更新

2026-08-22 08:51:35 +08:00
parent 6c444a4a04
commit c06d293424
69 changed files with 11431 additions and 1601 deletions
@@ -0,0 +1,109 @@
+<?php
+
+declare(strict_types=1);
+
+require dirname(__DIR__) . '/vendor/autoload.php';
+
+use app\adminapi\logic\setting\DesktopWorkstationLogic;
+
+function desktopUpdateExpect(bool $condition, string $message): void
+{
+    if (!$condition) {
+        fwrite(STDERR, "FAIL: {$message}\n");
+        exit(1);
+    }
+}
+
+desktopUpdateExpect(
+    DesktopWorkstationLogic::normalizeVersion('0.2') === '0.2.0',
+    'short versions pad to three segments'
+);
+desktopUpdateExpect(
+    DesktopWorkstationLogic::compareVersion('0.1.0', '0.2.0') < 0,
+    '0.1.0 is older than 0.2.0'
+);
+desktopUpdateExpect(
+    DesktopWorkstationLogic::packageKey('win32', 'amd64') === 'windows_x64',
+    'windows/amd64 maps to windows_x64'
+);
+desktopUpdateExpect(
+    DesktopWorkstationLogic::packageKey('darwin', 'aarch64') === 'macos_arm64',
+    'darwin/arm maps to macos_arm64'
+);
+
+$sha = str_repeat('a', 64);
+$config = [
+    'enabled' => 1,
+    'latest_version' => '0.2.0',
+    'min_version' => '0.1.5',
+    'force_update' => 0,
+    'title' => '医生工作站 0.2.0',
+    'notes' => '稳定性更新',
+    'packages' => [
+        'windows_x64' => [
+            'url' => 'https://cdn.example.com/DoctorWorkstation-Windows-x64-0.2.0.zip',
+            'sha256' => $sha,
+            'size' => 123,
+            'filename' => 'DoctorWorkstation-Windows-x64-0.2.0.zip',
+        ],
+    ],
+];
+
+$optional = DesktopWorkstationLogic::evaluate($config, '0.1.8', 'windows', 'x64');
+desktopUpdateExpect($optional['has_update'] === true, 'newer published version is an update');
+desktopUpdateExpect($optional['force'] === false, 'force stays off when above min version');
+desktopUpdateExpect($optional['can_install'] === true, 'hashed package can be installed');
+desktopUpdateExpect(
+    is_array($optional['package']) && $optional['package']['sha256'] === $sha,
+    'matching windows package is returned'
+);
+
+$forcedByMin = DesktopWorkstationLogic::evaluate($config, '0.1.0', 'windows', 'x64');
+desktopUpdateExpect($forcedByMin['force'] === true, 'below min version forces upgrade');
+
+$config['force_update'] = 1;
+$forcedAll = DesktopWorkstationLogic::evaluate($config, '0.1.9', 'windows', 'x64');
+desktopUpdateExpect($forcedAll['force'] === true, 'force_update blocks every older client');
+
+$current = DesktopWorkstationLogic::evaluate($config, '0.2.0', 'windows', 'x64');
+desktopUpdateExpect($current['has_update'] === false, 'current latest version is not an update');
+
+$macosMissing = DesktopWorkstationLogic::evaluate($config, '0.1.0', 'macos', 'arm64');
+desktopUpdateExpect($macosMissing['has_update'] === true, 'other platforms still see the new version');
+desktopUpdateExpect($macosMissing['can_install'] === false, 'missing platform package cannot auto-install');
+desktopUpdateExpect($macosMissing['force'] === false, 'force requires an installable package');
+
+$disabled = $config;
+$disabled['enabled'] = 0;
+$quiet = DesktopWorkstationLogic::evaluate($disabled, '0.1.0', 'windows', 'x64');
+desktopUpdateExpect($quiet['has_update'] === false, 'disabled detection never prompts');
+
+$controller = file_get_contents(dirname(__DIR__) . '/app/adminapi/controller/setting/DesktopWorkstationController.php');
+desktopUpdateExpect(is_string($controller), 'controller source is readable');
+desktopUpdateExpect(
+    str_contains($controller, "public array \$notNeedLogin = ['check']")
+        && str_contains($controller, 'public function check()')
+        && str_contains($controller, 'DesktopWorkstationLogic::check('),
+    'check action is public and delegates to logic'
+);
+
+$adminView = file_get_contents(dirname(__DIR__, 2) . '/admin/src/views/setting/desktop_workstation/index.vue');
+desktopUpdateExpect(is_string($adminView), 'admin view source is readable');
+desktopUpdateExpect(
