更新

app/tests/test_ai_consult_ui.py

@@ -1,5 +1,6 @@
 from __future__ import annotations
 
+import json
 import os
 from types import SimpleNamespace
 from typing import Any
@@ -7,13 +8,22 @@ from typing import Any
 os.environ.setdefault("QT_QPA_PLATFORM", "offscreen")
 
 import pytest
-from PySide6.QtWidgets import QApplication, QLabel, QTextBrowser
+from PySide6.QtCore import Qt
+from PySide6.QtTest import QTest
+from PySide6.QtWidgets import (
+    QApplication,
+    QLabel,
+    QPushButton,
+    QTextBrowser,
+    QWidget,
+)
 
 from doctor_workstation.core import PermissionSet
 from doctor_workstation.services import DemoDoctorRepository
 from doctor_workstation.ui.dialogs import ai_consult as ai_consult_module
 from doctor_workstation.ui.dialogs.ai_consult import (
     AiConsultDialog,
+    build_patient_ai_context,
     can_open_ai_consult,
     present_ai_consult,
     render_chat_payload,
@@ -27,6 +37,34 @@ from doctor_workstation.ui.pages.consultations import ConsultationsPage
 from doctor_workstation.ui.pages.patients import PatientListWorkspace, PatientsPage
 from doctor_workstation.ui.pages.reception import ReceptionPage
 
+LONG_CLINICAL_REPLY = """
+基于本诊单资料，患者为56岁男性，空腹血糖偏高（6.4 mmol/L），既往有脂肪肝并主诉性功能下降。
+
+### 1. 可能证候分析
+- **脾肾两虚，兼夹痰湿**
+  - **支持点：** 脾虚失健运，痰湿内阻，空腹血糖受损。
+  - **肾气不足：** 年过五旬且性功能下降，需结合四诊进一步辨别。
+- **肝肾阴虚，虚火内扰（需鉴别）**
+  - **支持点：** 若伴口干、潮热、舌红少苔，则需要纳入鉴别。
+
+### 2. 关键矛盾与不足
+- **缺乏四诊合参：** 尚无舌象与脉象资料。
+- **症状细节模糊：** 性功能下降的具体表现与病程仍需确认。
+- **代谢指标单一：** 缺少糖化血红蛋白与餐后血糖。
+
+### 3. 建议下一步
+1. **补充四诊：** 采集舌象、脉象及症状细节。
+2. **完善检查：** 复查糖化血红蛋白、餐后血糖、肝功能和血脂。
+3. **评估代谢风险：** 综合评估胰岛素抵抗、脂肪肝及心血管风险。
+4. **制定随访：** 根据检查结果制定治疗与随访计划。
+
+### 4. 风险提示
+- **代谢综合征风险：** 血糖偏高合并脂肪肝，需要关注代谢风险。
+- **排查心血管因素：** 性功能异常可能与血管因素有关。
+
+**重要提示：** 以上分析仅作临床辅助，不能替代执业医师的面诊、确诊或处方。
+""".strip()
+
 
 @pytest.fixture(scope="module")
 def application() -> QApplication:
@@ -85,6 +123,333 @@ def test_ai_consult_dialog_matches_workspace_chrome(
     dialog.close()
 
 
+@pytest.mark.parametrize("key", [Qt.Key.Key_Return, Qt.Key.Key_Enter])
+def test_input_enter_submits_once_without_closing_dialog(
+    application: QApplication,
+    key: Qt.Key,
+) -> None:
+    dialog = AiConsultDialog(
+        DemoDoctorRepository(),
+        PermissionSet(["tcm.diagnosis/aiAssistant"]),
+    )
+    submitted: list[str] = []
+    rejected: list[bool] = []
+    dialog._ask = lambda text: submitted.append(text)  # type: ignore[method-assign]
+    dialog.rejected.connect(lambda: rejected.append(True))
+    dialog.show()
+    dialog.input.setText("总结当前病情")
+    dialog.input.setFocus()
+    application.processEvents()
+
+    QTest.keyClick(dialog.input, key)
+    application.processEvents()
+
+    assert submitted == ["总结当前病情"]
+    assert rejected == []
+    assert dialog.isVisible()
+    dialog.close()
+
+
+@pytest.mark.parametrize(
+    ("prompt", "expected"),
+    [
+        ("开个处方", True),
+        ("请给当前患者开一张处方", True),
+        ("新建处方", True),
+        ("分析当前处方", False),
+        ("怎么开方更合理", False),
+        ("是否需要开方", False),
+        ("给出用药建议", False),
+    ],
+)
+def test_prescription_action_intent_is_explicit_and_conservative(
+    prompt: str,
+    expected: bool,
+) -> None:
+    assert ai_consult_module._is_open_prescription_intent(prompt) is expected
+
+
+def test_prescription_action_without_permission_does_not_call_ai_or_repository(
+    application: QApplication,
+) -> None:
+    class Repository:
+        def create_prescription(self, _payload: Any) -> None:
+            raise AssertionError("must not create without permission")
