1127 lines
99 KiB
PHP
1127 lines
99 KiB
PHP
<?php
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declare(strict_types=1);
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require dirname(__DIR__) . '/vendor/autoload.php';
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require __DIR__ . '/fixtures/CompleteTcmCase.php';
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use app\adminapi\logic\tcm\PatientAiReportLogic;
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use app\adminapi\service\AiRequiredSource;
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use app\adminapi\service\TcmClinicalFactStateGuard as Guard;
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use app\adminapi\service\TcmClinicalReportStream;
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$count = 0;
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$guardOnly = in_array('--guard-only', $argv ?? [], true);
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$expect = static function (bool $condition, string $message) use (&$count): void {
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++$count;
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if (!$condition) throw new RuntimeException($message);
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};
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$snapshot = (new ReflectionMethod(PatientAiReportLogic::class, 'buildSourceSnapshotFromRows'))
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->invoke(null, CompleteTcmCase::rows());
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$submission = (new ReflectionMethod(PatientAiReportLogic::class, 'sanitizeSnapshotForUpstream'))
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->invoke(null, AiRequiredSource::submission($snapshot));
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$ledger = Guard::build(CompleteTcmCase::current(), $submission);
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$expect($ledger['version'] === 'clinical-source-state-v2', 'The ledger schema/version is unchanged.');
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$expect($ledger['sources']['s5']['quote'] === '本次询问无已知药物过敏史'
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&& $ledger['sources']['s5']['date'] === '2026-10-23'
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&& $ledger['sources']['s5']['scope'] === 'current', 'The real pure fixture projection proves the s5 quote/date/scope.');
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$expect($ledger['sources']['s2']['quote'] === CompleteTcmCase::current()['present_illness']
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&& $ledger['sources']['s14']['quote'] === CompleteTcmCase::current()['present_illness'],
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'Both original rejection source IDs refer to the unchanged actual fixture history.');
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$check = static function (string $text, bool $valid, string $label, string $code = '', ?array $caseLedger = null) use ($ledger, $expect, $guardOnly): void {
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$targetLedger = $caseLedger ?? $ledger;
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$before = $text;
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$review = Guard::validate($targetLedger, $text);
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$expect($review['valid'] === $valid, $label . ': ' . json_encode($review, JSON_UNESCAPED_UNICODE));
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if ($code !== '') $expect(in_array($code, array_column($review['issues'], 'code'), true), $label . ': expected ' . $code . ': ' . json_encode([$text, $review], JSON_UNESCAPED_UNICODE));
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$expect($text === $before, $label . ': validation preserves the original string.');
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if ($guardOnly) return;
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$raw = preg_match('/(?:\r?\n){2}$/D', $text) ? $text : $text . "\n\n";
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foreach ([1, 2, 7, 31] as $size) {
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$visible = '';
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$stream = new TcmClinicalReportStream($targetLedger, static function (string $delta) use (&$visible): bool {
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$visible .= $delta;
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return true;
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});
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$pushed = true;
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foreach (str_split($raw, $size) as $chunk) if (!$stream->push($chunk)) { $pushed = false; break; }
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$finished = $stream->finish();
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$expect(($pushed && $finished) === $valid && $stream->rejected() === !$valid, $label . ': stream state, chunk ' . $size);
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$expect($visible === ($valid ? $raw : ''), $label . ': exact bytes or zero rejected-unit bytes, chunk ' . $size);
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$expect($stream->acceptedContent() === $visible, $label . ': accepted/visible identity, chunk ' . $size);
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}
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};
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// Portable exact retained units, also compared to the ignored artifact when present.
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$units = [
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"适用前须核实：是否存在感冒、感染或其他急性疾病表现？是否存在舌苔转厚腻、胸脘痞闷等不宜收敛或滋腻的情况？是否另有处方药、保健品或中药同用？\n\n",
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"适用前须核实：是否另用处方药、保健品或中药？“本次询问无已知药物过敏史”（s5）仅代表已知范围，新用药仍须审核过敏及相互作用。\n\n",
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];
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$artifact = dirname(__DIR__, 2) . '/app/artifacts/ai_concurrency/tcm_complete_v43r5_single_openai_20261024_0_openai.rejected.json';
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if (is_file($artifact)) {
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$saved = json_decode((string) file_get_contents($artifact), true, 512, JSON_THROW_ON_ERROR);
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$expect(array_column($saved['rejections'], 'unit') === $units, 'Portable units exactly equal both original retained rejection units.');
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}
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foreach ($units as $i => $unit) $check($unit, true, 'Exact retained unit ' . $i);
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foreach ([
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'是否存在心悸？', '是否有固定刺痛？', '是否另有处方药、保健品或中药同用？',
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'是否另用处方药、保健品或中药？', '是否使用中药？', '有无心悸或固定刺痛？',
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'是否存在舌质红绛、脉滑？', '是否存在不宜运动的情况？',
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'适用前须核实：是否存在心悸?',
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'适用前须复核：是否有固定刺痛？是否存在舌苔厚腻？',
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] as $question) $check($question, true, 'A terminated neutral question owns only its object: ' . $question);
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foreach ([
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['是否存在心悸。', 'NEGATIVE_TO_POSITIVE'],
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['是否有固定刺痛', 'UNKNOWN_TO_POSITIVE'],
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['是否存在舌苔厚腻。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
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['适用前须核实：患者有心悸？', 'NEGATIVE_TO_POSITIVE'],
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['适用前须核实：患者无固定刺痛？', 'UNKNOWN_TO_NEGATIVE'],
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['是否存在患者有心悸？', 'NEGATIVE_TO_POSITIVE'],