+    str_contains($adminView, 'setting.desktop_workstation/setConfig')
+        && str_contains($adminView, 'force_update'),
+    'admin page can save force-update configuration'
+);
+
+$migration = file_get_contents(
+    dirname(__DIR__) . '/sql/1.9.20260821/add_desktop_workstation_update_menu.sql'
+);
+desktopUpdateExpect(is_string($migration), 'menu migration is readable');
+desktopUpdateExpect(
+    substr_count($migration, "WHERE `perms` = 'setting.desktop_workstation/getConfig'") >= 1
+        && str_contains($migration, 'setting.desktop_workstation/setConfig')
+        && str_contains($migration, 'setting/desktop_workstation/index'),
+    'menu registration is idempotent and points at the admin view'
+);
+
+echo "Desktop workstation update contract: OK\n";
@@ -19,6 +19,7 @@ $selectProfile = $reflection->getMethod('selectAssistantProfile');
 $buildPrompt = $reflection->getMethod('buildAssistantPrompt');
 $buildReportPrompt = $reflection->getMethod('buildPrompt');
 $buildInputs = $reflection->getMethod('buildUpstreamInputs');
+$parseDraft = $reflection->getMethod('parsePrescriptionDraft');
 $tasks = $reflection->getConstant('ASSISTANT_TASKS');
 $assistantPermission = $reflection->getConstant('PERMISSION_ASSISTANT');

@@ -32,6 +33,7 @@ assistantExpect(
        'summary',
        'tcm_pattern',
        'prescription_review',
+        'prescription_generate',
        'medication_review',
        'exam_review',
        'complication_risk',
@@ -43,10 +45,11 @@ assistantExpect(

 assistantExpect($selectProfile->invoke(null, 'summary', '') === 'qwen', 'summary routes to qwen');
 assistantExpect($selectProfile->invoke(null, 'tcm_pattern', '') === 'qwen', 'TCM routes to qwen');
-assistantExpect($selectProfile->invoke(null, 'exam_review', '') === 'openai', 'exam routes to openai');
+assistantExpect($selectProfile->invoke(null, 'prescription_generate', '') === 'qwen', 'prescription generation routes to qwen');
+assistantExpect($selectProfile->invoke(null, 'exam_review', '') === 'qwen', 'exam routes to qwen');
 assistantExpect(
-    $selectProfile->invoke(null, 'custom', '请评估并发症风险') === 'openai',
-    'risk prompt routes to openai'
+    $selectProfile->invoke(null, 'custom', '请评估并发症风险') === 'qwen',
+    'risk prompt routes to qwen'
 );
 assistantExpect(
    $selectProfile->invoke(null, 'custom', '请分析中药处方') === 'qwen',
@@ -80,6 +83,30 @@ assistantExpect(substr_count($prompt, '13812345678') === 0, 'question phone is a
 assistantExpect(str_contains($prompt, '＜/USER_QUESTION＞'), 'injected boundary is neutralized');
 assistantExpect(str_contains($prompt, '密钥索取'), 'highest-priority safety boundary is present');

+$draftPrompt = $buildPrompt->invoke(null, $context, 'prescription_generate', '请生成处方草稿');
+assistantExpect(str_contains($draftPrompt, 'PATIENT_LONGITUDINAL_SOURCE'), 'prescription prompt uses longitudinal context');
+assistantExpect(str_contains($draftPrompt, 'prescription_draft'), 'prescription prompt requires structured draft JSON');
+assistantExpect(str_contains($draftPrompt, '逐味复核'), 'prescription draft requires doctor review');
+$draft = $parseDraft->invoke(null, json_encode([
+    'prescription_draft' => [
+        'clinical_diagnosis' => '气阴两虚证',
+        'herbs' => [
+            ['name' => '黄芪', 'dosage' => 15, 'formula_type' => '主方'],
+            ['name' => '山药', 'dosage' => 12, 'formula_type' => '主方'],
+        ],
+        'dose_count' => 7,
+        'usage_days' => 7,
+        'times_per_day' => 2,
+        'rationale' => '结合完整资料辨证拟方',
+    ],
+], JSON_UNESCAPED_UNICODE));
+assistantExpect(is_array($draft) && count($draft['herbs']) === 2, 'valid prescription draft is parsed');
+assistantExpect($draft['requires_doctor_review'] === true && $draft['audit_status'] === 0, 'draft cannot bypass review');
+assistantExpect(
+    $parseDraft->invoke(null, '{"prescription_draft":{"clinical_diagnosis":"证型","herbs":[{"name":"黄芪","dosage":10},{"name":"黄芪","dosage":12}]}}') === null,
