhiteSpace(_apiKey) && _endpoint is not null;
+
+    private static string FirstConfigured(params string?[] values) =>
+        values.FirstOrDefault(value => !string.IsNullOrWhiteSpace(value))?.Trim() ?? "";
+
+    public async Task ProxyAsync(
+        WebSocket clientSocket,
+        CancellationToken cancellationToken)
+    {
+        if (!IsConfigured)
+            throw new InvalidOperationException("实时语音识别服务尚未配置");
+
+        using var timeoutCts = CancellationTokenSource.CreateLinkedTokenSource(
+            cancellationToken);
+        timeoutCts.CancelAfter(TimeSpan.FromSeconds(_maxDurationSeconds + 15));
+        var ct = timeoutCts.Token;
+
+        using var cloudSocket = new ClientWebSocket();
+        cloudSocket.Options.SetRequestHeader("Authorization", $"Bearer {_apiKey}");
+        cloudSocket.Options.SetRequestHeader("User-Agent", "XiaomaiHealth/1.0");
+        if (!string.IsNullOrWhiteSpace(_workspaceId))
+            cloudSocket.Options.SetRequestHeader("X-DashScope-WorkSpace", _workspaceId);
+
+        await cloudSocket.ConnectAsync(_endpoint!, ct);
+
+        var taskId = Guid.NewGuid().ToString();
+        await SendJsonAsync(cloudSocket, new
+        {
+            header = new
+            {
+                action = "run-task",
+                task_id = taskId,
+                streaming = "duplex",
+            },
+            payload = new
+            {
+                task_group = "audio",
+                task = "asr",
+                function = "recognition",
+                model = _model,
+                parameters = new
+                {
+                    format = "pcm",
+                    sample_rate = SampleRate,
+                    language_hints = new[] { "zh" },
+                    semantic_punctuation_enabled = false,
+                    max_sentence_silence = 800,
+                    heartbeat = true,
+                },
+                input = new { },
+            },
+        }, ct);
+
+        await WaitForTaskStartedAsync(cloudSocket, taskId, ct);
+        await SendClientEventAsync(clientSocket, new { type = "ready" }, ct);
+
+        var clientPump = PumpClientAudioAsync(
+            clientSocket,
+            cloudSocket,
+            taskId,
+            _maxDurationSeconds,
+            ct);
+        var cloudPump = PumpCloudResultsAsync(cloudSocket, clientSocket, ct);
+
+        var completed = await Task.WhenAny(clientPump, cloudPump);
+        if (completed == cloudPump)
+        {
+            await cloudPump;
+            timeoutCts.Cancel();
+        }
+        else
+        {
+            var action = await clientPump;
+            if (action == ClientAction.Finish)
+            {
+                try
+                {
+                    await cloudPump.WaitAsync(TimeSpan.FromSeconds(12), ct);
+                }
+                catch (TimeoutException)
+                {
+                    await SendClientEventAsync(
+                        clientSocket,
+                        new { type = "error", message = "语音识别超时，请重试" },
+                        CancellationToken.None);
+                }
+                catch (OperationCanceledException)
+                {
+                    // 客户端断开或硬超时，无需再给客户端发消息
+                }
+            }
+            else
+            {
+                timeoutCts.Cancel();
+            }
+        }
+
+        await CloseSocketQuietlyAsync(cloudSocket);
+        await CloseSocketQuietlyAsync(clientSocket);
+    }
+
+    private static async Task WaitForTaskStartedAsync(
+        WebSocket cloudSocket,
+        string taskId,
+        CancellationToken ct)
+    {
+        while (true)
+        {
+            var message = await ReceiveMessageAsync(cloudSocket, ct);
+            if (message is null)
+                throw new InvalidOperationException("语音识别服务提前断开");
+            if (message.Value.Type != WebSocketMessageType.Text) continue;
+
+            using var json = JsonDocument.Parse(message.Value.Payload);