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['是否有患者无固定刺痛？', 'UNKNOWN_TO_NEGATIVE'],
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['是否存在感染、无固定刺痛？', 'UNKNOWN_TO_NEGATIVE'],
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['是否存在感染或有心悸？', 'NEGATIVE_TO_POSITIVE'],
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] as [$text, $code]) $check($text, false, 'No absent terminator/header/embedded assertion exemption', $code);
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$assertions = [
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['患者有心悸', 'NEGATIVE_TO_POSITIVE'],
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['患者无固定刺痛', 'UNKNOWN_TO_NEGATIVE'],
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['患者有固定刺痛', 'UNKNOWN_TO_POSITIVE'],
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['心悸未记录', 'NEGATIVE_TO_UNKNOWN'],
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['口干未记录', 'POSITIVE_TO_UNKNOWN'],
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['舌质红绛', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
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['脉滑', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE'],
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['无五心烦热', 'NEGATION_SCOPE_WIDENED'],
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];
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foreach (['，', ',', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
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foreach ($assertions as [$assertion, $code]) {
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$check('适用前须核实：是否存在感染' . $joiner . $assertion . '？', false,
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'An assertion cannot borrow a question mark through ' . $joiner . ': ' . $assertion, $code);
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}
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}
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foreach ([
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['是否存在感染患者有心悸？', 'NEGATIVE_TO_POSITIVE'],
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['是否存在感染并诉称固定刺痛？', 'UNKNOWN_TO_POSITIVE'],
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['是否存在感染并诊见舌质红绛？', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
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['是否存在感染且需复核，心悸未记录？', 'NEGATIVE_TO_UNKNOWN'],
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['是否存在感染且需复核，口干未记录？', 'POSITIVE_TO_UNKNOWN'],
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['患者有心悸，是否存在感染？', 'NEGATIVE_TO_POSITIVE'],
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[rtrim($units[0]) . '患者无固定刺痛。', 'UNKNOWN_TO_NEGATIVE'],
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[rtrim($units[0]) . '心悸未记录。', 'NEGATIVE_TO_UNKNOWN'],
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] as [$text, $code]) $check($text, false, 'Actual assertions before/after/inside question fragments survive', $code);
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$quote = '“本次询问无已知药物过敏史”（s5）';
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foreach (['s9', 's10'] as $id) {
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$sourceQuote = '“' . $ledger['sources'][$id]['quote'] . '”（' . $id . '）';
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$check($sourceQuote . '仅说明既有记录的范围。', true, 'The full-source citation boundary applies to another recorded field: ' . $id);
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$check($sourceQuote . '仅说明既有记录的范围且患者有心悸。', false,
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'Another recorded field cannot lend source scope to an actual assertion: ' . $id, 'NEGATIVE_TO_POSITIVE');
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}
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foreach (['仅代表已知范围', '仅说明既有记录的范围', '新用药仍须复核'] as $comment) {
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$check($quote . $comment . '。', true, 'Source-bound whole quote ends before ordinary commentary.');
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foreach ($assertions as [$assertion, $code]) {
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$check($quote . $comment . '，' . $assertion . '。', false,
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'Quote commentary retains an actual clinical tail: ' . $assertion, $code);
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}
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}
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foreach (['且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
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$check($quote . '仅代表已知范围' . $joiner . '患者有心悸。', false,
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'No commentary/joiner consumes the actual assertion: ' . $joiner, 'NEGATIVE_TO_POSITIVE');
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$check($quote . $joiner . '患者无固定刺痛。', false,
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'A direct post-citation assertion stays separate: ' . $joiner, 'UNKNOWN_TO_NEGATIVE');
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}
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foreach ([
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['“本次询问无已知药物过敏史”（s9）仅代表已知范围。', 'SOURCE_ANNOTATION_INVALID'],
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['“本次询问无已知药物过敏史”（s9、s10）仅代表已知范围。', 'SOURCE_ANNOTATION_INVALID'],
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['“本次询问无已知药物过敏史”（s999）仅代表已知范围。', 'SOURCE_ANNOTATION_INVALID'],
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['“本次询问无已知药物过敏史”（2026-10-22，s5）仅代表已知范围。', 'SOURCE_ANNOTATION_INVALID'],
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['“本次询问无已知药物过敏史”（2026-13-99，s5）仅代表已知范围。', 'SOURCE_ANNOTATION_INVALID'],
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['“本次询问无药物过敏史”（s5）仅代表已知范围。', 'NEGATIVE_NOT_IN_SOURCE'],
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['无药物过敏史。', 'NEGATION_SCOPE_WIDENED'],
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['“无”（s5）药物过敏史。', 'NEGATION_SCOPE_WIDENED'],
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['“本次询问无已知药物过敏史”（s5，患者无固定刺痛）仅代表已知范围。', 'UNKNOWN_TO_NEGATIVE'],
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['患者有心悸，' . $quote . '仅代表已知范围。', 'NEGATIVE_TO_POSITIVE'],
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[$quote . '仅代表已知范围且口干未记录。', 'POSITIVE_TO_UNKNOWN'],
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[$quote . '仅代表已知范围并心悸未记录。', 'NEGATIVE_TO_UNKNOWN'],
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[$quote . '仅代表已知范围舌质红绛。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
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[$quote . '新用药仍须复核舌质红绛。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
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[str_replace('（s5）', '（s9）', rtrim($units[1])), 'SOURCE_ANNOTATION_INVALID'],
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[str_replace('（s5）', '（2026-10-22，s5）', rtrim($units[1])), 'SOURCE_ANNOTATION_INVALID'],
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] as [$text, $code]) $check($text, false, 'A citation boundary requires its own intact source proof', $code);
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// Offset-sensitive source/date proof still works after an earlier inserted boundary.
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$check($quote . '仅代表已知范围；“本次面诊记录：舌质淡红，舌面少津，苔少；无黄腻苔、紫暗或瘀斑。”（2026-10-23，s9）。',
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true, 'Internal boundary insertion precedes quote offsets for every later source.');
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$check($quote . '仅代表已知范围；“本次面诊记录：舌质淡红，舌面少津，苔少；无黄腻苔、紫暗或瘀斑。”（2026-10-22，s9）。',
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false, 'Later source date proof cannot drift after the inserted boundary.', 'SOURCE_ANNOTATION_INVALID');
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// v43r6: source locators carry no clinical polarity; 合并 is a compound, not a list joiner.