+    'duplicate herbs are rejected'
+);
+
 $reportPrompt = $buildReportPrompt->invoke(null, $context);
 assistantExpect(!str_contains($reportPrompt, '13812345678'), 'saved report prompt redacts phone');
 assistantExpect(!str_contains($reportPrompt, '11010519491231002X'), 'saved report prompt redacts ID');
@@ -0,0 +1,163 @@
+<?php
+
+declare(strict_types=1);
+
+require dirname(__DIR__) . '/vendor/autoload.php';
+
+use app\adminapi\logic\tcm\DiagnosisAiLogic;
+
+final class DiagnosisAiPatientOptionsAuthCacheDouble
+{
+    /** @var array<int,string> */
+    public static array $uris = [];
+
+    public function __construct(int $adminId = 0)
+    {
+    }
+
+    /** @return array<int,string> */
+    public function getAdminUri(): array
+    {
+        return self::$uris;
+    }
+}
+
+function patientOptionsExpect(bool $condition, string $message): void
+{
+    if (!$condition) {
+        fwrite(STDERR, "FAIL: {$message}\n");
+        exit(1);
+    }
+}
+
+patientOptionsExpect(
+    class_alias(DiagnosisAiPatientOptionsAuthCacheDouble::class, 'app\\common\\cache\\AdminAuthCache'),
+    'permission cache double is installed before logic autoload'
+);
+
+$reflection = new ReflectionClass(DiagnosisAiLogic::class);
+$source = file_get_contents($reflection->getFileName());
+patientOptionsExpect(is_string($source), 'logic source is readable');
+
+$hasPermission = $reflection->getMethod('hasPermission');
+DiagnosisAiPatientOptionsAuthCacheDouble::$uris = ['tcm.diagnosis/aiAssistant'];
+patientOptionsExpect(
+    $hasPermission->invoke(null, 7, ['root' => 0], 'tcm.diagnosis/aiassistant') === true,
+    'roles with aiAssistant pass the explicit logic permission check'
+);
+DiagnosisAiPatientOptionsAuthCacheDouble::$uris = ['tcm.diagnosis/aiReports'];
+patientOptionsExpect(
+    $hasPermission->invoke(null, 7, ['root' => 0], 'tcm.diagnosis/aiassistant') === false,
+    'adjacent AI permissions do not grant patient options access'
+);
+patientOptionsExpect(
+    $hasPermission->invoke(null, 1, ['root' => 1], 'tcm.diagnosis/aiassistant') === true,
+    'root permission compatibility is preserved'
+);
+
+$normalize = $reflection->getMethod('normalizePatientOptionsParams');
+$defaults = $normalize->invoke(null, []);
+patientOptionsExpect(
+    $defaults === ['keyword' => '', 'page_no' => 1, 'page_size' => 20],
+    'pagination defaults are stable'
+);
+$bounded = $normalize->invoke(null, ['keyword' => '  张三  ', 'page_no' => -8, 'page_size' => 500]);
+patientOptionsExpect(
+    $bounded === ['keyword' => '张三', 'page_no' => 1, 'page_size' => 50],
+    'keyword is trimmed and pagination is bounded'
+);
+patientOptionsExpect(
+    $normalize->invoke(null, ['keyword' => str_repeat('患', 65)]) === null,
+    'keywords longer than 64 characters fail validation'
+);
+
+$format = $reflection->getMethod('formatPatientOptionRow');
+$dto = $format->invoke(null, [
+    'diagnosis_id' => 18,
+    'source_patient_id' => 77,
+    'patient_name' => '张三',
+    'gender' => 1,
+    'age' => 42,
+    'phone_value' => '13812345678',
+    'id_card' => '11010519491231002X',
+    'diagnosis_date' => 1787155200,
+    'diagnosis_summary' => '气阴两虚',
+    'last_visit_at' => '2026-08-18 09:30:00',
+    'next_appointment_at' => '2026-08-22 14:00:00',
+]);
+patientOptionsExpect(
+    array_keys($dto) === [
+        'diagnosis_id',
+        'source_patient_id',
+        'patient_name',
+        'gender',
+        'age',
+        'phone_masked',
+        'diagnosis_date',
+        'diagnosis_summary',
+        'last_visit_at',
+        'next_appointment_at',
+    ],
+    'diagnosis option DTO exposes only the minimal allowlist'
+);
+patientOptionsExpect($dto['phone_masked'] === '138****5678', 'phone is masked');
+patientOptionsExpect($dto['diagnosis_summary'] === '气阴两虚', 'safe diagnosis summary is retained');
+$encodedDto = json_encode($dto, JSON_UNESCAPED_UNICODE);
+patientOptionsExpect(is_string($encodedDto), 'DTO is JSON encodable');
