更新

2026-08-12 14:48:57 +08:00
parent bc9ad1d3cd
commit 6d9fe1bbf8
403 changed files with 1790 additions and 1573 deletions
@@ -16,9 +16,20 @@ from datetime import date, datetime
 from pathlib import Path
 from typing import Any

-from PySide6.QtCore import QBuffer, QByteArray, QDate, QIODevice, QPoint, Qt, QTimer, Signal
+from PySide6.QtCore import (
+    QBuffer,
+    QByteArray,
+    QDate,
+    QIODevice,
+    QPoint,
+    QRectF,
+    Qt,
+    QTimer,
+    Signal,
+)
 from PySide6.QtGui import (
    QColor,
+    QFont,
    QImage,
    QMouseEvent,
    QPageSize,
@@ -2437,7 +2448,14 @@ def _status_text(value: Any) -> str:


 def render_case_record_html(prescription: Any) -> str:
-    """Render the immutable diagnosis snapshot stored with a prescription."""
+    """Render the immutable diagnosis snapshot as the admin A3 case sheet.
+
+    ``QTextDocument`` only implements a deliberately small HTML/CSS subset.  In
+    particular, CSS grid and ``display: table-row`` silently degrade into a
+    vertical text stream.  The admin preview uses a three-column grid, so this
+    version expresses that layout with real HTML tables which Qt renders
+    consistently on screen, printers and PDF devices.
+    """

    source = _mapping(prescription)
    snapshot = _mapping(source.get("case_record"))
@@ -2452,11 +2470,35 @@ def render_case_record_html(prescription: Any) -> str:
            value = json.dumps(value, ensure_ascii=False, default=str)
        return html.escape(display_text(value, default))

+    def value(*keys: str, default: Any = None) -> Any:
+        for key in keys:
+            translated = case.get(f"{key}_text")
+            if translated not in (None, ""):
+                return translated
+            candidate = case.get(key)
+            if candidate not in (None, ""):
+                return candidate
+        return default
+
+    def present_date(raw: Any) -> Any:
+        return None if raw in (None, "", 0, "0", "0000-00-00") else raw
+
    gender = case.get("gender", source.get("gender"))
-    gender_label = "男" if gender in (1, "1") else "女" if gender in (0, "0", 2, "2") else "—"
-    marital = {0: "未婚", 1: "已婚", 2: "离异"}.get(_int(case.get("marital_status"), -1), "—")
+    gender_label = (
+        case.get("gender_text")
+        or case.get("gender_desc")
+        or ("男" if gender in (1, "1") else "女" if gender in (0, "0", 2, "2") else "—")
+    )
+    marital = case.get("marital_status_text") or {0: "未婚", 1: "已婚", 2: "离异"}.get(
+        _int(case.get("marital_status"), -1), "—"
+    )
+    age = case.get("age") or source.get("age")
+    age_text = f"{age}岁" if age not in (None, "") and not str(age).endswith("岁") else age
+    diabetes_history = value("diabetes_discovery_year")
+    if diabetes_history not in (None, "") and str(diabetes_history).strip().isdigit():
+        diabetes_history = f"{str(diabetes_history).strip()}年"
    blood_pressure = "—"
-    if case.get("systolic_pressure") not in (None, "") or case.get("diastolic_pressure") not in (
+    if case.get("systolic_pressure") not in (None, "") and case.get("diastolic_pressure") not in (
        None,
        "",
    ):
@@ -2465,102 +2507,173 @@ def render_case_record_html(prescription: Any) -> str:
            f"{display_text(case.get('diastolic_pressure'))} mmHg"
        )

-    def section(title: str, fields: Sequence[tuple[str, Any]]) -> str:
-        rows = "".join(
-            f'<div class="item"><span class="label">{html.escape(label)}</span>'
-            f'<span class="value">{esc(value)}</span></div>'
-            for label, value in fields
+    diagnosis_type = value("diagnosis_type_desc", "diagnosis_type")
+    diagnosis_type = _DIAGNOSIS_TYPE_LABELS.get(str(diagnosis_type or "").strip(), diagnosis_type)
+
+    def field_cell(label: str, field_value: Any, *, colspan: int = 1) -> str:
+        return (
+            f'<td class="cr-item" colspan="{colspan}">'
+            '<table class="cr-kv" width="100%" cellspacing="0" cellpadding="0"><tr>'
+            f'<td class="cr-label">{html.escape(label)}</td>'
+            f'<td class="cr-value">{esc(field_value)}</td>'
+            "</tr></table></td>"
+        )
+
+    def section(
+        title: str,
+        fields: Sequence[tuple[str, Any, bool]],
+    ) -> str:
+        rows: list[str] = []
+        pending: list[str] = []
+        for label, field_value, full_width in fields:
+            if full_width:
+                if pending:
+                    pending.extend('<td class="cr-item empty"></td>' for _ in range(3 - len(pending)))
+                    rows.append(f'<tr>{"".join(pending)}</tr>')
+                    pending = []
+                rows.append(f'<tr>{field_cell(label, field_value, colspan=3)}</tr>')
+                continue
+            pending.append(field_cell(label, field_value))
+            if len(pending) == 3:
+                rows.append(f'<tr>{"".join(pending)}</tr>')
+                pending = []
+        if pending:
+            pending.extend('<td class="cr-item empty"></td>' for _ in range(3 - len(pending)))
+            rows.append(f'<tr>{"".join(pending)}</tr>')
+        return (
+            '<table class="cr-section" width="100%" cellspacing="0" cellpadding="0">'
+            f'<tr><td class="cr-section-title">{html.escape(title)}</td></tr>'
+            '<tr><td><table class="cr-grid" width="100%" cellspacing="0" cellpadding="0">'
+            f'{"".join(rows)}</table></td></tr>'
+            '<tr><td class="cr-rule"></td></tr></table>'
        )
-        return f'<section><h2>{html.escape(title)}</h2><div class="grid">{rows}</div></section>'