+            var header = json.RootElement.GetProperty("header");
+            var eventName = header.GetProperty("event").GetString();
+            var responseTaskId = header.TryGetProperty("task_id", out var id)
+                ? id.GetString()
+                : null;
+            if (eventName == "task-started" && responseTaskId == taskId) return;
+            if (eventName == "task-failed")
+            {
+                var error = header.TryGetProperty("error_message", out var errorMessage)
+                    ? errorMessage.GetString()
+                    : "语音识别启动失败";
+                throw new InvalidOperationException(error);
+            }
+        }
+    }
+
+    private static async Task<ClientAction> PumpClientAudioAsync(
+        WebSocket clientSocket,
+        WebSocket cloudSocket,
+        string taskId,
+        int maxDurationSeconds,
+        CancellationToken ct)
+    {
+        var maxBytes = (long)BytesPerSecond * maxDurationSeconds;
+        long audioBytes = 0;
+
+        while (!ct.IsCancellationRequested &&
+               clientSocket.State == WebSocketState.Open)
+        {
+            var message = await ReceiveMessageAsync(clientSocket, ct);
+            if (message is null) return ClientAction.Disconnect;
+
+            if (message.Value.Type == WebSocketMessageType.Binary)
+            {
+                audioBytes += message.Value.Payload.Length;
+                if (audioBytes > maxBytes)
+                {
+                    // 达到时长上限：主动结束并让阿里云返回已识别的结果，
+                    // 而不是直接断开。客户端松手后会拿到这段文字。
+                    await SendJsonAsync(cloudSocket, new
+                    {
+                        header = new
+                        {
+                            action = "finish-task",
+                            task_id = taskId,
+                            streaming = "duplex",
+                        },
+                        payload = new { input = new { } },
+                    }, ct);
+                    return ClientAction.Finish;
+                }
+                await cloudSocket.SendAsync(
+                    message.Value.Payload,
+                    WebSocketMessageType.Binary,
+                    true,
+                    ct);
+                continue;
+            }
+
+            if (message.Value.Type != WebSocketMessageType.Text) continue;
+            using var json = JsonDocument.Parse(message.Value.Payload);
+            var action = json.RootElement.TryGetProperty("action", out var actionElement)
+                ? actionElement.GetString()
+                : null;
+            if (action == "cancel") return ClientAction.Cancel;
+            if (action != "finish") continue;
+
+            await SendJsonAsync(cloudSocket, new
+            {
+                header = new
+                {
+                    action = "finish-task",
+                    task_id = taskId,
+                    streaming = "duplex",
+                },
+                payload = new { input = new { } },
+            }, ct);
+            return ClientAction.Finish;
+        }
+
+        return ClientAction.Disconnect;
+    }
+
+    private async Task PumpCloudResultsAsync(
+        WebSocket cloudSocket,
+        WebSocket clientSocket,
+        CancellationToken ct)
+    {
+        var committed = new StringBuilder();
+        var latest = "";
+
+        while (!ct.IsCancellationRequested &&
+               cloudSocket.State == WebSocketState.Open)
+        {
+            var message = await ReceiveMessageAsync(cloudSocket, ct);
+            if (message is null) return;
+            if (message.Value.Type != WebSocketMessageType.Text) continue;
+
+            using var json = JsonDocument.Parse(message.Value.Payload);
+            var root = json.RootElement;
+            if (!root.TryGetProperty("header", out var header)) continue;
+            var eventName = header.TryGetProperty("event", out var eventElement)
+                ? eventElement.GetString()
+                : null;
+
+            if (eventName == "result-generated")