+
+    dialog = AiConsultDialog(
+        Repository(),
+        PermissionSet(["tcm.diagnosis/aiAssistant"]),
+    )
+    dialog.diagnosis_id = 501
+
+    dialog._ask("开个处方")
+    application.processEvents()
+
+    bodies = [
+        browser.toPlainText()
+        for browser in dialog.findChildren(QTextBrowser, "AiConsultBubbleText")
+    ]
+    assert any("没有开方权限" in body for body in bodies)
+    assert dialog._stream_worker is None
+    assert not dialog._asking
+    dialog.close()
+
+
+def test_prescription_action_opens_editor_and_forces_current_diagnosis_ownership(
+    application: QApplication,
+    immediate_async: None,
+    monkeypatch: pytest.MonkeyPatch,
+) -> None:
+    created: list[dict[str, Any]] = []
+    editor_seeds: list[dict[str, Any]] = []
+    current_user = {"id": 12, "name": "甄医生"}
+
+    class Repository:
+        def get_diagnosis_detail(
+            self,
+            diagnosis_id: int,
+            *,
+            readonly: bool = False,
+        ) -> dict[str, Any]:
+            assert diagnosis_id == 501
+            assert readonly
+            return {
+                "diagnosis": {
+                    "id": 501,
+                    "patient_id": 301,
+                    "patient_name": "尹山",
+                    "gender": 1,
+                    "age": 56,
+                    "phone": "13800000000",
+                    "clinical_diagnosis": "脾肾两虚证",
+                    "case_record": {"chief_complaint": "性功能下降"},
+                },
+                "patient": {"id": 301, "name": "尹山"},
+                "appointment": {"id": 801, "doctor_name": "甄医生"},
+            }
+
+        @staticmethod
+        def generate_ai_prescription(diagnosis_id: int) -> dict[str, Any]:
+            assert diagnosis_id == 501
+            return {
+                "diagnosis_id": 501,
+                "task": "prescription_generate",
+                "context_scope": "patient_longitudinal",
+                "prescription_draft": {
+                    "clinical_diagnosis": "脾肾两虚证",
+                    "herbs": [
+                        {"name": "茯苓", "dosage": 10, "formula_type": "主方"}
+                    ],
+                    "dose_count": 7,
+                    "usage_days": 7,
+                },
+            }
+
+        def create_prescription(self, prescription: dict[str, Any]) -> dict[str, Any]:
+            created.append(prescription)
+            return {"id": 9001, **prescription}
+
+        def list_prescriptions_by_diagnosis(
+            self,
+            diagnosis_id: int,
+        ) -> list[dict[str, Any]]:
+            return [{"id": 9001, "diagnosis_id": diagnosis_id, "sn": "RX-9001"}]
+
+    class FakeSignal:
+        def connect(self, _slot: Any) -> None:
+            return None
+
+    class FakeEditor:
+        def __init__(
+            self,
+            _repository: Any,
+            seed: dict[str, Any],
+            **kwargs: Any,
+        ) -> None:
+            editor_seeds.append(seed)
+            assert kwargs["mode"] == "add"
+            assert kwargs["current_user"] == current_user
+            self.diagnosis_requested = FakeSignal()
+
+        def exec(self) -> Any:
+            return ai_consult_module.QDialog.DialogCode.Accepted
+
+        @staticmethod
+        def payload() -> dict[str, Any]:
+            return {
+                "diagnosis_id": 999,
+                "appointment_id": 998,
+                "case_record": {"forged": True},
+                "doctor_name": "甄医生",