    sections = [
        section(
            "基本信息",
            (
-                ("诊单ID", case.get("id") or case.get("diagnosis_id") or source.get("diagnosis_id")),
-                ("姓名", case.get("patient_name") or source.get("patient_name")),
-                ("身份证号", case.get("id_card")),
-                ("手机号", case.get("phone") or source.get("phone")),
-                ("性别", gender_label),
-                ("年龄", case.get("age") or source.get("age")),
-                ("婚姻状态", marital),
-                ("身高", f"{case.get('height')} cm" if case.get("height") not in (None, "") else None),
-                ("体重", f"{case.get('weight')} kg" if case.get("weight") not in (None, "") else None),
-                ("地区", case.get("region")),
+                (
+                    "诊单ID",
+                    case.get("id") or case.get("diagnosis_id") or source.get("diagnosis_id"),
+                    False,
+                ),
+                ("姓名", case.get("patient_name") or source.get("patient_name"), False),
+                ("身份证号", case.get("id_card"), False),
+                ("手机号", case.get("phone") or source.get("phone"), False),
+                ("性别", gender_label, False),
+                ("年龄", age_text, False),
+                ("婚姻状态", marital, False),
+                (
+                    "身高",
+                    f"{case.get('height')} cm" if case.get("height") not in (None, "") else None,
+                    False,
+                ),
+                (
+                    "体重",
+                    f"{case.get('weight')} kg" if case.get("weight") not in (None, "") else None,
+                    False,
+                ),
+                ("地区", case.get("region"), False),
            ),
        ),
        section(
            "生命体征",
            (
-                ("血压", blood_pressure),
+                ("血压", blood_pressure, False),
                (
                    "空腹血糖",
                    f"{case.get('fasting_blood_sugar')} mmol/L"
                    if case.get("fasting_blood_sugar") not in (None, "")
                    else None,
+                    False,
                ),
            ),
        ),
        section(
-            "主诉与诊断",
+            "主诉",
            (
-                ("诊断日期", case.get("diagnosis_date")),
-                ("诊断类型", case.get("diagnosis_type_desc") or case.get("diagnosis_type")),
-                ("证型", case.get("syndrome_type_desc") or case.get("syndrome_type")),
-                ("糖尿病期数", case.get("diabetes_type_desc") or case.get("diabetes_type")),
-                ("糖尿病病史", case.get("diabetes_discovery_year")),
-                ("当地医院诊断", case.get("local_hospital_diagnosis")),
-                ("当地就诊医院", case.get("local_hospital_name")),
-                ("症状补充", case.get("symptoms") or case.get("clinical_diagnosis")),
+                ("诊断日期", present_date(value("diagnosis_date")), False),
+                ("诊断类型", diagnosis_type, False),
+                ("证型", value("syndrome_type_desc", "syndrome_type"), False),
+                ("糖尿病期数", value("diabetes_type_desc", "diabetes_type"), False),
+                ("发现糖尿病患病史", diabetes_history, False),
+                ("当地医院诊断", value("local_hospital_diagnosis"), True),
+                ("当地就诊医院", value("local_hospital_name"), True),
            ),
        ),
        section(
            "现病史",
            (
-                ("口腔感觉", case.get("appetite")),
-                ("每日饮水量", case.get("water_intake")),
-                ("体重变化", case.get("weight_change")),
-                ("脂肪肝程度", case.get("fatty_liver_degree")),
-                ("饮食情况", case.get("diet_condition")),
-                ("肢体感觉", case.get("body_feeling")),
-                ("睡眠情况", case.get("sleep_condition")),
-                ("眼睛情况", case.get("eye_condition")),
-                ("头部感觉", case.get("head_feeling")),
-                ("出汗情况", case.get("sweat_condition")),
-                ("皮肤情况", case.get("skin_condition")),
-                ("小便情况", case.get("urine_condition")),
-                ("大便情况", case.get("stool_condition")),
-                ("腰肾情况", case.get("kidney_condition")),
+                ("口腔感觉", value("appetite"), True),
+                ("每日饮水量", value("water_intake"), True),
+                ("体重变化", value("weight_change"), True),
+                ("脂肪肝程度", value("fatty_liver_degree"), True),
+                ("饮食情况", value("diet_condition"), True),
+                ("肢体感觉", value("body_feeling"), True),
+                ("睡眠情况", value("sleep_condition"), True),
+                ("眼睛情况", value("eye_condition"), True),
+                ("头部感觉", value("head_feeling"), True),
+                ("出汗情况", value("sweat_condition"), True),
+                ("皮肤情况", value("skin_condition"), True),
+                ("小便情况", value("urine_condition"), True),
+                ("大便情况", value("stool_condition"), True),
+                ("腰肾情况", value("kidney_condition"), True),
+                ("其他补充", case.get("symptoms") or case.get("clinical_diagnosis"), True),
            ),
        ),
        section(
-            "病史与中医诊断",
+            "既往史",
            (
-                ("既往史", case.get("past_history")),
-                ("外伤史", "有" if _bool(case.get("trauma_history")) else "无"),
-                ("手术史", "有" if _bool(case.get("surgery_history")) else "无"),
-                ("过敏史", "有" if _bool(case.get("allergy_history")) else "无"),
-                ("家族病史", "有" if _bool(case.get("family_history")) else "无"),
-                ("妊娠哺乳史", "有" if _bool(case.get("pregnancy_history")) else "无"),
-                ("舌象", case.get("tongue_coating") or case.get("tongue")),
-                ("脉象", case.get("pulse")),
-                ("治则", case.get("treatment_principle")),
-                ("医嘱", case.get("doctor_advice")),
+                ("", value("past_history"), True),
+            ),
+        ),
+        section(
+            "其他病史",
+            (
+                ("外伤史", "有" if _bool(case.get("trauma_history")) else "无", False),
+                ("手术史", "有" if _bool(case.get("surgery_history")) else "无", False),
+                ("过敏史", "有" if _bool(case.get("allergy_history")) else "无", False),
+                ("家族病史", "有" if _bool(case.get("family_history")) else "无", False),
+                (
+                    "妊娠哺乳史",
+                    "有" if _bool(case.get("pregnancy_history")) else "无",
+                    False,
+                ),
+            ),
+        ),
+        section(
+            "诊断信息",
+            (
+                ("舌象", case.get("tongue_coating") or case.get("tongue"), True),
+                ("脉象", case.get("pulse"), True),
+                ("治则", case.get("treatment_principle"), True),
+                ("医嘱", case.get("doctor_advice"), True),
            ),
        ),
    ]
    return f"""
 <!doctype html><html><head><meta charset="utf-8"><style>
-body {{ font-family:"Microsoft YaHei","PingFang SC",sans-serif; color:#17231d; margin:18px; }}
-h1 {{ text-align:center; font-size:22px; margin:0 0 18px; }}
-section {{ margin:0 0 16px; border:1px solid #bdc7c2; }}
-h2 {{ font-size:15px; margin:0; padding:8px 10px; background:#edf2ef; }}
-.grid {{ display:table; width:100%; }}
-.item {{ display:table-row; }}
-.label,.value {{ display:table-cell; padding:7px 10px; border-top:1px solid #d7dfdb; }}
-.label {{ width:120px; color:#65736c; font-weight:600; }}
-.value {{ line-height:1.6; }}
-</style></head><body><h1>详细病历</h1>{''.join(sections)}</body></html>
+body {{ margin:0; padding:12px; background:#eef1f5; color:#303133;
+        font-family:"Microsoft YaHei","PingFang SC","Segoe UI",sans-serif;
+        font-size:13px; }}
+.paper {{ width:100%; margin:0 auto; background:#ffffff; border:1px solid #dcdfe6; }}
+.paper-content {{ padding:26px 30px 34px; vertical-align:top; }}
+h1 {{ text-align:center; font-size:20px; font-weight:600; margin:0;
+      padding:0 0 14px; border-bottom:2px solid #303133; }}
+.cr-section {{ margin-top:14px; border-collapse:collapse; }}
+.cr-section-title {{ padding:0 0 8px; color:#303133; font-size:15px; font-weight:600; }}
+.cr-grid {{ table-layout:fixed; border-collapse:collapse; }}
+.cr-item {{ width:33.33%; padding:4px 10px 5px 0; vertical-align:top; }}
+.cr-item.empty {{ padding:0; }}
+.cr-kv {{ border-collapse:collapse; table-layout:fixed; }}
+.cr-label {{ width:88px; padding:0 7px 0 0; color:#909399; white-space:nowrap;
+             vertical-align:top; line-height:1.65; }}
+.cr-value {{ padding:0; color:#303133; vertical-align:top; line-height:1.65; }}
+.cr-rule {{ height:1px; border-bottom:1px solid #eeeeee; }}
+</style></head><body>
+<table class="paper" width="100%" cellspacing="0" cellpadding="0"><tr>
+<td class="paper-content"><h1>甄养堂 详细病历</h1>{''.join(sections)}</td>
+</tr></table></body></html>
 """