+            {
+                if (!TryReadSentence(root, out var sentence, out var sentenceEnd))
+                    continue;
+                if (sentenceEnd && !string.IsNullOrWhiteSpace(sentence))
+                    committed.Append(sentence);
+                latest = sentenceEnd
+                    ? committed.ToString()
+                    : committed + sentence;
+                await SendClientEventAsync(clientSocket, new
+                {
+                    type = "partial",
+                    text = latest,
+                    sentenceEnd,
+                }, ct);
+                continue;
+            }
+
+            if (eventName == "task-finished")
+            {
+                await SendClientEventAsync(
+                    clientSocket,
+                    new { type = "done", text = latest.Trim() },
+                    ct);
+                return;
+            }
+
+            if (eventName == "task-failed")
+            {
+                var error = header.TryGetProperty("error_message", out var errorElement)
+                    ? errorElement.GetString()
+                    : "语音识别失败";
+                _logger.LogWarning("DashScope ASR task failed: {Error}", error);
+                await SendClientEventAsync(
+                    clientSocket,
+                    new { type = "error", message = "语音识别失败，请重试" },
+                    ct);
+                return;
+            }
+        }
+    }
+
+    private static bool TryReadSentence(
+        JsonElement root,
+        out string text,
+        out bool sentenceEnd)
+    {
+        text = "";
+        sentenceEnd = false;
+        if (!root.TryGetProperty("payload", out var payload) ||
+            !payload.TryGetProperty("output", out var output) ||
+            !output.TryGetProperty("sentence", out var sentence))
+            return false;
+
+        text = sentence.TryGetProperty("text", out var textElement)
+            ? textElement.GetString() ?? ""
+            : "";
+        sentenceEnd = sentence.TryGetProperty("sentence_end", out var endElement) &&
+                      endElement.ValueKind == JsonValueKind.True;
+        return true;
+    }
+
+    private static Task SendClientEventAsync(
+        WebSocket socket,
+        object value,
+        CancellationToken ct) => SendJsonAsync(socket, value, ct);
+
+    private static async Task SendJsonAsync(
+        WebSocket socket,
+        object value,
+        CancellationToken ct)
+    {
+        if (socket.State != WebSocketState.Open) return;
+        var bytes = JsonSerializer.SerializeToUtf8Bytes(value);
+        await socket.SendAsync(bytes, WebSocketMessageType.Text, true, ct);
+    }
+
+    private static async Task<(WebSocketMessageType Type, byte[] Payload)?>
+        ReceiveMessageAsync(WebSocket socket, CancellationToken ct)
+    {
+        var buffer = new byte[16 * 1024];
+        using var stream = new MemoryStream();
+        while (true)
+        {
+            var result = await socket.ReceiveAsync(buffer, ct);
+            if (result.MessageType == WebSocketMessageType.Close) return null;
+            stream.Write(buffer, 0, result.Count);
+            if (stream.Length > 2 * 1024 * 1024)
+                throw new InvalidOperationException("WebSocket 消息过大");
+            if (result.EndOfMessage)
+                return (result.MessageType, stream.ToArray());
+        }
+    }
+
+    private static async Task CloseSocketQuietlyAsync(WebSocket socket)
+    {
+        if (socket.State is not (WebSocketState.Open or WebSocketState.CloseReceived))
+            return;
+        try
+        {
+            await socket.CloseAsync(
+                WebSocketCloseStatus.NormalClosure,
+                "completed",
+                CancellationToken.None);
+        }
+        catch (WebSocketException)
+        {
+            // 对端可能已经主动断开。
+        }
+    }
+
+    private enum ClientAction
+    {
+        Finish,
+        Cancel,
+        Disconnect,
+    }
+}