+                "herbs": [{"name": "茯苓", "dosage": 10, "unit": "g"}],
+            }
+
+    from doctor_workstation.ui.dialogs import prescription as prescription_module
+
+    monkeypatch.setattr(
+        prescription_module,
+        "PrescriptionEditorDialog",
+        FakeEditor,
+    )
+    host = QWidget()
+    host.current_user = current_user  # type: ignore[attr-defined]
+    dialog = AiConsultDialog(
+        Repository(),
+        PermissionSet(
+            ["tcm.diagnosis/aiAssistant", "tcm.diagnosis/chufang"]
+        ),
+        parent=host,
+    )
+    dialog.diagnosis_id = 501
+    dialog.patient_id = 301
+    dialog.show()
+
+    dialog._ask("开个处方")
+    for _ in range(3):
+        application.processEvents()
+
+    assert len(editor_seeds) == 1
+    assert editor_seeds[0]["diagnosis_id"] == 501
+    assert editor_seeds[0]["appointment_id"] == 801
+    assert editor_seeds[0]["herbs"][0]["name"] == "茯苓"
+    assert created and created[0]["diagnosis_id"] == 501
+    assert created[0]["appointment_id"] == 801
+    assert created[0]["case_record"] == {"chief_complaint": "性功能下降"}
+    assert created[0]["patient_id"] == 301
+    assert created[0]["phone"] == "13800000000"
+    assert dialog._stream_worker is None
+    assert not dialog._asking
+    bodies = [
+        browser.toPlainText()
+        for browser in dialog.findChildren(QTextBrowser, "AiConsultBubbleText")
+    ]
+    assert any("处方已开具并提交审核" in body for body in bodies)
+    dialog.close()
+    host.close()
+
+
+def test_prescription_action_rejects_mismatched_patient_detail(
+    application: QApplication,
+    immediate_async: None,
+) -> None:
+    opened = False
+    created = False
+
+    class Repository:
+        @staticmethod
+        def get_diagnosis_detail(
+            diagnosis_id: int,
+            *,
+            readonly: bool = False,
+        ) -> dict[str, Any]:
+            assert readonly
+            return {
+                "diagnosis": {
+                    "id": diagnosis_id,
+                    "patient_id": 999,
+                    "patient_name": "其他患者",
+                }
+            }
+
+        @staticmethod
+        def create_prescription(prescription: Any) -> None:
+            nonlocal created
+            del prescription
+            created = True
+
+        @staticmethod
+        def generate_ai_prescription(diagnosis_id: int) -> dict[str, Any]:
+            raise AssertionError(f"mismatched diagnosis {diagnosis_id} must fail before AI")
+
+    dialog = AiConsultDialog(
+        Repository(),
+        PermissionSet(
+            ["tcm.diagnosis/aiAssistant", "tcm.diagnosis/chufang"]
+        ),
+    )
+    dialog.diagnosis_id = 501
+    dialog.patient_id = 301
+
+    def capture_open(*_args: Any) -> None:
+        nonlocal opened
+        opened = True
+
+    dialog._open_prescription_editor_from_chat = capture_open  # type: ignore[method-assign]
+    dialog._ask("开个处方")
+    for _ in range(2):
+        application.processEvents()
+
+    assert not opened
+    assert not created
+    bodies = [
+        browser.toPlainText()
+        for browser in dialog.findChildren(QTextBrowser, "AiConsultBubbleText")
+    ]
+    assert any("患者与当前会话不一致" in body for body in bodies)
+    dialog.close()
+
+
+def test_cancelling_prescription_editor_never_creates_prescription(
+    monkeypatch: pytest.MonkeyPatch,
+) -> None:
+    created: list[Any] = []
+
+    class Repository:
+        @staticmethod
+        def create_prescription(prescription: Any) -> None:
+            created.append(prescription)
+
+    class FakeEditor:
+        def __init__(self, *_args: Any, **_kwargs: Any) -> None:
+            return None
+
+        @staticmethod
+        def exec() -> Any:
+            return ai_consult_module.QDialog.DialogCode.Rejected
+
+        @staticmethod
+        def payload() -> dict[str, Any]:
+            raise AssertionError("cancelled editor must not read payload")
+
+    from doctor_workstation.ui.dialogs import prescription as prescription_module
+
+    monkeypatch.setattr(
+        prescription_module,
+        "PrescriptionEditorDialog",
+        FakeEditor,
+    )
+    dialog = AiConsultDialog(
+        Repository(),
+        PermissionSet(
+            ["tcm.diagnosis/aiAssistant", "tcm.diagnosis/kaifang"]
+        ),
+    )
+    dialog.diagnosis_id = 501
+    dialog.patient_id = 301
+    status = dialog._append_bubble("ai", "正在打开处方编辑器。", time_text="系统")
+    detail = {
+        "diagnosis": {
+            "id": 501,
+            "patient_id": 301,
+            "patient_name": "尹山",
+            "case_record": {},
+        },
+        "appointment": {"id": 801},
+    }
+
+    dialog._open_prescription_editor_from_chat(
+        dialog._generation,
+        501,
+        status,
+        detail,
+    )
+
+    assert created == []
+    assert status.body is not None
+    assert "已取消开方" in status.body.toPlainText()
+    dialog.close()
+
+
 def test_present_ai_consult_requires_diagnosis_id(
     application: QApplication,
     monkeypatch: pytest.MonkeyPatch,
@@ -294,9 +659,286 @@ def test_chat_payload_parses_markdown_html_and_json(application: QApplication) -
 
     render_chat_payload(browser, '{"diagnosis":"肝郁脾虚证","risk":["血糖波动"]}')
     assert "肝郁脾虚证" in browser.toPlainText()
+    assert "{\"diagnosis\"" not in browser.toPlainText()
     browser.deleteLater()
 
 
+@pytest.mark.parametrize(
+    ("business_id", "expected_title", "expected_marker"),
+    [
+        ("patient_opened_chat", "患者进入在线问诊", "入"),
+        ("patient_closed_chat", "患者离开在线问诊", "离"),
+        ("doctor_entered_consult_room", "医生进入在线诊室", "医"),
+        ("consultation_complete", "本次问诊已完成", "完"),
+    ],
+)
+def test_custom_im_events_are_normalized_before_rendering(
+    business_id: str,
+    expected_title: str,
+    expected_marker: str,
+) -> None:
+    item = ai_consult_module._parse_chat_item(
+        {
+            "msg_type": "custom",
+            "text": json.dumps(
+                {
+                    "businessID": business_id,
+                    "patientId": "11173",
+                    "patientName": "尹山",
+                    "doctorId": "12",
+                    "time": 1787045982311,
+                },
+                ensure_ascii=False,
+            ),
+            "is_from_doctor": False,
+        }
+    )
+
+    assert item is not None
+    assert item.variant == "event"
+    assert item.title == expected_title
+    assert item.marker == expected_marker
+    assert item.time_text
+    assert "11173" not in item.detail
+    assert "doctorId" not in item.detail
+
+
+def test_rtc_event_prefers_nested_command_and_formats_duration() -> None:
+    payload = {
+        "businessID": 1,
+        "data": json.dumps(
+            {
+                "version": 4,
+                "call_type": 2,
+                "businessID": "rtc_call",
+                "data": {"cmd": "hangup", "inviter": "doctor_12"},
+                "call_end": 81,
+            }
+        ),
+        # A conflicting legacy action must not override the nested command.