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$r6Units = [
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"血：面色少华、脉细可供血虚鉴别（s3、s10），但舌质仅淡红，且头晕、唇甲色泽等资料未记录，现有资料不足以确定血虚；固定刺痛相关情况见s2，血瘀不立。\n\n",
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"适用前须核实：是否存在影响黄芪、防风、白术使用的个体禁忌、近期感染、肝肾功能变化，及与全部在用药、保健品的相互作用？妊娠问题不适用于本例男性；其他合并用药未记录。\n\n",
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];
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$r6Artifact = dirname(__DIR__, 2) . '/app/artifacts/ai_concurrency/tcm_complete_v43r6_single_openai_20261024_0_openai.rejected.json';
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if (is_file($r6Artifact)) {
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$saved = json_decode((string) file_get_contents($r6Artifact), true, 512, JSON_THROW_ON_ERROR);
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$expect(array_column($saved['rejections'], 'unit') === $r6Units, 'Both r6 portable units equal the retained original bytes.');
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}
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foreach ($r6Units as $i => $unit) $check($unit, true, 'Exact retained r6 unit ' . $i);
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foreach ([
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'固定刺痛相关情况见s2。', '口干资料见s2。', '心悸记录参见s2。',
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'固定刺痛、心悸相关情况见s2。', '舌象结果见s9。', '脉象记录见s10。',
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'2026-10-23固定刺痛相关情况见s2。',
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'其他合并用药未记录。', '其他合并用药、保健品未记录。',
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'固定刺痛相关情况见s2，其他合并用药未记录。',
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'是否另有合并用药？',
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] as $text) $check($text, true, 'A proved locator or additional-data gap asserts no new patient finding: ' . $text);
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foreach ([
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['固定刺痛相关情况见s999。', 'SOURCE_ANNOTATION_INVALID'],
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['固定刺痛相关情况见s9。', 'SOURCE_ANNOTATION_INVALID'],
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['固定刺痛、头晕相关情况见s2。', 'SOURCE_ANNOTATION_INVALID'],
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['舌象结果见s10。', 'SOURCE_ANNOTATION_INVALID'],
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['2026-10-22固定刺痛相关情况见s2。', 'SOURCE_ANNOTATION_INVALID'],
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['历史固定刺痛相关情况见s2。', 'SOURCE_ANNOTATION_INVALID'],
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['患者有固定刺痛相关情况见s2。', 'UNKNOWN_TO_POSITIVE'],
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['患者无固定刺痛相关情况见s2。', 'UNKNOWN_TO_NEGATIVE'],
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['诉称固定刺痛相关情况见s2。', 'UNKNOWN_TO_POSITIVE'],
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['固定刺痛相关情况见s2，须复核，心悸未记录。', 'NEGATIVE_TO_UNKNOWN'],
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['固定刺痛相关情况见s2，其他合并用药、口干未记录。', 'POSITIVE_TO_UNKNOWN'],
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['其他合并用药、心悸未记录。', 'NEGATIVE_TO_UNKNOWN'],
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['其他合并用药未记录而舌质红绛。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
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['其他合并用药未记录并诉称固定刺痛。', 'UNKNOWN_TO_POSITIVE'],
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['其他合并用药未记录且合并有心悸。', 'NEGATIVE_TO_POSITIVE'],
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['肾系定位因自述固定刺痛未记录而待定。', 'UNKNOWN_TO_POSITIVE'],
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['肾系定位因自述固定刺痛未记录而仍待定。', 'UNKNOWN_TO_POSITIVE'],
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['二甲双胍未记录。', 'POSITIVE_TO_UNKNOWN'],
|
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['胰岛素未记录。', 'NEGATIVE_TO_UNKNOWN'],
|
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['用药未记录。', 'POSITIVE_TO_UNKNOWN'],
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||
] as [$text, $code]) $check($text, false, 'Reference proof and recorded clinical/medication states stay enforced', $code);
|
||
foreach (['，', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
|
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foreach ($assertions as [$assertion, $code]) {
|
||
$check('固定刺痛相关情况见s2' . $joiner . $assertion . '。', false,
|
||
'A locator cannot swallow a following assertion through ' . $joiner, $code);
|
||
$check('其他合并用药未记录' . $joiner . $assertion . '。', false,
|
||
'The additional-data gap cannot swallow a following assertion through ' . $joiner, $code);
|
||
}
|
||
}
|
||
$recordedAdditional = Guard::build(['id' => 2, 'diagnosis_date' => '2026-10-23',
|
||
'current_medications' => '二甲双胍。现用的其他合并用药为阿卡波糖。未使用胰岛素。']);
|
||
foreach ([['其他合并用药未记录。', 'POSITIVE_TO_UNKNOWN'], ['合并用药未记录。', 'POSITIVE_TO_UNKNOWN'],
|
||
['阿卡波糖未记录。', 'POSITIVE_TO_UNKNOWN'], ['胰岛素未记录。', 'NEGATIVE_TO_UNKNOWN']] as [$text, $code]) {
|
||
$check($text, false, 'Actually recorded additional medication cannot become unknown', $code, $recordedAdditional);
|
||
}
|
||
$compoundFinding = Guard::build(['id' => 3, 'diagnosis_date' => '2026-10-23', 'present_illness' => '本次合并心悸。']);
|
||
$check('心悸未记录。', false, 'The compound correction also retains a recorded non-medication finding', 'POSITIVE_TO_UNKNOWN', $compoundFinding);
|
||
|
||
// v43r8: an anchored pending list and a complete future precondition are operators,
|
||
// rather than new present patient observations. No topic/formula list is consulted.
|
||
$r8Units = [
|
||
'tcm_complete_v43r8_single_openai_20261024_0_openai' => "适用前须核实：是否存在明显五心烦热、潮热盗汗等表现的近期变化；是否存在畏寒肢冷等寒象变化；是否有咽干、干咳、纳差腹胀及长期便溏等补充证据？\n\n",
|
||
'tcm_complete_v43r8_supplement_ooc2_20261024_0_openai' => "适用前须核实：是否另有未记录的处方药、非处方药、保健品或草药；是否存在吞咽困难、胃肠不耐受或近期血糖异常波动；是否有拟用药材或辅料过敏；是否出现感染、脱水或肝肾指标变化。\n\n",
|
||
'tcm_complete_v43r8_supplement_ooc2_20261024_1_openai' => "适用条件：医师复诊确认当前仍以乏力、活动后气短、自汗、口干少津、弱脉为核心，且不存在更需优先处理的感染、心肺事件、脱水或明显血糖失控时，方可考虑该方向。\n\n",
|
||
];
|
||
foreach ($r8Units as $stem => $unit) {
|
||
$artifact = dirname(__DIR__, 2) . '/app/artifacts/ai_concurrency/' . $stem . '.rejected.json';