@@ -2568,18 +2681,20 @@ def render_prescription_html(prescription: Any, *, print_layout: bool = False) -
    """Build the pharmacy-copy A4 slip used by preview, print and PDF export."""

    source = _mapping(prescription)
-    paper_width = "100%" if print_layout else "820px"
-    paper_dimensions = 'width="100%"' if print_layout else 'width="820" height="1050"'
-    body_padding = "0" if print_layout else "10px"
-    body_background = "#ffffff" if print_layout else "#eef1f5"
+    # consumer/prescription/index.vue uses a strict 210 x 297 mm sheet.  At
+    # Qt's 96 logical DPI this is 794 x 1123 px; keeping the HTML width fixed
+    # prevents QTextDocument from stretching the medicine columns with the
+    # containing dialog.
+    paper_width = "100%" if print_layout else "794px"
+    paper_dimensions = 'width="100%"' if print_layout else 'width="794" height="1123"'
+    body_padding = "0" if print_layout else "12px"
+    body_background = "#ffffff" if print_layout else "#f5f6f8"
    paper_border = "0" if print_layout else "1px solid #d6d6d6"
    base_font_size = "10px" if print_layout else "13px"
-    notice_font_size = "8.5px" if print_layout else "11px"
+    notice_font_size = "8.5px" if print_layout else "12px"
    rp_font_size = "12px" if print_layout else "16px"
    section_font_size = "9px" if print_layout else "12px"
-    watermark_height = "58px" if print_layout else "76px"
-    watermark_font_size = "41px" if print_layout else "54px"
-    bottom_height = "44px" if print_layout else "58px"
+    bottom_height = "44px" if print_layout else "70px"
    herbs = _herb_rows(prescription)
    dose_count = max(1, _int(source.get("dose_count"), 1))
    main = [row for row in herbs if _formula(row.get("formula_type")) == "主方"]
@@ -2662,13 +2777,15 @@ def render_prescription_html(prescription: Any, *, print_layout: bool = False) -
        if not rows:
            return ""
        output = [
-            f'<tr><td class="rp-indent"></td><td class="section {kind}" colspan="4">'
+            f'<tr><td class="rp-indent"></td><td class="section {kind}" colspan="5">'
            f"{html.escape(title)}</td></tr>"
        ]
        for index in range(0, len(rows), 2):
            pair = rows[index : index + 2]
            cells: list[str] = []
-            for row in pair:
+            for pair_index, row in enumerate(pair):
+                if pair_index == 1:
+                    cells.append('<td class="rp-gap"></td>')
                dosage = number_text(row.get("dosage"))
                total = number_text(_float(row.get("dosage")) * dose_count)
                cells.extend(
@@ -2678,7 +2795,13 @@ def render_prescription_html(prescription: Any, *, print_layout: bool = False) -
                    )
                )
            if len(pair) == 1:
-                cells.extend(('<td class="herb-name">&nbsp;</td>', '<td class="herb-total"></td>'))
+                cells.extend(
+                    (
+                        '<td class="rp-gap"></td>',
+                        '<td class="herb-name">&nbsp;</td>',
+                        '<td class="herb-total"></td>',
+                    )
+                )
            output.append(f'<tr><td class="rp-indent"></td>{"".join(cells)}</tr>')
        return "".join(output)