+        "actionType": 1,
+        "inviteID": "sensitive-invite-id",
+    }
+    item = ai_consult_module._parse_chat_item(
+        {
+            "msg_type": "custom",
+            "text": json.dumps(payload),
+            "time": 1787103129,
+        }
+    )
+
+    assert item is not None
+    assert item.variant == "event"
+    assert item.title == "视频问诊已结束"
+    assert item.detail == "通话 1 分 21 秒"
+    assert "sensitive-invite-id" not in item.detail
+
+
+def test_transient_typing_event_is_not_added_to_history() -> None:
+    item = ai_consult_module._parse_chat_item(
+        {
+            "msg_type": "custom",
+            "text": '{"businessID":"user_typing_status","typing":true}',
+        }
+    )
+    assert item is None
+
+
+def test_chat_archive_renders_system_timeline_without_raw_signals(
+    application: QApplication,
+) -> None:
+    dialog = AiConsultDialog(
+        DemoDoctorRepository(),
+        PermissionSet(["tcm.diagnosis/aiAssistant"]),
+    )
+    dialog._render_messages(
+        [
+            {
+                "msg_type": "custom",
+                "text": '{"businessID":"patient_opened_chat","patientName":"尹山","patientId":"11173"}',
+                "time": 1787103040,
+            },
+            {
+                "msg_type": "text",
+                "text": "我已确认问诊信息无误。",
+                "is_from_doctor": "0",
+                "time": 1787103050,
+            },
+        ]
+    )
+    dialog.show()
+    application.processEvents()
+
+    event_titles = {
+        label.text()
+        for label in dialog.findChildren(QLabel)
+        if label.objectName() == "AiConsultEventTitle"
+    }
+    bodies = [
+        browser.toPlainText()
+        for browser in dialog.findChildren(QTextBrowser)
+        if browser.objectName() == "AiConsultBubbleText"
+    ]
+    visible_copy = "\n".join([*event_titles, *bodies])
+
+    assert "患者进入在线问诊" in event_titles
+    assert any("我已确认问诊信息无误" in text for text in bodies)
+    assert "businessID" not in visible_copy
+    assert "11173" not in visible_copy
+    dialog.close()
+
+
+def test_archived_ai_clinical_reply_restores_the_structured_panel(
+    application: QApplication,
+) -> None:
+    dialog = AiConsultDialog(
+        DemoDoctorRepository(),
+        PermissionSet(["tcm.diagnosis/aiAssistant"]),
+    )
+    dialog._render_messages(
+        [
+            {
+                "msg_type": "text",
+                "role": "assistant",
+                "text": LONG_CLINICAL_REPLY,
+                "time": 1787103050,
+            }
+        ]
+    )
+    dialog.show()
+    application.processEvents()
+
+    panels = dialog.findChildren(QWidget, "AiConsultClinicalPanel")
+    assert len(panels) == 1
+    assert panels[0].isVisible()
+    dialog.close()
+
+
+def test_chat_layout_keeps_ai_answer_readable_in_compact_window(
+    application: QApplication,
+) -> None:
+    dialog = AiConsultDialog(
+        DemoDoctorRepository(),
+        PermissionSet(["tcm.diagnosis/aiAssistant"]),
+    )
+    dialog.resize(1080, 680)
+    dialog._append_bubble(
+        "ai",
+        "### 病情分析\n\n" + "需要结合病历与检查结果综合判断。" * 8,
+        time_text="AI 分析",
+    )
+    dialog.show()
+    application.processEvents()
+
+    ai_frames = [
+        frame
+        for frame in dialog.findChildren(ai_consult_module.QFrame)
+        if frame.objectName() == "AiConsultBubbleAi"
+    ]
+    assert ai_frames
+    assert ai_frames[-1].width() >= dialog.chat_scroll.viewport().width() * 0.6
+    assert dialog.input.height() <= 50
+    assert dialog.input.parentWidget().height() <= 120
+    dialog.close()
+
+
+def test_completed_clinical_reply_is_parsed_into_scan_first_sections() -> None:
+    model = ai_consult_module._parse_clinical_analysis(LONG_CLINICAL_REPLY)
+
+    assert model is not None
+    assert "脾肾两虚" in model.summary