|
||
if (is_file($artifact)) {
|
||
$saved = json_decode((string) file_get_contents($artifact), true, 512, JSON_THROW_ON_ERROR);
|
||
$expect(array_column($saved['rejections'], 'unit') === [$unit], 'Portable r8 unit equals the exact retained bytes: ' . $stem);
|
||
}
|
||
$check($unit, true, 'Exact r8 pending-question/precondition unit: ' . $stem);
|
||
}
|
||
foreach (['；', ';'] as $separator) foreach (['？', '?', '。', ''] as $ending) {
|
||
$check('适用前须核实：是否存在心悸' . $separator . '是否有固定刺痛' . $separator . '是否出现舌质红绛' . $ending,
|
||
true, 'Only consecutive same-line neutral questions inherit the pending operator.');
|
||
}
|
||
foreach ([
|
||
'适用前须核实：是否存在心悸。',
|
||
'适用前需复核：是否另有未记录的处方药、非处方药。',
|
||
'适用前应确认：是否存在药物不耐受。',
|
||
'是否存在胃肠不耐受？',
|
||
'适用前须核实：是否有未采集的体征；是否可见舌质红绛。',
|
||
'适用条件：医师复诊确认有心悸时，方可考虑该方向。',
|
||
'适用条件：复诊确认存在固定刺痛时，才可评估该方向。',
|
||
'适用条件：医生在复诊时核实无固定刺痛时，方可讨论后续方案。',
|
||
'适用条件：医师复诊确认不存在感染且有口干时，方可考虑该方向。',
|
||
'适用条件：医师复诊确认舌质红绛、脉滑时，方可考虑该方向。',
|
||
'适用条件：医师复诊确认无五心烦热时，方可考虑该方向。',
|
||
'适用条件：医师复诊确认当前仍以固定刺痛为核心时，方可考虑该方向。',
|
||
] as $text) $check($text, true, 'A prospective question/condition does not assert current polarity: ' . $text);
|
||
|
||
foreach ([
|
||
['是否存在心悸；是否有固定刺痛。', 'NEGATIVE_TO_POSITIVE'],
|
||
["适用前须核实：是否有心悸；\n是否存在固定刺痛。", 'UNKNOWN_TO_POSITIVE'],
|
||
['适用前须核实：患者有心悸；是否有固定刺痛。', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用前须核实：是否存在感染不伴固定刺痛。', 'UNKNOWN_TO_NEGATIVE'],
|
||
['适用前须核实：是否存在感染；患者有固定刺痛。', 'UNKNOWN_TO_POSITIVE'],
|
||
['适用前须核实：是否存在感染；目前无固定刺痛。', 'UNKNOWN_TO_NEGATIVE'],
|
||
['适用前须核实：是否存在感染；心悸未记录。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['适用条件：医师复诊确认患者已存在固定刺痛时，方可考虑该方向。', 'UNKNOWN_TO_POSITIVE'],
|
||
['适用条件：医师复诊确认患者已无固定刺痛时，方可考虑该方向。', 'UNKNOWN_TO_NEGATIVE'],
|
||
['适用条件：医师复诊确认目前有心悸时，方可考虑该方向。', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用条件：医师复诊确认当前有心悸时，方可考虑该方向。', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用条件：医师复诊确认本次有心悸时，方可考虑该方向。', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用条件：医师复诊确认目前无五心烦热时，方可考虑该方向。', 'NEGATION_SCOPE_WIDENED'],
|
||
['适用条件：医师复诊确认口干未记录时，方可考虑该方向。', 'POSITIVE_TO_UNKNOWN'],
|
||
['适用条件：医师复诊确认心悸未记录时，方可考虑该方向。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['适用条件：医师复诊确认诊见舌质红绛时，方可考虑该方向。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
['适用条件：医师复诊确认条件满足时，方可考虑患者有心悸。', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用条件：医师复诊确认条件满足时，方可考虑心悸未记录。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['适用条件：医师复诊确认条件满足时，方可考虑舌质红绛。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
['适用条件：医师确认存在固定刺痛时，方可考虑该方向。', 'UNKNOWN_TO_POSITIVE'],
|
||
['适用条件：医师复诊确认有心悸。', 'NEGATIVE_TO_POSITIVE'],
|
||
['患者有固定刺痛，适用条件：医师复诊确认条件满足时，方可考虑该方向。', 'UNKNOWN_TO_POSITIVE'],
|
||
['适用条件：医师复诊确认条件满足时，方可考虑该方向，须复核，心悸未记录。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['适用前须核实：是否存在感染（s999）；是否出现心悸。', 'SOURCE_ANNOTATION_INVALID'],
|
||
['适用条件：医师复诊确认条件满足（s999）时，方可考虑该方向。', 'SOURCE_ANNOTATION_INVALID'],
|
||
] as [$text, $code]) $check($text, false, 'Pending/conditional operators cannot swallow actual assertions or bad proof', $code);
|
||
|
||
$futurePrefix = '适用条件：医师复诊确认存在固定刺痛且无五心烦热时，方可考虑该方向';
|
||
foreach (['，', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check('适用前须核实：是否存在感染' . $joiner . $assertion . '；是否出现心悸。', false,
|
||
'A pending semicolon list retains the assertion before it continues: ' . $joiner, $code);
|
||
$check($futurePrefix . $joiner . $assertion . '。', false,
|
||
'An only-then decision retains the actual following assertion: ' . $joiner, $code);
|
||
}
|
||
}
|
||
|
||
// v43r9: UNKNOWN 的 is attributive only at a bounded nominal-item start.
|
||
$r9Unit = "适用前须核实：是否存在感染、痰多胸闷、腹胀纳差等可能不宜收敛或滋腻的情况；是否有肝肾功能后续变化及其他未记录的药物过敏。\n\n";
|
||
$r9Artifact = dirname(__DIR__, 2) . '/app/artifacts/ai_concurrency/tcm_complete_v43r9_single_openai_20261024_0_openai.rejected.json';
|
||
if (is_file($r9Artifact)) {
|
||
$saved = json_decode((string) file_get_contents($r9Artifact), true, 512, JSON_THROW_ON_ERROR);
|
||
$expect($saved['rejections'][1]['unit'] === $r9Unit, 'The r9 second retained unit is tested without rewriting any byte.');
|
||
}
|
||
$check($r9Unit, true, 'Exact retained r9 nested attributive-question unit.');
|
||
foreach (['尚未记录', '尚未评估', '未曾采集', '未填写', '未询问', '未检查', '未明确',
|
||
'不详', '未知', '不清楚', '待核实', '待补充', '待补采', '待补', '待采集', '待查'] as $state) {
|
||
foreach ([
|
||
$state . '的药物过敏及肝肾功能变化',
|
||
'肝肾功能变化及其他' . $state . '的药物过敏',
|
||
'用药变更或者' . $state . '的其他禁忌',
|
||
'其余' . $state . '的体征以及饮水变化',
|
||
'饮水变化、额外' . $state . '的体征',
|
||
] as $object) $check('适用前须核实：是否有' . $object . '。', true,
|
||
'Attributive record state remains a question across unrelated object/order variants: ' . $state);
|
||
}
|
||
foreach ([
|
||
['药物过敏未记录。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['药物过敏不详。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['药物过敏未知。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['药物过敏不清楚。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['适用前须核实：是否有药物过敏未记录。', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用前须核实：是否有未知的药物过敏未记录。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['是否有未知的药物过敏。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['适用前须核实：是否有肝肾变化及其他未记录的药物过敏；药物过敏未记录。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['适用前须核实：是否有其他未知的禁忌（s999）。', 'SOURCE_ANNOTATION_INVALID'],
|
||
['适用前须核实：是否有其他未记录的资料，患者已存在固定刺痛。', 'UNKNOWN_TO_POSITIVE'],
|
||
['适用前须核实：是否有其他未记录的资料，目前无固定刺痛。', 'UNKNOWN_TO_NEGATIVE'],
|
||
['适用前须核实：是否有其他未记录的资料，本次诊见舌质红绛。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
] as [$text, $code]) $check($text, false, 'An attributive question does not waive postfix erasure or current assertions', $code);
|
||
foreach (['，', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check('适用前须核实：是否有肝肾变化及其他未记录的药物过敏' . $joiner . $assertion . '。', false,
|
||
'A nested attributive modifier cannot consume an actual adjacent assertion: ' . $joiner, $code);
|
||
}
|
||
$check('适用前须核实：是否有未知的药物过敏' . $joiner . '药物过敏未记录。', false,
|
||
'A known allergy record stays known after every assertion joiner: ' . $joiner, 'NEGATIVE_TO_UNKNOWN');
|
||
}
|
||
|
||
// v43r10: inference labels, source-opening/suffix quotes and post-subject questions.