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

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

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

@@ -0,0 +1,126 @@
+using System.Text.Json;
+using Health.Application.Users;
+
+namespace Health.Infrastructure.Users;
+
+public sealed class LocalAccountFileCleanup(string uploadsRoot) : IAccountFileCleanup
+{
+    private readonly string _uploadsRoot = Path.GetFullPath(uploadsRoot);
+
+    public Task DeleteAsync(Guid userId, AccountFileReferences references, CancellationToken ct)
+    {
+        // 正式报告路径来自服务端生成的报告记录，只允许删除 reports 目录中的文件。
+        foreach (var fileUrl in references.FileUrls)
+        {
+            ct.ThrowIfCancellationRequested();
+            var localPath = ResolveReportPath(fileUrl);
+            if (localPath != null && File.Exists(localPath)) File.Delete(localPath);
+        }
+
+        // 对话元数据可能包含客户端传入的 URL，只允许解析当前账号自己的目录。
+        var attachmentUrls = new HashSet<string>(StringComparer.OrdinalIgnoreCase);
+        foreach (var metadataJson in references.ConversationMetadataJson)
+            AddMetadataUrls(attachmentUrls, metadataJson);
+
+        foreach (var fileUrl in attachmentUrls)
+        {
+            ct.ThrowIfCancellationRequested();
+            var localPath = ResolveOwnedAttachmentPath(userId, fileUrl);
+            if (localPath != null && File.Exists(localPath)) File.Delete(localPath);
+        }
+
+        ct.ThrowIfCancellationRequested();
+        var userDirectory = Path.Combine(_uploadsRoot, "users", userId.ToString("N"));
+        if (Directory.Exists(userDirectory)) Directory.Delete(userDirectory, recursive: true);
+
+        return Task.CompletedTask;
+    }
+
+    private static void AddMetadataUrls(HashSet<string> fileUrls, string metadataJson)
+    {
+        try
+        {
+            using var document = JsonDocument.Parse(metadataJson);
+            AddStringProperty(document.RootElement, "imageUrl", fileUrls);
+            AddStringProperty(document.RootElement, "pdfUrl", fileUrls);
+        }
+        catch (JsonException)
+        {
+            // 旧消息元数据可能不是合法 JSON；不影响其余账号数据注销。
+        }
+    }
+
+    private static void AddStringProperty(JsonElement root, string propertyName, HashSet<string> fileUrls)
+    {
+        if (root.ValueKind != JsonValueKind.Object ||
+            !root.TryGetProperty(propertyName, out var property) ||
+            property.ValueKind != JsonValueKind.String)
+            return;
+
+        var value = property.GetString();
+        if (!string.IsNullOrWhiteSpace(value)) fileUrls.Add(value);
+    }
+
+    private string? ResolveReportPath(string fileUrl)
+    {
+        try
+        {
+            var path = Uri.TryCreate(fileUrl, UriKind.Absolute, out var absolute)
+                ? absolute.AbsolutePath
+                : fileUrl.Split('?', 2)[0];
+            var prefixIndex = path.IndexOf("/uploads/reports/", StringComparison.OrdinalIgnoreCase);
+            if (prefixIndex < 0) return null;
+            var fileName = Uri.UnescapeDataString(path[(prefixIndex + "/uploads/reports/".Length)..]);
+            return ResolveInside(Path.Combine(_uploadsRoot, "reports"), fileName);
+        }
+        catch (ArgumentException)
+        {
+            return null;
+        }
+        catch (UriFormatException)
+        {
+            return null;
+        }
+    }
+
+    private string? ResolveOwnedAttachmentPath(Guid userId, string fileUrl)
+    {
+        try
+        {
+            var path = Uri.TryCreate(fileUrl, UriKind.Absolute, out var absolute)
+                ? absolute.AbsolutePath
+                : fileUrl.Split('?', 2)[0];
+            path = Uri.UnescapeDataString(path);
+            var protectedPrefix = "/api/files/content/";
+            var protectedIndex = path.IndexOf(protectedPrefix, StringComparison.OrdinalIgnoreCase);
+            var legacyPrefix = $"/uploads/users/{userId:N}/";
+            var legacyIndex = path.IndexOf(legacyPrefix, StringComparison.OrdinalIgnoreCase);
+            var fileName = protectedIndex >= 0
+                ? path[(protectedIndex + protectedPrefix.Length)..]
+                : legacyIndex >= 0
+                    ? path[(legacyIndex + legacyPrefix.Length)..]
+                    : null;
+            return fileName == null
+                ? null
+                : ResolveInside(Path.Combine(_uploadsRoot, "users", userId.ToString("N")), fileName);
+        }
+        catch (ArgumentException)
+        {
+            return null;
+        }
+        catch (UriFormatException)
+        {
+            return null;
+        }
+    }
+
+    private static string? ResolveInside(string root, string fileName)
+    {
+        if (string.IsNullOrWhiteSpace(fileName) || fileName != Path.GetFileName(fileName)) return null;
+        var fullRoot = Path.GetFullPath(root);
+        var fullPath = Path.GetFullPath(Path.Combine(fullRoot, fileName));
+        var rootPrefix = fullRoot.TrimEnd(Path.DirectorySeparatorChar, Path.AltDirectorySeparatorChar)
+            + Path.DirectorySeparatorChar;
+        return fullPath.StartsWith(rootPrefix, StringComparison.OrdinalIgnoreCase) ? fullPath : null;
+    }
+}