+    assert [item.label for item in model.evidence] == [
+        "空腹血糖",
+        "既往史",
+        "主诉",
+        "基本信息",
+    ]
+    assert len(model.hypotheses) == 2
+    assert len(model.gaps) == 3
+    assert len(model.steps) == 4
+    assert len(model.risks) == 2
+    assert "不能替代执业医师" in model.disclaimer
+
+
+@pytest.mark.parametrize(
+    "payload",
+    [
+        "请继续补充舌象与脉象。",
+        '{"businessID":"patient_opened_chat"}',
+        "<p>普通 HTML 回复</p>",
+    ],
+)
+def test_short_or_machine_payloads_keep_the_standard_chat_bubble(payload: str) -> None:
+    assert ai_consult_module._parse_clinical_analysis(payload) is None
+
+
+def test_completed_clinical_reply_switches_one_bubble_to_structured_panel(
+    application: QApplication,
+) -> None:
+    dialog = AiConsultDialog(
+        DemoDoctorRepository(),
+        PermissionSet(["tcm.diagnosis/aiAssistant"]),
+    )
+    bubble = dialog._append_bubble("ai", LONG_CLINICAL_REPLY, time_text="千问 · 11:48")
+    assert bubble.body is not None and not bubble.body.isHidden()
+
+    assert bubble.finalize_clinical_analysis()
+    dialog.show()
+    application.processEvents()
+
+    panel = bubble.findChild(QWidget, "AiConsultClinicalPanel")
+    assert panel is not None and panel.isVisible()
+    assert bubble.body.isHidden()
+    assert "可能证候分析" in bubble.body.toPlainText()
+    assert len(panel.findChildren(ai_consult_module.QFrame, "AiConsultEvidenceCard")) == 4
+    assert len(panel.findChildren(ai_consult_module.QFrame, "AiConsultGapRow")) == 3
+    assert len(panel.findChildren(ai_consult_module.QFrame, "AiConsultWorkflowStep")) == 4
+    assert len(panel.findChildren(ai_consult_module.QFrame, "AiConsultRiskCard")) == 1
+    dialog.close()
+
+
+def test_structured_clinical_reply_has_no_horizontal_overflow_at_minimum_size(
+    application: QApplication,
+) -> None:
+    dialog = AiConsultDialog(
+        DemoDoctorRepository(),
+        PermissionSet(["tcm.diagnosis/aiAssistant"]),
+    )
+    dialog.resize(1080, 680)
+    bubble = dialog._append_bubble("ai", LONG_CLINICAL_REPLY, time_text="千问 · 11:48")
+    assert bubble.finalize_clinical_analysis()
+    dialog.show()
+    for _ in range(3):
+        application.processEvents()
+
+    panel = bubble.findChild(QWidget, "AiConsultClinicalPanel")
+    assert panel is not None
+    assert dialog.chat_scroll.horizontalScrollBar().maximum() == 0
+    assert panel.width() <= dialog.chat_scroll.viewport().width()
+    assert panel.minimumSizeHint().width() <= dialog.chat_scroll.viewport().width()
+    dialog.close()
+
+
+def test_sidebar_replacement_hides_old_cards_immediately() -> None:
+    dialog = AiConsultDialog(
+        DemoDoctorRepository(),
+        PermissionSet(["tcm.diagnosis/aiAssistant"]),
+    )
+    dialog._set_key_facts([("病程", "2个月"), ("BMI", "22.1")])
+    previous = [
+        frame
+        for frame in dialog.findChildren(ai_consult_module.QFrame)
+        if frame.objectName() == "AiConsultKeyCard"
+    ]
+    assert previous
+
+    dialog._set_key_facts([("病程", "3个月")])
+
+    assert all(frame.isHidden() for frame in previous)
+    assert all(frame.parentWidget() is None for frame in previous)
+    dialog.close()
+
+
 def test_stream_chunks_update_one_ai_bubble_before_done_and_preserve_order(
     application: QApplication,
 ) -> None:
@@ -342,6 +984,51 @@ def test_stream_chunks_update_one_ai_bubble_before_done_and_preserve_order(
     dialog.close()
 
 
+def test_long_stream_stays_markdown_until_done_then_switches_in_place(
+    application: QApplication,
+) -> None:
+    dialog = AiConsultDialog(
+        DemoDoctorRepository(),
+        PermissionSet(["tcm.diagnosis/aiAssistant"]),
+    )
+    dialog.show()
+    dialog._stream_bubble = dialog._append_bubble("ai", "")
+    bubble = dialog._stream_bubble
+    assert bubble is not None
+    generation = dialog._generation