|
||
$r10Units = [
|
||
['tcm_complete_v43r10_supplement_ooc2_20261024_0_openai', 0, "本例支持点：气虚方面见乏力、动则气短、低声、脉细弱无力；津少方面见口干少量频饮、舌少津苔少；卫外不固线索为白天自汗并活动后加重（s1、s2、s3、s9、s10、s29）。\n\n"],
|
||
['tcm_complete_v43r10_supplement_ooc2_20261024_0_openai', 1, "本次询问“无已知药物过敏史”（s5），不等于排除首次反应。治疗期间监测口干、汗出、气短、体力、饮水与尿量变化，并复查空腹及餐后血糖、HbA1c、肝肾功能；异常加重及时就医。\n\n"],
|
||
['tcm_complete_v43r10_supplement_ooc2_20261024_1_openai', 1, "适用前须核实：是否存在甘草、人参类或五味子相关既往不耐受；是否另服处方药、非处方药、保健品或中药；是否存在影响选方的肝肾功能变化；汗出与气短是否出现新的严重程度或诱因。\n\n"],
|
||
];
|
||
foreach ($r10Units as [$stem, $index, $unit]) {
|
||
$artifact = dirname(__DIR__, 2) . '/app/artifacts/ai_concurrency/' . $stem . '.rejected.json';
|
||
if (is_file($artifact)) {
|
||
$saved = json_decode((string) file_get_contents($artifact), true, 512, JSON_THROW_ON_ERROR);
|
||
$expect($saved['rejections'][$index]['unit'] === $unit, 'Exact r10 retained unit: ' . $stem . ':' . $index);
|
||
}
|
||
$check($unit, true, 'Exact r10 grammatical-role unit: ' . $stem . ':' . $index);
|
||
}
|
||
foreach ([
|
||
'卫外不固线索为白天自汗并活动后加重。',
|
||
'津液不足依据为口干少量频饮。',
|
||
'气机不畅证据是乏力。',
|
||
'本次询问“无已知药物过敏史”（s5），不等于排除首次反应。',
|
||
'本次询问“无已知药物过敏史”（2026-10-23，s5），仅代表已知范围。',
|
||
'适用前须核实：是否另服中药；汗出与气短是否出现新的严重程度或诱因。',
|
||
'适用前须核实：固定刺痛是否存在；饮水与尿量是否出现新变化。',
|
||
'汗出与气短是否出现新的严重程度或诱因？',
|
||
'固定刺痛是否存在？',
|
||
] as $text) $check($text, true, 'The bounded role retains the independent clinical claims.');
|
||
foreach ([
|
||
['卫外不固线索为无自汗。', 'POSITIVE_TO_NEGATIVE'],
|
||
['无自汗，津液不足依据为口干。', 'POSITIVE_TO_NEGATIVE'],
|
||
['固定刺痛不足线索为口干。', 'UNKNOWN_TO_POSITIVE'],
|
||
['舌质红绛不润线索为口干。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
['卫外不固线索为患者有固定刺痛。', 'UNKNOWN_TO_POSITIVE'],
|
||
['津液不足依据为患者无固定刺痛。', 'UNKNOWN_TO_NEGATIVE'],
|
||
['津液不足线索为口干未记录。', 'POSITIVE_TO_UNKNOWN'],
|
||
['本次询问“无药物过敏史”（s5），不等于排除首次反应。', 'NEGATIVE_NOT_IN_SOURCE'],
|
||
['本次询问“无已知药物过敏史”（s9），不等于排除首次反应。', 'SOURCE_ANNOTATION_INVALID'],
|
||
['本次询问“无已知药物过敏史”（s999），不等于排除首次反应。', 'SOURCE_ANNOTATION_INVALID'],
|
||
['本次询问“无已知药物过敏史”（2026-10-22，s5），不等于排除首次反应。', 'SOURCE_ANNOTATION_INVALID'],
|
||
['本次询问“无已知药物过敏史”（s5），药物过敏未记录。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['患者有固定刺痛，汗出与气短是否出现新的严重程度或诱因？', 'UNKNOWN_TO_POSITIVE'],
|
||
['适用前须核实：目前舌质红绛是否出现新变化。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
['适用前须核实：患者已无固定刺痛是否出现新变化。', 'UNKNOWN_TO_NEGATIVE'],
|
||
['适用前须核实：诉称固定刺痛是否出现新变化。', 'UNKNOWN_TO_POSITIVE'],
|
||
['汗出与气短是否出现感染。', 'NEGATIVE_TO_POSITIVE'],
|
||
] as [$text, $code]) $check($text, false, 'Inference/quote/question roles cannot hide actual state or bad proof', $code);
|
||
foreach (['，', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check('卫外不固线索为口干' . $joiner . $assertion . '。', false,
|
||
'An inference label does not change an actual clue/tail: ' . $joiner, $code);
|
||
$check('本次询问“无已知药物过敏史”（s5），不等于排除首次反应' . $joiner . $assertion . '。', false,
|
||
'Source-bound quote commentary retains its actual tail: ' . $joiner, $code);
|
||
$check('适用前须核实：汗出与气短是否出现新变化' . $joiner . $assertion . '。', false,
|
||
'Post-subject questions retain their actual tail: ' . $joiner, $code);
|
||
}
|
||
}
|
||
// v43r12: a prospective prepositional object owns its question predicate.