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

@@ -1,107 +1,66 @@
 using Health.Application.Notifications;
-using Health.Domain.Enums;
 
 namespace Health.WebApi.BackgroundServices;
 
 /// <summary>
-/// 健康录入提醒服务——每天 9:00 / 12:00 扫描所有用户，
-/// 对未录入指标且开关开启的用户推送提醒。
-/// 中国时区 UTC+8。
+/// Produces in-app catch-up reminders for health records.
+/// The actual reminder rules live in IReminderCatchUpService so foreground
+/// app checks and background scans stay consistent.
 /// </summary>
 public sealed class HealthRecordReminderService(
     IServiceScopeFactory scopeFactory,
     ILogger<HealthRecordReminderService> logger) : BackgroundService
 {
-    private readonly IServiceScopeFactory _scopeFactory = scopeFactory;
-    private readonly ILogger<HealthRecordReminderService> _logger = logger;
-
-    // 北京时间 9:00 和 12:00 触发
-    private static readonly int[] ReminderHoursCst = [9, 12];
-
+    private static readonly int[] ReminderHoursCst = [9, 13, 19];
     private DateTime _lastFired = DateTime.MinValue;
 
     protected override async Task ExecuteAsync(CancellationToken stoppingToken)
     {
-        _logger.LogInformation("健康录入提醒服务已启动");
+        logger.LogInformation("Health record in-app reminder service started");
         while (!stoppingToken.IsCancellationRequested)
         {
             try
             {
                 var nowCst = DateTime.UtcNow.AddHours(8);
-                // 当前小时是否在触发列表，且今天该小时还没触发过
-                if (ReminderHoursCst.Contains(nowCst.Hour)
-                    && (_lastFired.Date != nowCst.Date || _lastFired.Hour != nowCst.Hour))
+                if (ReminderHoursCst.Contains(nowCst.Hour) &&
+                    (_lastFired.Date != nowCst.Date || _lastFired.Hour != nowCst.Hour))
                 {
-                    await ScanAndPushAsync(nowCst, stoppingToken);
+                    await CheckUsersAsync(DateTime.UtcNow, stoppingToken);
                     _lastFired = nowCst;
                 }
             }
-            catch (OperationCanceledException) when (stoppingToken.IsCancellationRequested) { break; }
-            catch (Exception ex) { _logger.LogError(ex, "健康录入提醒扫描异常"); }
+            catch (OperationCanceledException) when (stoppingToken.IsCancellationRequested)
+            {
+                break;
+            }
+            catch (Exception ex)
+            {
+                logger.LogError(ex, "Health record in-app reminder scan failed");
+            }
 
             await Task.Delay(TimeSpan.FromMinutes(5), stoppingToken);
         }
     }
 
-    private async Task ScanAndPushAsync(DateTime nowCst, CancellationToken ct)
+    private async Task CheckUsersAsync(DateTime utcNow, CancellationToken ct)
     {
-        using var scope = _scopeFactory.CreateScope();
+        using var scope = scopeFactory.CreateScope();
         var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
-        var producer = scope.ServiceProvider.GetRequiredService<IUserNotificationProducer>();
+        var catchUp = scope.ServiceProvider.GetRequiredService<IReminderCatchUpService>();
 