+    stream_generation = dialog._stream_generation
+    midpoint = len(LONG_CLINICAL_REPLY) // 2
+
+    dialog._stream_event(
+        generation,
+        stream_generation,
+        {"event": "delta", "text": LONG_CLINICAL_REPLY[:midpoint]},
+    )
+    dialog._flush_timer.stop()
+    dialog._flush_stream_chunks()
+    application.processEvents()
+    assert bubble.findChild(QWidget, "AiConsultClinicalPanel") is None
+    assert bubble.body is not None and not bubble.body.isHidden()
+
+    dialog._stream_event(
+        generation,
+        stream_generation,
+        {"event": "delta", "text": LONG_CLINICAL_REPLY[midpoint:]},
+    )
+    dialog._stream_event(
+        generation,
+        stream_generation,
+        {"event": "done", "model_label": "千问"},
+    )
+    application.processEvents()
+
+    panel = bubble.findChild(QWidget, "AiConsultClinicalPanel")
+    assert panel is not None and panel.isVisible()
+    assert bubble.body.toPlainText().startswith("基于本诊单资料")
+    assert bubble.body.isHidden()
+    dialog.close()
+
+
 def test_stream_error_and_cancelled_late_chunk_reuse_or_leave_current_bubble(
     application: QApplication,
 ) -> None:
@@ -407,3 +1094,200 @@ def test_chat_scroll_follows_bottom_but_respects_user_scroll_and_send_restores_i
     assert dialog._follow_chat
     assert bar.value() == bar.maximum()
     dialog.close()
+
+
+def test_build_patient_ai_context_covers_videos_tongue_blood_sugar_and_reports() -> None:
+    detail = {
+        "diagnosis": {
+            "fasting_blood_sugar": "6.8",
+            "tongue": "舌淡红，苔薄白",
+            "pulse": "弦细",
+        },
+        "tongue_images": ["a.jpg", "b.jpg"],
+    }
+    tracking = {
+        "blood_sugar": {
+            "entries": [
+                {"date": "2026-08-18", "value": "7.2", "period": "空腹"},
+                {"date": "2026-08-19", "value": "9.1", "period": "餐后"},
+            ],
+        }
+    }
+    analysis = {"summary": "血糖控制欠佳", "risk_assessment": ["低血糖风险"]}
+    prescriptions = [{"prescription_name": "逍遥散", "prescription_remark": "疏肝健脾"}]
+    call_records = [
+        {
+            "diagnosis_id": 501,
+            "transcript_text": "患者：睡眠好转。医生：继续观察。",
+            "start_time_text": "2026-08-20 09:10:00",
+        },
+        {
+            "diagnosis_id": 999,
+            "transcript_text": "其他诊单的文字不应混入",
+        },
+    ]
+
+    text, labels = build_patient_ai_context(
+        detail=detail,
+        tracking=tracking,
+        analysis=analysis,
+        prescriptions=prescriptions,
+        call_records=call_records,
+        diagnosis_id=501,
+    )
+
+    assert labels == ["每日血糖", "舌苔/脉象", "视频问诊文字", "历史AI报告", "处方记录"]
+    assert text.startswith("【患者综合资料】")
+    assert "【每日血糖】" in text and "7.2" in text and "9.1" in text
+    assert "【舌苔/脉象】" in text and "舌淡红" in text and "舌苔图片 2 张" in text
+    assert "【视频问诊文字】" in text and "睡眠好转" in text
+    assert "其他诊单的文字不应混入" not in text
+    assert "【历史AI报告】" in text and "血糖控制欠佳" in text
+    assert "【处方记录】" in text and "逍遥散" in text
+    assert len(text) <= 360
+
+
+def test_build_patient_ai_context_with_minimal_detail_returns_empty() -> None:
+    text, labels = build_patient_ai_context(
+        detail={"patient_name": "张三", "age": 45},
+        diagnosis_id=1,
+    )
+    assert text == ""
+    assert labels == []
+
+    text_none, labels_none = build_patient_ai_context(diagnosis_id=0)
+    assert text_none == ""
+    assert labels_none == []
+
+
+def test_compose_ai_prompt_truncates_long_question_within_limit() -> None:
+    context = "【患者综合资料】\n【每日血糖】诊时6.8"
+    long_question = "请详细分析血糖波动原因与调护建议：" * 30
+
+    composed = ai_consult_module._compose_ai_prompt(long_question, context)
+    assert composed.startswith(context)
+    assert "— 医生提问 —" in composed
+    assert composed.endswith("…")
+    assert len(composed) <= ai_consult_module.AI_PROMPT_LIMIT
+