|
||
$r11Unit = "六、中药方药及复核监测\n\n主方方向可考虑生脉散方向，仅供医师复诊辨证后决定，不构成可执行处方，不列新增剂量、频次、疗程、合方或加味。\n\n支持点：气虚证据见s1、s3、s10，津亏证据见s2、s9，自汗另有2026-10-22追踪s29。三组证据与益气、生津、敛汗目标相应，并非依据糖尿病病名选方。\n\n反证与局限：相关限制依据回指s2、s9、s10，不能反向证明本方适用。肺脾定位尚不充分，口渴与血糖波动是否同步、汗量及近期体重变化未记录，故须以复诊主次为准。\n\n适用条件：复诊仍以气虚为主、津亏为兼，且舌脉与本次记录基本一致时，方可考虑。若口渴、汗出或活动耐量变化，或出现新的舌脉资料，应重新辨证。\n\n方义：人参类益气，麦冬类养阴生津，五味子类敛汗生津，共同对应第五节的主次治法；此处仅说明组方结构，不确定药材品种、炮制规格及处方量。\n\n适用前须核实：是否另用处方药、非处方药、保健品或中药？是否对拟用各药材有过敏或不耐受？是否存在影响出汗、口渴及气短判断的疾病或药物因素？\n\n";
|
||
$r11Artifact = dirname(__DIR__, 2) . '/app/artifacts/ai_concurrency/tcm_complete_v43r11_single_openai_20261024_0_openai.rejected.json';
|
||
if (is_file($r11Artifact)) {
|
||
$saved = json_decode((string) file_get_contents($r11Artifact), true, 512, JSON_THROW_ON_ERROR);
|
||
$expect($saved['rejections'][1]['unit'] === $r11Unit, 'The complete r11 second retained unit is tested byte-for-byte.');
|
||
}
|
||
$check($r11Unit, true, 'The exact retained r11 unit no longer asserts a prospective allergy.');
|
||
foreach (['对', '针对', '对于'] as $preposition) {
|
||
foreach (['拟用', '拟选', '拟选用', '拟采用', '拟使用', '待选', '待用', '待选用', '候选', '计划使用', '准备采用'] as $prospective) {
|
||
foreach (['有', '存在', '出现', '可见'] as $predicate) {
|
||
foreach (['过敏或不耐受', '心悸', '固定刺痛', '舌质红绛、脉滑', '不耐受'] as $property) {
|
||
$check('是否' . $preposition . $prospective . '方案' . $predicate . $property . '？', true,
|
||
'Only the bounded prospective operator owns this pending predicate.');
|
||
}
|
||
}
|
||
}
|
||
}
|
||
foreach ([
|
||
'适用前须核实：是否对拟用各药材有过敏或不耐受。',
|
||
'适用前须复核：是否另用中药；是否针对待选材料存在不耐受；是否对准备采用方案有心悸。',
|
||
'是否对于候选材料出现过敏？是否对拟用方案可见固定刺痛？',
|
||
] as $text) $check($text, true, 'A bounded pending context permits neutral prospective objects.');
|
||
foreach ([
|
||
['是否对拟用方案有过敏。', 'NEGATIVE_TO_POSITIVE'],
|
||
['是否针对待选材料有心悸', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用前须核实：是否对已用方案有药物过敏？', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用前须核实：是否对当前方案有心悸？', 'NEGATIVE_TO_POSITIVE'],
|
||
['是否对拟用目前方案有药物过敏？', 'NEGATIVE_TO_POSITIVE'],
|
||
['是否对拟用患者已有心悸的方案有过敏？', 'NEGATIVE_TO_POSITIVE'],
|
||
['是否对拟用诉称固定刺痛的方案有过敏？', 'UNKNOWN_TO_POSITIVE'],
|
||
['是否对拟用药物过敏未记录的方案有心悸？', 'NEGATIVE_TO_UNKNOWN'],
|
||
['是否对拟用方案有药物过敏未记录？', 'NEGATIVE_TO_UNKNOWN'],
|
||
['是否对拟用方案有口干未记录？', 'POSITIVE_TO_UNKNOWN'],
|
||
['是否对拟用方案有患者无固定刺痛？', 'UNKNOWN_TO_NEGATIVE'],
|
||
['是否对拟用方案有过敏或有心悸？', 'NEGATIVE_TO_POSITIVE'],
|
||
['是否对拟用方案有过敏因已出现心悸？', 'NEGATIVE_TO_POSITIVE'],
|
||
['是否对拟用方案有过敏，患者目前已有心悸？', 'NEGATIVE_TO_POSITIVE'],
|
||
['是否对拟用方案有过敏，已诊见舌质红绛？', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
['是否对拟用方案有不伴心悸？', 'NEGATION_SCOPE_WIDENED'],
|
||
['是否对拟用方案无固定刺痛？', 'UNKNOWN_TO_NEGATIVE'],
|
||
['是否对拟用方案有无五心烦热？', 'NEGATION_SCOPE_WIDENED'],
|
||
['是否对拟用方案有过敏（s999）？', 'SOURCE_ANNOTATION_INVALID'],
|
||
['是否对拟用方案有过敏（2026-10-22，s5）？', 'SOURCE_ANNOTATION_INVALID'],
|
||
['对拟用方案有药物过敏。', 'NEGATIVE_TO_POSITIVE'],
|
||
['患者目前对拟用方案有药物过敏。', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用前须核实：是否对拟用方案有过敏？药物过敏未记录。', 'NEGATIVE_TO_UNKNOWN'],
|
||
] as [$text, $code]) $check($text, false, 'Prospective objects do not waive observations, erasure, qualifier or proof errors.', $code);
|
||
foreach (['，', ',', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
foreach (['是否对拟用方案有过敏或不耐受', '适用前须核实：是否针对待选材料存在不耐受'] as $question) {
|
||
$check($question . $joiner . $assertion . '？', false,
|
||
'A prospective object cannot absorb a joined actual assertion: ' . $joiner, $code);
|
||
}
|
||
}
|
||
}
|
||
// v43r13: a neutral post-subject question can lead into a bounded contingency.