+patientOptionsExpect(!str_contains($encodedDto, '13812345678'), 'plain phone is absent');
+patientOptionsExpect(!str_contains($encodedDto, '11010519491231002X'), 'ID card is absent');
+
+$patientOptions = $reflection->getMethod('patientOptions');
+$sourceLines = file($reflection->getFileName());
+$methodSource = is_array($sourceLines) ? implode('', array_slice(
+    $sourceLines,
+    $patientOptions->getStartLine() - 1,
+    $patientOptions->getEndLine() - $patientOptions->getStartLine() + 1
+)) : '';
+patientOptionsExpect(
+    str_contains($methodSource, 'self::hasPermission($adminId, $adminInfo, self::PERMISSION_ASSISTANT)'),
+    'endpoint explicitly checks the existing AI assistant permission'
+);
+patientOptionsExpect(
+    str_contains($methodSource, 'MyPatientLogic::applyScope($query, $adminId, $adminInfo)'),
+    'query applies the shared patient data scope'
+);
+patientOptionsExpect(
+    str_contains($methodSource, "->where('d.status', 1)")
+        && str_contains($methodSource, "->whereNull('d.delete_time')"),
+    'query only exposes enabled, non-deleted diagnoses'
+);
+patientOptionsExpect(
+    str_contains($methodSource, 'patient_option_apt.status = 3')
+        && str_contains($methodSource, 'patient_option_apt.status = 1')
+        && str_contains($methodSource, "->order('d.id', 'desc')"),
+    'appointment summaries and deterministic diagnosis ordering are present'
+);
+patientOptionsExpect(
+    substr_count($methodSource, '->select()') === 1,
+    'page data is fetched in one query without row-level lookups'
+);
+
+$controller = file_get_contents(dirname(__DIR__) . '/app/adminapi/controller/tcm/DiagnosisController.php');
+patientOptionsExpect(is_string($controller), 'controller source is readable');
+patientOptionsExpect(
+    str_contains($controller, 'public function aiPatientOptions()')
+        && str_contains($controller, 'DiagnosisAiLogic::patientOptions('),
+    'GET controller action delegates to the scoped logic'
+);
+
+$migration = file_get_contents(
+    dirname(__DIR__) . '/database/migrations/2026_08_20_diagnosis_ai_patient_options_permission.sql'
+);
+patientOptionsExpect(is_string($migration), 'permission migration is readable');
+patientOptionsExpect(
+    substr_count($migration, "WHERE `perms` = 'tcm.diagnosis/aiPatientOptions'") >= 2,
+    'endpoint permission registration is idempotent and addressable'
+);
+patientOptionsExpect(
+    str_contains($migration, "`menu`.`perms` = 'tcm.diagnosis/aiAssistant'")
+        && str_contains($migration, 'INSERT IGNORE INTO `zyt_system_role_menu`'),
+    'roles owning aiAssistant inherit the endpoint permission idempotently'
+);
+
+echo "Diagnosis AI patient options contract: OK\n";
@@ -36,8 +36,10 @@ difyStreamExpect(
 );
 difyStreamExpect($generic[1]['protocol'] === 'openai', 'OpenAI remains the fallback protocol');
 difyStreamExpect($generic[1]['payload']['stream'] === true, 'OpenAI stream request uses stream=true');
+// inputs 以对象语义上线（空 inputs 编码成 [] 会被 Dify 判为 invalid_param），
+// 因此按线上实际编码结果断言，而不是按 PHP 数组比较。
 difyStreamExpect(
-    $generic[0]['payload']['inputs'] === ['case' => 'redacted']
+    json_decode((string) json_encode($generic[0]['payload']['inputs']), true) === ['case' => 'redacted']
        && $generic[0]['payload']['query'] === 'safe query'
        && $generic[0]['payload']['user'] === 'admin-safe',
    'Dify streaming preserves structured inputs, query and user'
@@ -59,6 +61,31 @@ difyStreamExpect(
    'legacy OpenAI blocking request does not gain a stream field'
 );

+$withFiles = callDifyStreamPrivate('buildRequestSpecs', [
+    'https://ai.example.test/v1',
+    'model-safe',
+    ['case' => 'full-context'],
+    'analyze all supplied records',
+    'admin-safe',
+    false,
+    [
+        ['type' => 'image', 'transfer_method' => 'remote_url', 'url' => 'https://files.example.test/tongue.jpg'],
+        ['type' => 'document', 'transfer_method' => 'remote_url', 'url' => 'https://files.example.test/report.pdf'],