@@ -2740,7 +2863,6 @@ def render_prescription_html(prescription: Any, *, print_layout: bool = False) -
    pharmacy_remark = (
        source.get("pharmacy_remark")
        or source.get("pharmacy_note")
-        or source.get("remark_extra")
    )

    explicit_out = (
@@ -2783,7 +2905,7 @@ def render_prescription_html(prescription: Any, *, print_layout: bool = False) -
    herb_html = herb_group(main, "主方", "main") + herb_group(aux, "辅方", "aux")
    if not herb_html:
        herb_html = (
-            '<tr><td class="rp-indent"></td><td class="empty-herbs" colspan="4">'
+            '<tr><td class="rp-indent"></td><td class="empty-herbs" colspan="5">'
            "暂无药材明细</td></tr>"
        )
    text_rows = [f"<p>主方服法：{esc(main_usage_text)}</p>"]
@@ -2815,55 +2937,58 @@ def render_prescription_html(prescription: Any, *, print_layout: bool = False) -
    return f"""
 <!doctype html>
 <html><head><meta charset="utf-8"><style>
-body {{ margin:0; padding:{body_padding}; background:{body_background}; color:#151515;
-        font-family:"Microsoft YaHei","PingFang SC","Segoe UI",sans-serif;
-        font-size:{base_font_size}; }}
+body {{ margin:0; padding:{body_padding}; background:{body_background}; color:#1f1f1f;
+        font-family:"Microsoft YaHei","PingFang SC",-apple-system,BlinkMacSystemFont,"Segoe UI",sans-serif;
+        font-size:{base_font_size}; line-height:1.5; }}
 .paper {{ width:{paper_width}; margin:0 auto; background:#ffffff;
-          border:{paper_border}; border-collapse:separate; border-spacing:0; }}
+          border:{paper_border}; border-collapse:separate; border-spacing:0;
+          box-shadow:{"none" if print_layout else "0 0 0 1px #d6d6d6"}; }}
 .paper-content {{ padding:8mm 10mm; vertical-align:top; }}
 .notice {{ width:100%; border:1px solid #e5e7eb; border-collapse:collapse;
           table-layout:fixed; background:#f3f4f6; margin:0 0 6px;
-           font-size:{notice_font_size}; }}
+           font-size:{notice_font_size}; color:#1f1f1f; }}
 .notice td {{ border:0; padding:6px 10px; }}
 .notice-text {{ width:49%; }}
-.notice-meta {{ width:51%; text-align:right; }}
+.notice-meta {{ width:51%; text-align:right; white-space:nowrap; }}
 .info {{ width:100%; border-collapse:collapse; table-layout:fixed; }}
-.info td {{ border:1px solid #c8c8c8; padding:6px 10px; vertical-align:middle; }}
+.info td {{ border:1px solid #c8c8c8; padding:6px 10px; vertical-align:middle; font-size:13px; }}
 .info .full {{ border-top:0; }}
-.key {{ white-space:nowrap; }}
-.rp {{ width:100%; border-collapse:collapse; table-layout:fixed;
-       border-left:1px solid #c8c8c8; border-right:1px solid #c8c8c8; }}
-.rp td {{ border:0; padding:3px 6px; vertical-align:middle; }}
-.rp .rp-head td {{ border-bottom:1px solid #d4d4d4; padding-top:9px; padding-bottom:5px; }}
-.rp-indent {{ width:34px; }}
-.rp-mark {{ width:34px; font-size:{rp_font_size}; font-weight:700; }}
+.key {{ white-space:nowrap; color:#1f1f1f; }}
+.rp-frame {{ width:100%; border-collapse:collapse; table-layout:fixed;
+             border-left:1px solid #c8c8c8; border-right:1px solid #c8c8c8; }}
+.rp-padding {{ padding:8px 10px 16px; }}
+.rp {{ width:100%; border-collapse:collapse; table-layout:fixed; }}
+.rp td {{ border:0; padding:3px 0; vertical-align:middle; }}
+.rp .rp-head td {{ border-bottom:1px solid #d4d4d4; padding-top:4px; padding-bottom:4px; }}
+.rp-indent {{ width:44px; }}
+.rp-mark {{ width:44px; padding-right:8px !important;
+            font-size:{rp_font_size}; font-weight:700; color:#1f1f1f; }}
 .drug-head {{ color:#1f1f1f; }}
-.total-head, .herb-total {{ width:62px; text-align:right; white-space:nowrap; }}
+.total-head, .herb-total {{ width:64px; text-align:right; white-space:nowrap;
+                            font-variant-numeric:tabular-nums; }}
+.rp-gap {{ width:24px; padding:0 !important; }}
 .section {{ padding-top:7px !important; padding-bottom:1px !important;
            font-size:{section_font_size}; font-weight:600; }}
 .section.main {{ color:#409eff; }}
 .section.aux {{ color:#e6a23c; }}
-.herb-name {{ line-height:1.65; white-space:nowrap; }}
+.herb-name {{ line-height:1.85; white-space:nowrap; color:#1f1f1f; }}
 .empty-herbs {{ color:#8a8f98; padding:18px 6px !important; text-align:center; }}
-.watermark {{ height:{watermark_height}; color:#eeeeee; text-align:center;
-              font-size:{watermark_font_size};
-              font-weight:700; letter-spacing:18px; vertical-align:middle !important; }}
-.rx-text {{ border:1px solid #c8c8c8; border-top:0; padding:9px 12px; line-height:1.65; }}
-.rx-text p {{ margin:1px 0; padding:0; }}
+.rx-text {{ border:1px solid #c8c8c8; border-top:0; padding:10px 12px; line-height:1.85; font-size:13px; }}
+.rx-text p {{ margin:0; padding:0; }}
 .warning {{ color:#d72424; font-weight:600; }}
 .bottom {{ width:100%; border-collapse:collapse; table-layout:fixed; }}
-.bottom td {{ border:1px solid #c8c8c8; border-top:0; padding:7px 10px;
-              height:{bottom_height}; vertical-align:middle; }}
-.bottom .doctor {{ width:22%; vertical-align:top; }}
-.doctor-title {{ display:block; margin-bottom:4px; }}
-.doctor-name {{ display:block; margin-top:8px; }}
-.signature {{ max-width:130px; max-height:42px; vertical-align:middle; }}
-.meta-key {{ white-space:nowrap; }}
-.audit {{ width:{paper_width}; margin:8px auto 0; padding:8px 4px; color:#7b8492;
-          border-top:1px dashed #cfd5dd; font-size:12px; line-height:1.7; }}
+.bottom td {{ border:1px solid #c8c8c8; border-top:0; padding:6px 10px;
+              height:{bottom_height}; vertical-align:middle; font-size:12px; color:#1f1f1f; }}
+.bottom .doctor {{ width:28%; vertical-align:top; }}
+.doctor-title {{ display:block; margin-bottom:4px; font-size:13px; }}
+.doctor-name {{ display:block; margin-top:8px; font-size:13px; }}
+.signature {{ max-width:110px; max-height:40px; vertical-align:middle; object-fit:contain; }}
+.meta-key {{ white-space:nowrap; margin-right:6px; }}
+.audit {{ width:{paper_width}; margin:12px auto 0; padding:8px 12px; color:#6b7280;
+          border:1px dashed #d4d4d4; background:#fafafa; border-radius:4px;
+          font-size:12px; line-height:1.6; }}
 </style></head><body>
-<table class="paper" {paper_dimensions}><tr><td class="paper-content" valign="top">
-<table width="100%"><tr><td height="14"></td></tr></table>
+<table align="center" class="paper" {paper_dimensions}><tr><td class="paper-content" valign="top">
 <table class="notice" width="100%"><tr>
 <td class="notice-text">服药前请核对姓名、电话、医生等信息以及服法、医嘱等要点</td>
 <td class="notice-meta">日期：{esc(date_text())}　　编号：{esc(serial)}</td>
@@ -2876,13 +3001,15 @@ body {{ margin:0; padding:{body_padding}; background:{body_background}; color:#1
 <tr><td class="full" colspan="4"><span class="key">收件信息</span>　{esc(recipient_text)}</td></tr>
 <tr><td class="full" colspan="4"><span class="key">临床诊断</span>　{esc(source.get("clinical_diagnosis"))}</td></tr>
 </table>
+<table class="rp-frame" title="药房联" width="100%"><tr><td class="rp-padding">
 <table class="rp" width="100%">
-<col width="34"/><col/><col width="62"/><col/><col width="62"/>
+<col width="44"/><col/><col width="64"/><col width="24"/><col/><col width="64"/>
 <tr class="rp-head"><td class="rp-mark">Rp.</td><td class="drug-head">用药 (单剂)</td>
-<td class="total-head">总量</td><td class="drug-head">用药 (单剂)</td><td class="total-head">总量</td></tr>
+<td class="total-head">总量</td><td class="rp-gap"></td>
+<td class="drug-head">用药 (单剂)</td><td class="total-head">总量</td></tr>
 {herb_html}
-<tr><td class="rp-indent"></td><td class="watermark" colspan="4">药房联</td></tr>
 </table>
+</td></tr></table>
 <div class="rx-text">{"".join(text_rows)}</div>
 <table class="bottom" width="100%"><tr>
 <td class="doctor"><span class="doctor-title">医师</span>{signature_html}</td>
@@ -2896,6 +3023,57 @@ body {{ margin:0; padding:{body_padding}; background:{body_background}; color:#1
 """