|
||
$r12Tail = "适用前须核实：汗出是否伴胸部不适、心悸、晕厥、持续喘促或意识改变；如有，应优先按急症路径评估。\n\n";
|
||
$r12Unit = "六、中药方药及复核监测\n\n主方方向：可由医师评估生脉散方向。原文“动则气短、自汗、口干”（s1）对应益气、生津、敛汗三项目标；细弱无力脉及舌面少津（s9、s10）进一步支持该方向，优先次序与第五节一致。\n\n方义：方中益气部分着重改善神疲、活动耐量及气短；养津部分针对口干、少量频饮和舌面少津；敛汗部分针对自汗、活动后加重。其作用覆盖当前核心目标，但不能据方义反推本例已成立阴虚或肺脾气虚。\n\n反证与局限：寒热未定，脏腑定位仅偏肺；汗出程度缺少客观量化，口干也可能受血糖影响。相关阴性限制见s2、s9、s10，但只能缩小鉴别，不能证明本方必然适用。若复核出现新的实邪、湿热或急性代谢异常证据，应重新辨证，而非机械使用。\n\n适用条件：复诊四诊仍以气虚表现为主，口干少津持续，且出汗、气短不能由低血糖、感染、心肺事件或其他急症解释；服药后能够监测血糖、汗出、口渴、活动耐量及胃肠反应。条件未满足前不得形成可直接执行处方。\n\n适用前须核实：是否存在近期体重明显变化、进食减少、低血糖样发作或血糖剧烈波动？\n\n适用前须核实：是否另用保健品、中草药或其他处方药，以及是否曾对拟用方中成分发生不良反应？\n\n" . $r12Tail;
|
||
$r12Artifact = dirname(__DIR__, 2) . '/app/artifacts/ai_concurrency/tcm_complete_v43r12_supplement_ooc2_20261024_0_openai.rejected.json';
|
||
if (is_file($r12Artifact)) {
|
||
$saved = json_decode((string) file_get_contents($r12Artifact), true, 512, JSON_THROW_ON_ERROR);
|
||
$expect($saved['rejections'][0]['unit'] === $r12Unit, 'The exact complete r12 first retained unit is unchanged.');
|
||
}
|
||
$check($r12Unit, true, 'The entire retained r12 unit passes Guard without rewriting.');
|
||
$check($r12Tail, true, 'The isolated actual post-subject question and contingency are prospective.');
|
||
foreach (['汗出', '口渴', '固定刺痛'] as $subject) {
|
||
foreach (['伴', '伴有'] as $predicate) {
|
||
foreach (['心悸', '固定刺痛', '舌质红绛、脉滑'] as $object) {
|
||
foreach (['；', ';', '？'] as $separator) {
|
||
foreach (['如有', '若有', '如果有'] as $contingency) {
|
||
foreach (['应优先评估', '请及时按应急路径评估'] as $action) {
|
||
$check('适用前须核实：' . $subject . '是否' . $predicate . $object . $separator
|
||
. $contingency . '，' . $action . '。', true,
|
||
'A neutral question and immediate conditional action assert no patient finding.');
|
||
}
|
||
}
|
||
}
|
||
}
|
||
}
|
||
}
|
||
foreach ([
|
||
['汗出是否伴心悸。', 'NEGATIVE_TO_POSITIVE'],
|
||
['汗出是否伴固定刺痛；如有，应优先评估。', 'UNKNOWN_TO_POSITIVE'],
|
||
['适用前须核实：患者现有心悸是否伴固定刺痛；如有，应评估。', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用前须核实：已确定心悸是否伴固定刺痛；如有，应评估。', 'UNKNOWN_TO_POSITIVE'],
|
||
['适用前须核实：已确定有心悸是否伴固定刺痛；如有，应评估。', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用前须核实：完成检查舌质红绛是否伴心悸；如有，应评估。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
['适用前须核实：目前舌质红绛是否伴心悸；如有，应评估。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
['适用前须核实：诉称固定刺痛是否伴心悸；如有，应评估。', 'UNKNOWN_TO_POSITIVE'],
|
||
['适用前须核实：汗出是否伴患者有心悸；如有，应评估。', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用前须核实：汗出是否伴口干未记录；如有，应评估。', 'POSITIVE_TO_UNKNOWN'],
|
||
['适用前须核实：汗出是否伴心悸未记录；如有，应评估。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['适用前须核实：汗出是否伴药物过敏未记录；如有，应评估。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['适用前须核实：汗出是否伴舌象未记录；如有，应评估。', 'RECORDED_TO_UNKNOWN'],
|
||
['适用前须核实：汗出是否伴无五心烦热；如有，应评估。', 'NEGATION_SCOPE_WIDENED'],
|
||
['适用前须核实：汗出是否伴心悸（s999）；如有，应评估。', 'SOURCE_ANNOTATION_INVALID'],
|
||
['适用前须核实：汗出是否伴心悸（2026-10-22，s5）；如有，应评估。', 'SOURCE_ANNOTATION_INVALID'],
|
||
['适用前须核实：汗出是否伴心悸；如有，现有心悸。', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用前须核实：汗出是否伴心悸；如有，应评估，患者有固定刺痛。', 'UNKNOWN_TO_POSITIVE'],
|
||
['适用前须核实：汗出是否伴心悸？若有，应评估且患者无固定刺痛。', 'UNKNOWN_TO_NEGATIVE'],
|
||
['适用前须核实：汗出是否伴心悸；如果有，应复核，心悸未记录。', 'NEGATIVE_TO_UNKNOWN'],
|
||
] as [$text, $code]) $check($text, false, 'Question/contingency roles cannot hide actual or erased facts.', $code);
|
||
foreach (['，', ',', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
foreach (['如有', '若有', '如果有'] as $contingency) {
|
||
$check('适用前须核实：汗出是否伴心悸；' . $contingency . '，应优先评估'
|
||
. $joiner . $assertion . '。', false,
|
||
'A conditional action cannot lend its modal role to an actual tail: ' . $joiner, $code);
|
||
$check('适用前须核实：汗出是否伴心悸；' . $contingency
|
||
. $joiner . $assertion . '。', false,
|
||
'A contingency operator cannot absorb its actual adjoining assertion: ' . $joiner, $code);
|
||
}
|
||
$check('适用前须核实：汗出是否伴心悸' . $joiner . $assertion . '；如有，应评估。', false,
|
||
'A post-subject question retains its actual adjoining assertion: ' . $joiner, $code);
|
||
}
|
||
}
|
||
// r13 integration regression: occurrence questions and their own linked inquiry.