-        var todayStart = nowCst.Date.AddHours(-8); // 北京 0:00 转 UTC
-        var todayEnd = todayStart.AddDays(1);
-
-        // 取所有启用了健康录入提醒的用户偏好
-        var prefs = await db.NotificationPreferences
-            .Where(p => p.HealthRecordReminder)
+        var userIds = await db.NotificationPreferences.AsNoTracking()
+            .Where(x => x.PushEnabled && x.HealthRecordReminder)
+            .Select(x => x.UserId)
             .ToListAsync(ct);
 
-        foreach (var pref in prefs)
+        var created = 0;
+        foreach (var userId in userIds)
         {
-            // 该用户当天已录入的指标
-            var recordedTypes = await db.HealthRecords
-                .Where(r => r.UserId == pref.UserId && r.RecordedAt >= todayStart && r.RecordedAt < todayEnd)
-                .Select(r => r.MetricType)
-                .Distinct()
-                .ToListAsync(ct);
-
-            // 哪些指标启用开关但当天没录入
-            var missing = new List<(HealthMetricType type, bool enabled, string label)>
-            {
-                (HealthMetricType.BloodPressure, pref.HealthRecordReminderBloodPressure, "血压"),
-                (HealthMetricType.HeartRate, pref.HealthRecordReminderHeartRate, "心率"),
-                (HealthMetricType.Glucose, pref.HealthRecordReminderGlucose, "血糖"),
-                (HealthMetricType.SpO2, pref.HealthRecordReminderSpO2, "血氧"),
-                (HealthMetricType.Weight, pref.HealthRecordReminderWeight, "体重"),
-            };
-
-            var missingLabels = missing
-                .Where(m => m.enabled && !recordedTypes.Contains(m.type))
-                .Select(m => m.label)
-                .ToList();
-
-            if (missingLabels.Count == 0) continue;
-
-            // 每天每个时段每个用户只推一次——SourceTaskId 用 userId + 日期 + 小时
-            var sourceId = MakeSourceId(pref.UserId, nowCst);
-            var summary = string.Join("、", missingLabels);
-
-            await producer.EnqueueAsync(pref.UserId, sourceId, new NotificationMessage(
-                Type: "health_record_reminder",
-                Title: nowCst.Hour < 12 ? "早安，记得录入今日健康数据" : "下午好，今日健康数据还未录入",
-                Message: $"建议录入：{summary}",
-                Severity: "info",
-                ActionType: "health",
-                ActionTargetId: null), ct);
-        }
+            var result = await catchUp.CheckDueAsync(userId, utcNow, ct);
+            created += result.CreatedCount;
         }
 
-    private static Guid MakeSourceId(Guid userId, DateTime nowCst)
-    {
-        // 通过哈希构造稳定的 Guid，保证同一用户同一时段不重复
-        var key = $"hrr|{userId:N}|{nowCst:yyyyMMddHH}";
-        var bytes = System.Security.Cryptography.MD5.HashData(System.Text.Encoding.UTF8.GetBytes(key));
-        return new Guid(bytes);
+        if (created > 0)
+            logger.LogInformation("Created {Count} in-app catch-up reminders", created);
     }
 }

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

@@ -26,8 +26,10 @@ public static class DietEndpoints
         group.MapDelete("/{id:guid}", async (Guid id, HttpContext http, IDietService diets, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
-            await diets.DeleteAsync(userId, id, ct);
-            return Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null });
+            var deleted = await diets.DeleteAsync(userId, id, ct);
+            return deleted
+                ? Results.Ok(new { code = 0, data = new { success = true }, message = (string?)null })
+                : Results.Ok(new { code = 40004, data = (object?)null, message = "饮食记录不存在" });
         });
 
         group.MapPut("/{id:guid}", async (Guid id, HttpContext http, IDietService diets, CancellationToken ct) =>