+class _PrescriptionPaperPreview(QTextBrowser):
+    """A4 prescription preview with the consumer page's floating watermark.
+
+    Qt rich text cannot paint CSS absolute-positioned or transformed elements,
+    so placing the watermark in the HTML makes it consume a table row and
+    deforms the paper.  Paint it over the viewport at the corresponding
+    document position instead.
+    """
+
+    _PAPER_WIDTH = 794
+
+    def __init__(self, prescription: Any, parent: QWidget | None = None) -> None:
+        super().__init__(parent)
+        herbs = _herb_rows(prescription)
+        main_count = sum(
+            1 for row in herbs if _formula(row.get("formula_type")) == "主方"
+        )
+        aux_count = len(herbs) - main_count
+        medicine_rows = (main_count + 1) // 2 + (aux_count + 1) // 2
+        section_count = int(main_count > 0) + int(aux_count > 0)
+        rp_height = 65 + medicine_rows * 30 + section_count * 22
+        self._watermark_document_y = 150 + rp_height // 2
+
+    def paintEvent(self, event: Any) -> None:  # noqa: N802 - Qt override
+        super().paintEvent(event)
+        viewport = self.viewport()
+        center_y = self._watermark_document_y - self.verticalScrollBar().value()
+        if center_y < -90 or center_y > viewport.height() + 90:
+            return
+        paper_width = min(self._PAPER_WIDTH, viewport.width())
+        paper_left = max(0.0, (viewport.width() - paper_width) / 2)
+        painter = QPainter(viewport)
+        painter.setRenderHint(QPainter.RenderHint.Antialiasing)
+        painter.translate(paper_left + paper_width / 2, center_y)
+        painter.rotate(-22)
+        painter.setPen(QColor(31, 31, 31, 15))
+        font = QFont(
+            "Microsoft YaHei UI",
+            -1,
+            QFont.Weight.Bold,
+        )
+        font.setPixelSize(84)
+        painter.setFont(font)
+        painter.drawText(
+            QRectF(-230, -70, 460, 140),
+            Qt.AlignmentFlag.AlignCenter,
+            "药房联",
+        )
+        painter.end()
+
+
 class PrescriptionDetailDialog(QDialog):
    diagnosis_requested = Signal(int)
    orders_requested = Signal(int)
@@ -2937,12 +3115,12 @@ class PrescriptionDetailDialog(QDialog):
        pdf_button.clicked.connect(self.choose_pdf_path)
        actions.addWidget(pdf_button)
        root.addLayout(actions)
-        self.preview = QTextBrowser()
+        self.preview = _PrescriptionPaperPreview(prescription)
        self.preview.setObjectName("PrescriptionPaperPreview")
        self.preview.setOpenExternalLinks(False)
        self.preview.setStyleSheet(
            "QTextBrowser#PrescriptionPaperPreview {"
-            "background-color:#EEF1F5; border:1px solid #D8DEE8; padding:0;}"
+            "background-color:#F5F6F8; border:1px solid #D8DEE8; padding:0;}"
        )
        self.preview.setDocument(self.document)
        self.tabs = QTabWidget()
@@ -2952,8 +3130,15 @@ class PrescriptionDetailDialog(QDialog):
        self.case_preview: QTextBrowser | None = None
        if case_record:
            self.case_document = QTextDocument(self)
+            self.case_document.setDocumentMargin(0)
            self.case_document.setHtml(render_case_record_html(prescription))
            self.case_preview = QTextBrowser()
+            self.case_preview.setObjectName("CaseRecordPaperPreview")
+            self.case_preview.setOpenExternalLinks(False)
+            self.case_preview.setStyleSheet(
+                "QTextBrowser#CaseRecordPaperPreview {"
+                "background-color:#EEF1F5; border:1px solid #D8DEE8; padding:0;}"
+            )
            self.case_preview.setDocument(self.case_document)
            case_index = self.tabs.addTab(self.case_preview, "详细病历")
            if initial_tab == "case":
@@ -8,8 +8,8 @@ from datetime import date, timedelta
 from pathlib import Path
 from typing import Any