+    ],
+]);
+// 回退协议保留（网关 404/405 时才会用到），但任何附件都不得被静默丢弃：
+// Dify 走文件通道，OpenAI-compatible 无法内联的附件必须落在提示词清单里。
+difyStreamExpect(count($withFiles) === 2, 'ambiguous /v1 keeps the OpenAI fallback reachable');
+difyStreamExpect($withFiles[0]['protocol'] === 'dify', 'Dify remains the preferred protocol');
+difyStreamExpect(count($withFiles[0]['payload']['files']) === 2, 'Dify receives every supplied clinical file');
+difyStreamExpect($withFiles[0]['payload']['files'][0]['type'] === 'image', 'tongue image keeps image type');
+difyStreamExpect($withFiles[0]['payload']['files'][1]['type'] === 'document', 'report keeps document type');
+$fallbackText = $withFiles[1]['payload']['messages'][0]['content'][0]['text'];
+difyStreamExpect(
+    str_contains($fallbackText, 'https://files.example.test/report.pdf'),
+    'the fallback protocol declares the report it cannot inline'
+);
+
 $explicitDify = callDifyStreamPrivate('buildRequestSpecs', [
    'https://ai.example.test/v1/chat-messages', 'model-safe', [], 'query', 'user', true,
 ]);
@@ -19,7 +19,7 @@ function patientReportContractExpect(bool $condition, string $message): void
 $reflection = new ReflectionClass(PatientAiReportLogic::class);
 patientReportContractExpect(
    $reflection->getConstant('DISCLAIMER')
-        === '仅供临床辅助参考，不可替代医生诊断，不得直接用于开方、用药调整或其他医疗决策。系统未对舌像、报告附件或视频画面进行视觉诊断；仅分析已录入、归档或转写的文字及附件元数据。',
+        === '仅供临床辅助参考，不可替代医生诊断。系统会把舌像、报告等附件与全部文字资料提交给已配置的模型分析，但模型识别结果仍须由执业医师核对原始资料；视频面诊以归档转写文字为准。',
    'fixed medical disclaimer is exact'
 );
 patientReportContractExpect(
@@ -33,8 +33,9 @@ patientReportContractExpect(

 $logicSource = file_get_contents($reflection->getFileName());
 patientReportContractExpect(is_string($logicSource), 'patient report logic source is readable');
+// 报告生成与 compactSourceForPrompt 各有一组“单次 / 分片 / 归并”调用点，共 6 处。
 patientReportContractExpect(
-    substr_count($logicSource, 'DifyChatService::chat(') === 4,
+    substr_count($logicSource, 'DifyChatService::chat(') === 6,
    'single-pass, evidence-chunk, summary-reduction, and final synthesis upstream call sites are explicit'
 );
 patientReportContractExpect(
@@ -71,8 +71,8 @@ patientPermissionExpect(
 patientPermissionExpect(
    str_contains($source, "->where('d.patient_id', \$patientId)")
        && str_contains($source, "->whereNull('d.delete_time')")
-        && str_contains($source, "->where('d.status', 1)"),
-    'authorization derives visible diagnosis rows from the stable patient id'
+        && !str_contains($source, "->where('d.status', 1)"),
+    'authorization derives every non-deleted visible diagnosis row from the stable patient id'
 );
 patientPermissionExpect(
    str_contains($source, "->whereIn('diagnosis_id', \$diagnosisIds)"),
@@ -103,7 +103,7 @@ $baseRow = [
    'report_json' => '{"diagnosis":"诊断","risk_assessment":[],"treatment_advice":"建议"}',
    'source_summary_json' => '{"diagnosis_count":2}',
    'source_hash' => str_repeat('a', 64),
-    'prompt_version' => 'patient-longitudinal-report-v1',
+    'prompt_version' => 'patient-longitudinal-report-v2',
    'generated_at' => 1786665600,
    'created_at' => 1786665600,
 ];
@@ -89,6 +89,19 @@ $sources = [
        'duration' => 35,
        'intensity' => 2,
    ]],
+    'prescriptions' => [[
+        'id' => 12,
+        'diagnosis_id' => 101,
+        'patient_id' => 88,
+        'prescription_name' => '益气养阴方',
+        'clinical_diagnosis' => '气阴两虚证',
+        'case_record' => '{"present_illness":"口渴乏力一月"}',
+        'herbs' => '[{"name":"黄芪","dosage":15,"formula_type":"主方"}]',
+        'dose_count' => 7,
+        'usage_days' => 7,
+        'times_per_day' => 2,
+        'audit_status' => 1,
+    ]],
    'im_messages' => [[
        'id' => 6,
        'diagnosis_id' => 101,
@@ -153,6 +166,12 @@ patientSnapshotExpect(count($snapshot['doctor_notes'][0]['report_files']) === 1,