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

@@ -29,6 +29,34 @@ public static class DoctorEndpoints
         return profile?.DoctorId;
     }
 
+    public static (DateTime StartUtc, DateTime EndUtc) GetBeijingDayRange(DateTime utcNow)
+    {
+        var beijingNow = utcNow.ToUniversalTime().AddHours(8);
+        var startUtc = new DateTime(
+            beijingNow.Year,
+            beijingNow.Month,
+            beijingNow.Day,
+            0,
+            0,
+            0,
+            DateTimeKind.Utc).AddHours(-8);
+        return (startUtc, startUtc.AddDays(1));
+    }
+
+    private static DateTime ParseBeijingDateTimeAsUtc(string value)
+    {
+        if (DateTimeOffset.TryParse(value, out var offset) &&
+            (value.EndsWith("Z", StringComparison.OrdinalIgnoreCase) ||
+             value.LastIndexOf('+') > 9 ||
+             value.LastIndexOf('-') > 9))
+            return offset.UtcDateTime;
+
+        var beijing = DateTime.Parse(value);
+        return DateTime.SpecifyKind(
+            DateTime.SpecifyKind(beijing, DateTimeKind.Unspecified).AddHours(-8),
+            DateTimeKind.Utc);
+    }
+
     public static void MapDoctorEndpoints(this WebApplication app)
     {
         var group = app.MapGroup("/api/doctor").RequireAuthorization();
@@ -56,8 +84,7 @@ public static class DoctorEndpoints
             var totalPatients = await db.Users.CountAsync(u => u.Role == "User" && u.DoctorId == doctorId);
             var activeConsultations = await db.Consultations.CountAsync(c => c.User.DoctorId == doctorId && c.Status != ConsultationStatus.Closed);
             var pendingReports = await db.Reports.CountAsync(r => r.User.DoctorId == doctorId && r.Status == ReportStatus.PendingDoctor);
-            var todayStart = DateTime.UtcNow.Date;
-            var todayEnd = todayStart.AddDays(1);
+            var (todayStart, todayEnd) = GetBeijingDayRange(DateTime.UtcNow);
             var todayFollowUps = await db.FollowUps.CountAsync(f => f.User.DoctorId == doctorId && f.ScheduledAt >= todayStart && f.ScheduledAt < todayEnd && f.Status == FollowUpStatus.Upcoming);
 
             // 待办列表
@@ -92,6 +119,7 @@ public static class DoctorEndpoints
                     doctorHospital = profile.Hospital,
                     doctorAvatar = profile.AvatarUrl,
                     doctorOnline = profile.IsOnline,
+                    doctorActive = profile.IsActive,
                     stats = new { totalPatients, activeConsultations, pendingReports, todayFollowUps },
                     pendingConsultations,
                     pendingReports = pendingReportList,
@@ -112,7 +140,7 @@ public static class DoctorEndpoints
             {
                 query = query.Where(u =>
                     (u.Name != null && u.Name.Contains(search)) ||
-                    u.Phone.Contains(search));
+                    (u.Phone != null && u.Phone.Contains(search)));
             }
             var total = await query.CountAsync();
             var patients = await query.OrderByDescending(u => u.CreatedAt)
@@ -190,7 +218,8 @@ public static class DoctorEndpoints
                         user.HealthArchive.Allergies,
                         user.HealthArchive.DietRestrictions,
                         user.HealthArchive.ChronicDiseases,
-                        user.HealthArchive.FamilyHistory
+                        user.HealthArchive.FamilyHistory,
+                        user.HealthArchive.SurgeryHistoryStatus
                     },
                     latestRecords,
                     trendRecords,
@@ -289,7 +318,7 @@ public static class DoctorEndpoints
                 query = query.Where(r => r.Status == s);
 