-from PySide6.QtCore import Qt, QTimer, QUrl, Signal
-from PySide6.QtGui import QDesktopServices, QPixmap, QTextCursor
+from PySide6.QtCore import QSize, Qt, QTimer, QUrl, Signal
+from PySide6.QtGui import QDesktopServices, QIcon, QPixmap, QTextCursor
 from PySide6.QtWidgets import (
    QDialog,
    QFileDialog,
@@ -139,6 +139,73 @@ def _is_local_material_reference(value: str) -> bool:
    )


+class _NoteAttachmentPreview(QPushButton):
+    """Responsive inline thumbnail that remains clickable for a full preview."""
+
+    _THUMBNAIL_HEIGHT = 132
+
+    def __init__(self, caption: str, parent: QWidget | None = None) -> None:
+        super().__init__("正在加载图片…", parent)
+        self._source_pixmap = QPixmap()
+        self.setObjectName("NoteAttachmentPreview")
+        self.setProperty("variant", "secondary")
+        self.setProperty("loadState", "loading")
+        self.setAccessibleName(f"查看{caption}大图")
+        self.setCursor(Qt.CursorShape.PointingHandCursor)
+        self.setMinimumWidth(168)
+        self.setFixedHeight(self._THUMBNAIL_HEIGHT)
+        self.setSizePolicy(QSizePolicy.Policy.Expanding, QSizePolicy.Policy.Fixed)
+
+    def _refresh_preview(self) -> None:
+        if self._source_pixmap.isNull():
+            return
+        available = QSize(max(120, self.width() - 12), self._THUMBNAIL_HEIGHT - 12)
+        rendered = self._source_pixmap.scaled(
+            available,
+            Qt.AspectRatioMode.KeepAspectRatio,
+            Qt.TransformationMode.SmoothTransformation,
+        )
+        self.setIcon(QIcon(rendered))
+        self.setIconSize(rendered.size())
+
+    def show_loading(self) -> None:
+        self._source_pixmap = QPixmap()
+        self.setIcon(QIcon())
+        self.setText("正在加载图片…")
+        self.setProperty("loadState", "loading")
+        self.setEnabled(False)
+
+    def show_preview(self, pixmap: QPixmap) -> None:
+        """Render the decoded image directly in the note card."""
+
+        self._source_pixmap = pixmap.scaled(
+            QSize(960, 720),
+            Qt.AspectRatioMode.KeepAspectRatio,
+            Qt.TransformationMode.SmoothTransformation,
+        )
+        self.setText("")
+        self._refresh_preview()
+        self.setProperty("loadState", "ready")
+        self.setEnabled(True)
+        self.style().unpolish(self)
+        self.style().polish(self)
+
+    def show_failure(self) -> None:
+        """Keep a failed attachment actionable so the user can retry it."""
+
+        self._source_pixmap = QPixmap()
+        self.setIcon(QIcon())
+        self.setText("图片加载失败\n点击重试")
+        self.setProperty("loadState", "failed")
+        self.setEnabled(True)
+        self.style().unpolish(self)
+        self.style().polish(self)
+
+    def resizeEvent(self, event: Any) -> None:  # noqa: N802 - Qt override
+        super().resizeEvent(event)
+        self._refresh_preview()
+
+
 class QueueRow(QWidget):
    """Compact appointment summary rendered inside the queue list."""

@@ -232,6 +299,7 @@ class ReceptionPage(QWidget):
        self._pending_report_files: list[str] = []
        self._note_busy = False
        self._attachment_preview_generation = 0
+        self._attachment_render_generation = 0

        self._can_complete = has_permission(self.permissions, "doctor.appointment/complete")
        self._can_note = has_permission(self.permissions, "doctor.appointment/addDoctorNote")
@@ -1238,6 +1306,8 @@ class ReceptionPage(QWidget):
        self.daily_text.setText("\n".join(lines) if lines else "近 30 日暂无日常记录。")