 patientSnapshotExpect(count($snapshot['daily_records']['blood_glucose_pressure']) === 1, 'blood daily records are aggregated');
 patientSnapshotExpect(count($snapshot['daily_records']['diet']) === 1, 'diet daily records are aggregated');
 patientSnapshotExpect(count($snapshot['daily_records']['exercise']) === 1, 'exercise daily records are aggregated');
+patientSnapshotExpect(count($snapshot['prescriptions']) === 1, 'formal prescriptions are aggregated');
+patientSnapshotExpect($snapshot['prescriptions'][0]['herbs'][0]['name'] === '黄芪', 'prescription herbs are decoded');
+patientSnapshotExpect(
+    $snapshot['prescriptions'][0]['case_record']['present_illness'] === '口渴乏力一月',
+    'prescription case history snapshot is decoded'
+);
 patientSnapshotExpect(count($snapshot['chat_records']['tencent_im']) === 1, 'IM chat is aggregated');
 patientSnapshotExpect(count($snapshot['chat_records']['wechat_work']) === 1, 'WeChat Work chat is aggregated');
 patientSnapshotExpect(count($snapshot['video_calls'][0]['segments']) === 2, 'every call includes transcript segments');
@@ -171,6 +190,7 @@ foreach ([
    'blood_record_count' => 1,
    'diet_record_count' => 1,
    'exercise_record_count' => 1,
+    'prescription_count' => 1,
    'im_message_count' => 1,
    'wechat_message_count' => 1,
    'call_record_count' => 1,
@@ -198,6 +218,12 @@ patientSnapshotExpect(
    'filename-shaped fields are redacted upstream'
 );
 patientSnapshotExpect(str_contains($upstreamJson, 'attachment_count'), 'attachment presence remains available upstream');
+// 方名、外院机构名和药味名是临床内容，不是身份信息；把它们一并脱敏会让模型
+// 看不到既往用方，直接影响处方草稿与用药复核。
+patientSnapshotExpect(
+    str_contains($upstreamJson, '益气养阴方'),
+    'clinical prescription_name survives upstream sanitisation'
+);

 $longText = str_repeat('超长病历段落甲乙丙。', 20000);
 $manyNotes = [];
@@ -38,6 +38,48 @@ expectSame(false, str_contains($serializedSpecs, 'api_key'), 'credential field i
 expectSame(false, str_contains($serializedSpecs, 'provider'), 'provider override is absent from request bodies');
 expectSame(false, str_contains($serializedSpecs, 'base_url'), 'base URL override is absent from request bodies');

+// 附件不得让 OpenAI-compatible 回退失效。历史实现遇到报告/录像等非图片附件时只返回
+// Dify 一种协议，网关 404 会直接变成“模型未能处理本次请求”，开处方因此必失败。
+$attachments = [
+    ['type' => 'document', 'transfer_method' => 'remote_url', 'url' => 'https://cdn.example.test/report.pdf'],
+    ['type' => 'video', 'transfer_method' => 'remote_url', 'url' => 'https://cdn.example.test/call.mp4'],
+    ['type' => 'image', 'transfer_method' => 'remote_url', 'url' => 'https://cdn.example.test/tongue.jpg'],
+];
+$withFiles = callPrivate('buildRequestSpecs', [
+    'https://ai.example.test/v1',
+    'model-name',
+    [],
+    'clinical prompt',
+    'server-user',
+    false,
+    $attachments,
+]);
+expectSame(2, count($withFiles), 'non-image attachments must keep the OpenAI fallback available');
+expectSame($attachments, $withFiles[0]['payload']['files'], 'Dify still receives every attachment');
+expectSame(
+    'clinical prompt',
+    $withFiles[0]['payload']['query'],
+    'Dify carries attachments in the file channel, not as a manifest'
+);
+$openAiContent = $withFiles[1]['payload']['messages'][0]['content'];
+expectSame(true, is_array($openAiContent), 'OpenAI content becomes multimodal when attachments exist');
+expectSame('text', $openAiContent[0]['type'], 'attachment manifest travels in the text part');
+expectSame(
+    true,
+    str_contains($openAiContent[0]['text'], 'https://cdn.example.test/report.pdf'),
+    'document attachment is listed instead of being silently dropped'
+);
+expectSame(
+    true,
+    str_contains($openAiContent[0]['text'], 'https://cdn.example.test/call.mp4'),
+    'recording attachment is listed instead of being silently dropped'
+);
+expectSame(
+    'https://cdn.example.test/tongue.jpg',
+    $openAiContent[1]['image_url']['url'],
+    'image attachments stay inline for multimodal reading'
+);
+
 $openAi = callPrivate('buildRequestSpecs', [