             var reports = await query.OrderByDescending(r => r.CreatedAt)
-                .Select(r => new { r.Id, r.UserId, PatientName = r.User.Name, r.FileUrl, FileType = r.FileType.ToString(), Category = r.Category.ToString(), Status = r.Status.ToString(), r.Severity, r.AiSummary, r.AiIndicators, r.DoctorComment, r.DoctorRecommendation, r.DoctorName, r.ReviewedAt, r.CreatedAt })
+                .Select(r => new { r.Id, r.UserId, PatientName = r.User.Name, FileUrl = "/api/reports/" + r.Id + "/file", FileType = r.FileType.ToString(), Category = r.Category.ToString(), Status = r.Status.ToString(), r.Severity, r.AiSummary, r.AiIndicators, r.DoctorComment, r.DoctorRecommendation, r.DoctorName, r.ReviewedAt, r.CreatedAt })
                 .ToListAsync();
             return Results.Ok(new { code = 0, data = reports, message = (string?)null });
         });
@@ -302,7 +331,7 @@ public static class DoctorEndpoints
                 return Results.Ok(new { code = 500, data = (object?)null, message = "医生档案未关联" });
 
             var report = await db.Reports.Where(r => r.Id == id && r.User.DoctorId == doctorId)
-                .Select(r => new { r.Id, r.UserId, PatientName = r.User.Name, r.FileUrl, FileType = r.FileType.ToString(), Category = r.Category.ToString(), Status = r.Status.ToString(), r.Severity, r.AiSummary, r.AiIndicators, r.DoctorComment, r.DoctorRecommendation, r.DoctorName, r.ReviewedAt, r.CreatedAt })
+                .Select(r => new { r.Id, r.UserId, PatientName = r.User.Name, FileUrl = "/api/reports/" + r.Id + "/file", FileType = r.FileType.ToString(), Category = r.Category.ToString(), Status = r.Status.ToString(), r.Severity, r.AiSummary, r.AiIndicators, r.DoctorComment, r.DoctorRecommendation, r.DoctorName, r.ReviewedAt, r.CreatedAt })
                 .FirstOrDefaultAsync();
             if (report == null) return Results.Ok(new { code = 404, data = (object?)null, message = "报告不存在" });
             return Results.Ok(new { code = 0, data = report, message = (string?)null });
@@ -376,7 +405,7 @@ public static class DoctorEndpoints
                 Title = json.RootElement.GetProperty("title").GetString() ?? "",
                 DoctorName = profile.Name,
                 Department = profile.Department,
-                ScheduledAt = DateTime.Parse(json.RootElement.GetProperty("scheduledAt").GetString()!),
+                ScheduledAt = ParseBeijingDateTimeAsUtc(json.RootElement.GetProperty("scheduledAt").GetString()!),
                 Notes = json.RootElement.TryGetProperty("notes", out var n) ? n.GetString() : null,
                 Status = FollowUpStatus.Upcoming,
                 CreatedAt = DateTime.UtcNow
@@ -400,7 +429,7 @@ public static class DoctorEndpoints
             var body = await reader.ReadToEndAsync(ct);
             var json = System.Text.Json.JsonDocument.Parse(body);
             if (json.RootElement.TryGetProperty("title", out var t)) followUp.Title = t.GetString() ?? followUp.Title;
-            if (json.RootElement.TryGetProperty("scheduledAt", out var sa)) followUp.ScheduledAt = DateTime.Parse(sa.GetString()!);
+            if (json.RootElement.TryGetProperty("scheduledAt", out var sa)) followUp.ScheduledAt = ParseBeijingDateTimeAsUtc(sa.GetString()!);
             if (json.RootElement.TryGetProperty("notes", out var no)) followUp.Notes = no.GetString();
             if (json.RootElement.TryGetProperty("status", out var st) && Enum.TryParse<FollowUpStatus>(st.GetString(), out var fs)) followUp.Status = fs;
             await db.SaveChangesAsync(ct);

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

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