    def _render_notes(self, notes: list[Any]) -> None:
+        self._attachment_render_generation += 1
+        render_generation = self._attachment_render_generation
        clear_layout(self.notes_layout)
        self.notes_count.setText(f"{len(notes)} 条")
        if not notes:
@@ -1262,44 +1332,159 @@ class ReceptionPage(QWidget):
            meta.setProperty("role", "muted")
            layout.addWidget(meta)
            note_id = _as_int(first_value(note, "id", "note_id", default=None))
+            image_attachments: list[tuple[str, str, str]] = []
+            file_attachments: list[tuple[str, str, str]] = []
            for image_type, caption in (
                ("tongue_images", "舌苔图"),
                ("report_files", "检查报告"),
            ):
                for path in _sequence(first_value(note, image_type, default=[])):
                    path_text = str(path).strip()
-                    attachment = QWidget()
-                    attachment_layout = QHBoxLayout(attachment)
-                    attachment_layout.setContentsMargins(0, 0, 0, 0)
-                    label = QLabel(f"{caption}：{_attachment_name(path_text)}")
-                    label.setToolTip(path_text)
-                    label.setTextInteractionFlags(Qt.TextInteractionFlag.TextSelectableByMouse)
-                    attachment_layout.addWidget(label, 1)
-                    preview_button = QPushButton(
-                        "预览" if _is_image_attachment(path_text) else "打开"
-                    )
-                    preview_button.setProperty("variant", "secondary")
-                    preview_button.setEnabled(bool(path_text))
-                    preview_button.clicked.connect(
-                        lambda _checked=False, current_path=path_text, button=preview_button: (
+                    attachment = (image_type, caption, path_text)
+                    if _is_image_attachment(path_text):
+                        image_attachments.append(attachment)
+                    else:
+                        file_attachments.append(attachment)
+
+            if image_attachments:
+                image_title = QLabel("图片附件 · 点击图片查看大图")
+                image_title.setProperty("role", "muted")
+                layout.addWidget(image_title)
+                image_host = QWidget()
+                image_grid = QGridLayout(image_host)
+                image_grid.setContentsMargins(0, 0, 0, 0)
+                image_grid.setHorizontalSpacing(10)
+                image_grid.setVerticalSpacing(10)
+                for index, (image_type, caption, path_text) in enumerate(
+                    image_attachments
+                ):
+                    tile = QFrame()
+                    tile.setObjectName("NoteAttachmentTile")
+                    tile_layout = QVBoxLayout(tile)
+                    tile_layout.setContentsMargins(8, 8, 8, 8)
+                    tile_layout.setSpacing(6)
+                    preview = _NoteAttachmentPreview(caption)
+                    preview.setToolTip(f"{caption}：{path_text}\n点击查看大图")
+                    preview.clicked.connect(
+                        lambda _checked=False, current_path=path_text, button=preview: (
                            self._preview_note_attachment(current_path, button)
                        )
                    )
-                    attachment_layout.addWidget(preview_button)
+                    tile_layout.addWidget(preview)
+                    footer = QHBoxLayout()
+                    footer.setSpacing(6)
+                    label = QLabel(f"{caption} · {_attachment_name(path_text)}")
+                    label.setObjectName("NoteAttachmentName")
+                    label.setToolTip(path_text)
+                    label.setTextInteractionFlags(
+                        Qt.TextInteractionFlag.TextSelectableByMouse
+                    )
+                    label.setMinimumWidth(0)
+                    label.setSizePolicy(
+                        QSizePolicy.Policy.Ignored, QSizePolicy.Policy.Preferred
+                    )
+                    footer.addWidget(label, 1)
                    if self._can_note and note_id is not None:
                        delete_button = QPushButton("删除")
                        delete_button.setProperty("variant", "secondary")
                        delete_button.clicked.connect(
-                            lambda _checked=False, current_note_id=note_id, current_type=image_type, current_path=str(path), button=delete_button: (
+                            lambda _checked=False, current_note_id=note_id, current_type=image_type, current_path=path_text, button=delete_button: (
                                self._delete_note_attachment(
                                    current_note_id, current_type, current_path, button
                                )
                            )
                        )
-                        attachment_layout.addWidget(delete_button)
-                    layout.addWidget(attachment)
+                        footer.addWidget(delete_button)
+                    tile_layout.addLayout(footer)
+                    row, column = divmod(index, 3)
+                    image_grid.addWidget(tile, row, column)
+                    self._load_note_thumbnail(path_text, preview, render_generation)
+                for column in range(3):
+                    image_grid.setColumnStretch(column, 1)
+                layout.addWidget(image_host)
+
+            for image_type, caption, path_text in file_attachments:
+                attachment = QWidget()
+                attachment_layout = QHBoxLayout(attachment)
+                attachment_layout.setContentsMargins(0, 0, 0, 0)
+                label = QLabel(f"{caption}：{_attachment_name(path_text)}")
+                label.setToolTip(path_text)
+                label.setTextInteractionFlags(Qt.TextInteractionFlag.TextSelectableByMouse)
+                attachment_layout.addWidget(label, 1)
+                open_button = QPushButton("打开")
+                open_button.setProperty("variant", "secondary")
+                open_button.setEnabled(bool(path_text))
+                open_button.clicked.connect(
+                    lambda _checked=False, current_path=path_text, button=open_button: (
+                        self._preview_note_attachment(current_path, button)
+                    )
+                )
+                attachment_layout.addWidget(open_button)
+                if self._can_note and note_id is not None:
+                    delete_button = QPushButton("删除")
+                    delete_button.setProperty("variant", "secondary")
+                    delete_button.clicked.connect(
+                        lambda _checked=False, current_note_id=note_id, current_type=image_type, current_path=path_text, button=delete_button: (
+                            self._delete_note_attachment(
+                                current_note_id, current_type, current_path, button
+                            )
+                        )
+                    )
+                    attachment_layout.addWidget(delete_button)
+                layout.addWidget(attachment)
            self.notes_layout.addWidget(card)

+    def _load_note_thumbnail(
+        self,
+        path: str,
+        preview: _NoteAttachmentPreview,
+        generation: int,
+    ) -> None:
+        """Download and paint a note image without opening another window."""
+
+        download = getattr(self.repository, "download_public_image", None)
+        if not callable(download):
+            preview.show_failure()
+            return
+        run_async(
+            lambda: invoke(self.repository, "download_public_image", url=path),
+            on_success=lambda payload: self._apply_note_thumbnail(
+                payload, preview, generation
+            ),
+            on_error=lambda _error: self._fail_note_thumbnail(preview, generation),
+        )
+
+    def _apply_note_thumbnail(
+        self,
+        payload: Any,
+        preview: _NoteAttachmentPreview,
+        generation: int,
+    ) -> None:
+        if generation != self._attachment_render_generation:
+            return
+        content = bytes(payload or b"")
+        pixmap = QPixmap()
+        if (
+            not content
+            or len(content) > 10 * 1024 * 1024
+            or not pixmap.loadFromData(content)
+            or pixmap.isNull()
+        ):
+            self._fail_note_thumbnail(preview, generation)
+            return
+        with suppress(RuntimeError):
+            preview.show_preview(pixmap)
+
+    def _fail_note_thumbnail(
+        self,
+        preview: _NoteAttachmentPreview,
+        generation: int,
+    ) -> None:
+        if generation != self._attachment_render_generation:
+            return
+        with suppress(RuntimeError):
+            preview.show_failure()
+
    def _preview_note_attachment(self, path: str, button: QPushButton) -> None:
        """Preview note images in-app and open non-image reports safely."""