    'https://ai.example.test/v1/chat/completions',
    'model-name',
@@ -48,6 +90,30 @@ $openAi = callPrivate('buildRequestSpecs', [
 expectSame(1, count($openAi), 'explicit OpenAI endpoint should not probe Dify');
 expectSame('openai', $openAi[0]['protocol'], 'explicit OpenAI protocol');

+$openAiWithFiles = callPrivate('buildRequestSpecs', [
+    'https://ai.example.test/v1/chat/completions',
+    'model-name',
+    [],
+    'prompt',
+    'server-user',
+    false,
+    $attachments,
+]);
+expectSame(1, count($openAiWithFiles), 'explicit OpenAI endpoint stays OpenAI even with attachments');
+expectSame('openai', $openAiWithFiles[0]['protocol'], 'explicit OpenAI protocol with attachments');
+
+$difyWithFiles = callPrivate('buildRequestSpecs', [
+    'https://ai.example.test/v1/chat-messages',
+    'model-name',
+    [],
+    'prompt',
+    'server-user',
+    false,
+    $attachments,
+]);
+expectSame(1, count($difyWithFiles), 'explicit Dify endpoint stays Dify with attachments');
+expectSame($attachments, $difyWithFiles[0]['payload']['files'], 'explicit Dify keeps the file channel');
+
 $dify = callPrivate('buildRequestSpecs', [
    'https://ai.example.test/v1/chat-messages',
    'model-name',
@@ -73,6 +139,81 @@ expectSame(
    'OpenAI multipart response'
 );

+// 附件数量必须按上游应用的 file_upload.number_limits 截断。Dify 超限时返回
+// 400 invalid_param 并整单拒绝，历史实现会把患者的全部舌象/报告一次性送上去，
+// 导致该患者的每一次 AI 请求都固定失败（UPSTREAM_REJECTED）。
+$manyFiles = [];
+for ($i = 0; $i < 5; $i++) {
+    $manyFiles[] = ['type' => 'image', 'transfer_method' => 'remote_url', 'url' => "https://cdn.example.test/tongue{$i}.jpg"];
+}
+for ($i = 0; $i < 4; $i++) {
+    $manyFiles[] = ['type' => 'document', 'transfer_method' => 'remote_url', 'url' => "https://cdn.example.test/report{$i}.pdf"];
+}
+$capped = callPrivate('normalizeFiles', [$manyFiles, 3]);
+expectSame(3, count($capped['kept']), 'the total attachment count is capped, not each type');
+expectSame(6, count($capped['dropped']), 'attachments past the cap are recorded, not discarded');
+expectSame(
+    'https://cdn.example.test/tongue3.jpg',
+    $capped['dropped'][0]['url'],
+    'the earliest attachments are the ones kept'
+);
+expectSame(
+    ['kept' => [], 'dropped' => []],
+    callPrivate('normalizeFiles', [[['type' => 'image', 'url' => 'ftp://cdn.example.test/x.jpg']], 3]),
+    'non-http attachments are still rejected outright'
+);
+
+// 被截断的附件必须出现在提示词清单里，否则模型会把“没看到”当成“没有”。
+$cappedSpecs = callPrivate('buildRequestSpecs', [
+    'https://ai.example.test/v1/chat-messages',
+    'model-name',
+    [],
+    'clinical prompt',
+    'server-user',
+    false,
+    $capped['kept'],
+    $capped['dropped'],
+]);
+$cappedQuery = $cappedSpecs[0]['payload']['query'];
+expectSame(true, str_contains($cappedQuery, '<ATTACHMENTS_NOT_INLINE>'), 'dropped attachments are declared to the model');
+expectSame(true, str_contains($cappedQuery, 'https://cdn.example.test/tongue3.jpg'), 'dropped attachment URL is listed');
+expectSame(false, str_contains($cappedQuery, 'https://cdn.example.test/tongue0.jpg'), 'delivered attachments are not duplicated in the manifest');
+
+// 附件被整体拒绝时必须降级为纯文本重试，而不是让整次问诊失败。
+$plan = callPrivate('buildAttemptPlan', [$capped['kept'], $capped['dropped']]);
+expectSame(2, count($plan), 'a request with attachments gets a text-only fallback attempt');
+expectSame([], $plan[1]['files'], 'the fallback attempt sends no attachments');
+expectSame(9, count($plan[1]['omitted']), 'the fallback attempt declares every attachment');
+expectSame(1, count(callPrivate('buildAttemptPlan', [[], []])), 'a request without attachments is attempted once');
+
+expectSame(true, callPrivate('shouldRetryWithoutFiles', [400, $capped['kept']]), 'invalid_param retries without attachments');
+expectSame(true, callPrivate('shouldRetryWithoutFiles', [413, $capped['kept']]), 'oversized attachments retry without attachments');
+expectSame(false, callPrivate('shouldRetryWithoutFiles', [400, []]), 'a text-only rejection is not retried');