+    short = ai_consult_module._compose_ai_prompt("睡眠如何？", context)
+    assert short == f"{context}\n\n— 医生提问 —\n睡眠如何？"
+
+    assert ai_consult_module._compose_ai_prompt("", context) == ""
+    assert ai_consult_module._compose_ai_prompt("   ", context) == ""
+    assert ai_consult_module._compose_ai_prompt("问题内容", "") == "问题内容"
+
+
+def test_ai_consult_dialog_renders_patient_context_bubble(
+    application: QApplication,
+    immediate_async: None,
+) -> None:
+    dialog = AiConsultDialog(
+        DemoDoctorRepository(),
+        PermissionSet(["tcm.diagnosis/aiAssistant"]),
+    )
+    dialog.open_for(diagnosis_id=501, patient_id=301)
+    dialog.show()
+    application.processEvents()
+
+    assert dialog._patient_ai_context.startswith("【患者综合资料】")
+    assert "舌苔/脉象" in dialog._patient_ai_context_labels
+    assert "视频问诊文字" in dialog._patient_ai_context_labels
+    assert "睡眠比上周好一些" in dialog._patient_ai_context
+
+    bodies = [
+        widget.toPlainText()
+        for widget in dialog.findChildren(QTextBrowser)
+        if widget.objectName() == "AiConsultBubbleText"
+    ]
+    assert any("实际 AI 请求由服务端实时聚合全量纵向资料" in text for text in bodies)
+    assert any("共 1 条视频问诊记录" in text for text in bodies)
+
+    toggles = [
+        widget
+        for widget in dialog.findChildren(QPushButton)
+        if widget.objectName() == "AiConsultContextToggle"
+    ]
+    assert toggles
+    assert toggles[0].text() == "查看本地资料预览"
+
+    reveals = [
+        widget
+        for widget in dialog.findChildren(QLabel)
+        if widget.objectName() == "AiConsultContextReveal"
+    ]
+    assert reveals
+    assert reveals[0].text() == dialog._patient_ai_context
+    assert reveals[0].isHidden()
+
+    toggles[0].click()
+    application.processEvents()
+    assert reveals[0].isVisible()
+    assert toggles[0].text() == "收起本地资料预览"
+    dialog.close()
+
+
+def test_ask_sends_only_question_and_relies_on_server_full_context(
+    application: QApplication,
+    immediate_async: None,
+    monkeypatch: pytest.MonkeyPatch,
+) -> None:
+    captured: list[str] = []
+
+    class FakeSignal:
+        def connect(self, _slot: Any) -> None:
+            return None
+
+    class FakeWorker:
+        def __init__(
+            self,
+            repository: Any,
+            *,
+            diagnosis_id: int,
+            prompt: str,
+            task: str,
+        ) -> None:
+            captured.append(prompt)
+            self.signals = SimpleNamespace(
+                event=FakeSignal(),
+                error=FakeSignal(),
+                finished=FakeSignal(),
+            )
+
+        def cancel(self) -> None:
+            return None
+
+    monkeypatch.setattr(ai_consult_module, "_AiStreamWorker", FakeWorker)
+    monkeypatch.setattr(
+        ai_consult_module,
+        "QThreadPool",
+        SimpleNamespace(
+            globalInstance=lambda: SimpleNamespace(start=lambda worker: None)
+        ),
+    )
+
+    dialog = AiConsultDialog(
+        DemoDoctorRepository(),
+        PermissionSet(["tcm.diagnosis/aiAssistant"]),
+    )
+    dialog.open_for(diagnosis_id=501, patient_id=301)
+    dialog.show()
+    application.processEvents()
+    assert dialog._patient_ai_context
+
+    dialog._ask("请结合资料分析当前证候")
+    assert captured, "AI stream worker should have been started with a prompt"
+
+    prompt = captured[0]
+    assert prompt == "请结合资料分析当前证候"
+    assert dialog._patient_ai_context not in prompt
+    assert len(prompt) <= ai_consult_module.AI_PROMPT_LIMIT
+
+    all_bubble_texts = [
+        widget.toPlainText()
+        for widget in dialog.findChildren(QTextBrowser)
+        if widget.objectName() == "AiConsultBubbleText"
+    ]
+    assert any("请结合资料分析当前证候" in text for text in all_bubble_texts)
+    assert any("服务端将按当前诊单实时附带患者全部纵向资料" in text for text in all_bubble_texts)
+    dialog.close()