@@ -1325,8 +1510,11 @@ class ReceptionPage(QWidget):
            return
        self._attachment_preview_generation += 1
        generation = self._attachment_preview_generation
-        button.setEnabled(False)
-        button.setText("加载中…")
+        if isinstance(button, _NoteAttachmentPreview):
+            button.show_loading()
+        else:
+            button.setEnabled(False)
+            button.setText("加载中…")
        run_async(
            lambda: invoke(self.repository, "download_public_image", url=target),
            on_success=lambda payload: self._show_note_image_preview(
@@ -1346,13 +1534,21 @@ class ReceptionPage(QWidget):
    ) -> None:
        if generation != self._attachment_preview_generation:
            return
-        button.setEnabled(True)
-        button.setText("预览")
        content = bytes(payload or b"")
        pixmap = QPixmap()
        if not content or len(content) > 10 * 1024 * 1024 or not pixmap.loadFromData(content):
+            if isinstance(button, _NoteAttachmentPreview):
+                button.show_failure()
+            else:
+                button.setEnabled(True)
+                button.setText("预览")
            show_toast(self, "服务器返回的图片无法预览。", "danger", 4600)
            return
+        if isinstance(button, _NoteAttachmentPreview):
+            button.show_preview(pixmap)
+        else:
+            button.setEnabled(True)
+            button.setText("预览")
        dialog = QDialog(self)
        dialog.setWindowTitle(f"预览 · {_attachment_name(path)}")
        dialog.setModal(True)
@@ -1387,8 +1583,11 @@ class ReceptionPage(QWidget):
    ) -> None:
        if generation != self._attachment_preview_generation:
            return
-        button.setEnabled(True)
-        button.setText("预览")
+        if isinstance(button, _NoteAttachmentPreview):
+            button.show_failure()
+        else:
+            button.setEnabled(True)
+            button.setText("预览")
        show_toast(self, f"图片预览失败：{friendly_error(error)}", "danger", 5200)

    def _reset_detail_content(self, seed: Any = None) -> None:
@@ -205,6 +205,33 @@ QPushButton[variant="secondary"]:checked {
    border-color: $indigo_pressed;
 }

+QFrame#NoteAttachmentTile {
+    background-color: $surface;
+    border: 1px solid $line;
+    border-radius: 10px;
+}
+QPushButton#NoteAttachmentPreview {
+    min-height: 132px;
+    padding: 6px;
+    color: $muted;
+    background-color: $surface_alt;
+    border: 1px solid $line;
+    border-radius: 8px;
+    font-weight: 500;
+}
+QPushButton#NoteAttachmentPreview:hover {
+    background-color: $indigo_pale;
+    border-color: $indigo_hover;
+}
+QPushButton#NoteAttachmentPreview[loadState="failed"] {
+    color: $danger;
+    background-color: $danger_pale;
+}
+QLabel#NoteAttachmentName {
+    color: $text_soft;
+    font-size: 12px;
+}
+
 QPushButton[variant="danger"] {
    color: $danger;
    background-color: $danger_pale;
@@ -423,6 +423,8 @@ def test_order_payload_and_a4_print_document(
    assert "黄芪" in rendered
    assert "酸枣仁" in rendered
    assert "服药前请核对姓名、电话、医生等信息" in rendered
+    assert '<table align="center" class="paper" width="794" height="1123"' in rendered
+    assert '<col width="44"/><col/><col width="64"/><col width="24"/>' in rendered
    assert "Rp." in rendered
    assert "药房联" in rendered
    assert "主方" in rendered
@@ -433,8 +435,9 @@ def test_order_payload_and_a4_print_document(
    assert "每天2次, 一次2袋, 每袋5g, 温水送服, 饭后" in rendered
    viewer = PrescriptionDetailDialog(prescription)
    document_html = viewer.document.toHtml()
-    assert "药房联" in document_html
    assert "用药 (单剂)" in document_html
+    assert viewer.document.idealWidth() == pytest.approx(794.0)
+    assert viewer.preview.__class__.__name__ == "_PrescriptionPaperPreview"
    viewer.close()
    order.close()
    application.processEvents()
@@ -450,6 +453,7 @@ def test_prescription_detail_can_open_immutable_case_record_tab(
        "case_record": {
            "patient_name": "林晓岚",
            "phone": "13800138000",
+            "diagnosis_type": "follow_up",
            "local_hospital_name": "市中医院",
            "symptoms": "口渴乏力",
            "tongue_coating": "舌红少苔",
@@ -461,8 +465,15 @@ def test_prescription_detail_can_open_immutable_case_record_tab(
    assert viewer.tabs.tabText(viewer.tabs.currentIndex()) == "详细病历"
    assert viewer.case_document is not None
    case_html = viewer.case_document.toHtml()
+    source_html = dialog_module.render_case_record_html(prescription)
+    assert "甄养堂 详细病历" in case_html
+    assert '<table class="cr-grid"' in source_html
+    assert "follow_up" not in case_html
+    assert "复诊" in case_html
    assert "市中医院" in case_html
    assert "口渴乏力" in case_html
+    assert viewer.case_preview is not None
+    assert viewer.case_preview.objectName() == "CaseRecordPaperPreview"
    viewer.close()
    application.processEvents()

@@ -69,8 +69,9 @@ def test_note_attachment_preview_type_is_extension_aware(path: str, expected: bo
    assert _is_image_attachment(path) is expected


-def test_note_attachments_offer_image_preview_and_file_open(
+def test_note_attachments_expand_images_and_keep_file_open(
    application: QApplication,
+    immediate_async: None,
 ) -> None:
    page = ReceptionPage(DemoDoctorRepository(), PermissionSet([]))
    page._render_notes(
@@ -87,8 +88,13 @@ def test_note_attachments_offer_image_preview_and_file_open(
        ]
    )

+    previews = page.notes_container.findChildren(
+        QPushButton, "NoteAttachmentPreview"
+    )
+    assert len(previews) == 2
+    assert all(button.text() == "" for button in previews)
+    assert all(not button.icon().isNull() for button in previews)
    labels = [button.text() for button in page.notes_container.findChildren(QPushButton)]
-    assert labels.count("预览") == 2
    assert labels.count("打开") == 1
    page.close()
    application.processEvents()