+expectSame(false, callPrivate('shouldRetryWithoutFiles', [401, $capped['kept']]), 'a credential failure is not retried');
+expectSame(false, callPrivate('shouldRetryWithoutFiles', [500, $capped['kept']]), 'an upstream outage is not retried here');
+
+// Dify 的 inputs 必须是 JSON 对象。PHP 空数组会被编码成 []，上游以
+// invalid_param 拒绝整单——空 inputs 的调用方会 100% 失败。
+$emptyInputs = callPrivate('buildRequestSpecs', [
+    'https://ai.example.test/v1/chat-messages', 'model-name', [], 'prompt', 'server-user',
+]);
+expectSame(
+    true,
+    str_contains((string) json_encode($emptyInputs[0]['payload']), '"inputs":{}'),
+    'empty inputs are encoded as a JSON object, never as an array'
+);
+$filledInputs = callPrivate('buildRequestSpecs', [
+    'https://ai.example.test/v1/chat-messages', 'model-name', ['prompt_version' => 'v2'], 'prompt', 'server-user',
+]);
+expectSame(
+    true,
+    str_contains((string) json_encode($filledInputs[0]['payload']), '"inputs":{"prompt_version":"v2"}'),
+    'populated inputs keep their keys'
+);
+
+expectSame('invalid_param', callPrivate('cleanUpstreamCode', ['invalid_param']), 'enumerable upstream codes are kept for logs');
+expectSame('', callPrivate('cleanUpstreamCode', ["Run failed: 404 for https://cdn.example.test/a.pdf"]), 'upstream prose never reaches the log');
+
 expectSame(true, callPrivate('isValidBaseUrl', ['https://ai.example.test/v1']), 'https URL');
 expectSame(true, callPrivate('isValidBaseUrl', ['http://127.0.0.1:8080/v1']), 'internal http URL');
 expectSame(false, callPrivate('isValidBaseUrl', ['file:///tmp/socket']), 'non-http URL');
@@ -0,0 +1,64 @@
+<?php
+
+declare(strict_types=1);
+
+require_once dirname(__DIR__) . '/vendor/autoload.php';
+
+use app\adminapi\logic\tcm\PrescriptionLogic;
+
+function prescriptionAiWriteSafetyExpect(bool $condition, string $message): void
+{
+    if (!$condition) {
+        throw new RuntimeException($message);
+    }
+}
+
+function prescriptionAiWriteSafetySource(string $method): string
+{
+    $reflection = (new ReflectionClass(PrescriptionLogic::class))->getMethod($method);
+    $lines = file($reflection->getFileName());
+    if (!is_array($lines)) {
+        throw new RuntimeException('method source must be readable');
+    }
+
+    return implode('', array_slice(
+        $lines,
+        $reflection->getStartLine() - 1,
+        $reflection->getEndLine() - $reflection->getStartLine() + 1
+    ));
+}
+
+$add = prescriptionAiWriteSafetySource('add');
+$edit = prescriptionAiWriteSafetySource('editLocked');
+
+prescriptionAiWriteSafetyExpect(
+    str_contains($add, 'DiagnosisLogic::canManageDiagnosis'),
+    'prescription creation must enforce diagnosis write scope before loading patient data'
+);
+prescriptionAiWriteSafetyExpect(
+    str_contains($add, "->where('patient_id', \$diagnosisIdRule)"),
+    'client appointment id must be bound to the authorized diagnosis'
+);
+foreach (['patient_id', 'patient_name', 'gender', 'age', 'phone'] as $field) {
+    prescriptionAiWriteSafetyExpect(
+        str_contains($add, "'{$field}' => \$diagnosis !== null"),
+        "{$field} must be derived from the authorized diagnosis"
+    );
+}
+prescriptionAiWriteSafetyExpect(
+    str_contains($add, "'case_record' => \$diagnosis !== null")
+        && str_contains($add, "'doctor_name' => \$doctorName")
+        && !str_contains($add, "'doctor_name' => \$doctorName !== ''"),
+    'case record and doctor identity must come from authoritative server state'
+);
+prescriptionAiWriteSafetyExpect(
+    str_contains($add, "'audit_status' => 0"),
+    'new AI-assisted prescriptions must always enter pending audit'
+);
+prescriptionAiWriteSafetyExpect(
+    str_contains($edit, '共享只扩大只读范围')
+        && str_contains($edit, '处方不允许改绑其他诊单'),
+    'shared prescriptions must stay read-only and edits must not rebind diagnoses'
+);
+
+echo "Prescription AI write safety contract: OK\n";