|
||
$r30Portable = "适用前须核实：复核自汗与气短是否持续呈活动后加重，有无新发感染、胸闷胸痛、心悸、晕厥或气促加剧；补采完整饮水量、尿量、体重变化、腹诊及腰膝耳鸣等资料。若出现急性发热、明显实热、痰湿壅盛或其他实邪表现，应重新辨证，不能机械沿用本方向。\n\n";
|
||
$r30Artifact = dirname(__DIR__, 2) . '/app/artifacts/ai_concurrency/tcm_complete_v30_isolated_c4_20261023_3_openai.rejected.json';
|
||
if (is_file($r30Artifact)) {
|
||
$saved = json_decode((string) file_get_contents($r30Artifact), true, 512, JSON_THROW_ON_ERROR);
|
||
$expect($saved['rejections'][0]['unit'] === $r30Portable, 'The portable v30 regression reproduces its entire retained unit exactly.');
|
||
}
|
||
$check($r30Portable, true, 'The original complete v30 review role remains accepted.');
|
||
foreach (['汗出', '口干', '固定刺痛'] as $subject) {
|
||
foreach (['持续', '反复发作', '持续呈活动后加重', '加重', '缓解', '减轻', '复发', '发病', '发生', '持续3个月'] as $predicate) {
|
||
foreach (['有无心悸或固定刺痛', '是否伴心悸', '是否存在舌质红绛、脉滑'] as $linked) {
|
||
$check('适用前须核实：复核' . $subject . '是否' . $predicate . '，' . $linked . '。', true,
|
||
'Whether governs its occurrence predicate and each linked question has its own operator.');
|
||
}
|
||
}
|
||
}
|
||
$occurrenceReview = '适用前须核实：复核自汗与气短是否持续呈活动后加重，有无新发感染、心悸或气促加剧';
|
||
foreach ([
|
||
['适用前须核实：患者有心悸是否持续，有无固定刺痛。', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用前须核实：目前舌质红绛是否加重，有无心悸。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
['适用前须核实：已完成诊见舌质红绛是否加重，有无心悸。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
['适用前须核实：诉称固定刺痛是否持续，有无心悸。', 'UNKNOWN_TO_POSITIVE'],
|
||
['适用前须核实：汗出是否口干未记录，有无心悸。', 'POSITIVE_TO_UNKNOWN'],
|
||
['适用前须核实：汗出是否心悸未记录，有无固定刺痛。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['适用前须核实：汗出是否无五心烦热，有无心悸。', 'NEGATION_SCOPE_WIDENED'],
|
||
['适用前须核实：汗出是否持续，有心悸，有无固定刺痛。', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用前须核实：汗出是否持续，口干未记录，有无固定刺痛。', 'POSITIVE_TO_UNKNOWN'],
|
||
['适用前须核实：汗出是否持续，是否口干未记录。', 'POSITIVE_TO_UNKNOWN'],
|
||
['适用前须核实：汗出是否持续，是否心悸未记录。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['适用前须核实：汗出是否持续，有无口干未记录。', 'POSITIVE_TO_NEGATIVE'],
|
||
['适用前须核实：汗出是否持续，有无心悸未记录。', 'NEGATION_SCOPE_WIDENED'],
|
||
['适用前须核实：汗出是否持续，是否舌象未记录。', 'RECORDED_TO_UNKNOWN'],
|
||
['适用前须核实：汗出是否持续，无五心烦热，有无固定刺痛。', 'NEGATION_SCOPE_WIDENED'],
|
||
['适用前须核实：汗出是否持续，有无心悸（s999）。', 'SOURCE_ANNOTATION_INVALID'],
|
||
['适用前须核实：汗出是否持续，有无心悸（2026-10-22，s5）。', 'SOURCE_ANNOTATION_INVALID'],
|
||
] as [$text, $code]) $check($text, false, 'An occurrence query and linked inquiry cannot hide a finding, erasure or invalid proof.', $code);
|
||
foreach (['，', ',', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check($occurrenceReview . $joiner . $assertion . '。', false,
|
||
'Linked questions retain their actual or erased tail: ' . $joiner, $code);
|
||
$check('适用前须核实：复核汗出是否持续呈活动后加重' . $joiner . $assertion . '，有无心悸。', false,
|
||
'An assertion between independent questions stays checked: ' . $joiner, $code);
|
||
}
|
||
}
|
||
// r14: polarity entailment retains degree scope; prospective risk roles stay local.
|
||
$r14Units = [
|
||
['tcm_complete_v43r13_single_openai_20261024_0_openai', 0, "表里：症状逐渐出现且已持续3个月，并涉及汗出、饮水、二便等整体功能变化（s1、s2），倾向里证。表证所需的独立阳性证据不足，现有资料不足以确定表里兼夹。\n\n"],
|
||
['tcm_complete_v43r13_supplement_ooc2_20261024_1_openai', 0, "表里：病程3个月、症状逐渐出现，并涉及汗出、口渴、二便等内在功能表现（s1、s2），结合细弱无力脉（s10），偏里证；表证阳性依据不足，阴性限制见s2、s10。\n\n"],
|
||
['tcm_complete_v43r13_supplement_ooc2_20261024_1_openai', 1, "表里：症状持续3个月且逐渐出现，口干、汗出及二便改变均属内在功能失调（s1、s2），故偏里；表证所需的本次阳性证据不足，首节相关阴性仅用于限制判断。\n\n"],
|
||
['tcm_complete_v43r13_openai_deadline_20261024_openai_next_full90_openai', 0, "六、中药方药及复核监测\n\n主方方向限一个：生脉散方向，仅供医师在补齐安全条件后辨证复核，不构成可直接执行处方。本例同时存在气虚、津少与自汗证据（s1—s3、s9、s10），其益气、生津、敛汗三项方义可分别对应第五节目标，且以益气、生津为主，敛汗为辅。\n\n方义复核：人参类承担补气，针对神疲、动则气短、低声、脉弱；麦冬类侧重养津，对应口干、少量频饮、舌面少津；五味子类取收敛之意，对应白天自汗及活动后加重。这里只说明方义，不新增剂量、频次、疗程或加味。\n\n反证与局限：寒热总纲未定，阴虚尚未确立，故不能把本方向解释为治疗阴虚火旺；肺脏定位仅为倾向，亦不能据方名反向确认肺气虚。食欲一般且大便稍干（s2），消化耐受性仍需观察。\n\n适用条件：复诊时气虚、津少和自汗仍同时存在，且口干并非短期脱水、急性高血糖或其他可纠正因素所致；若症状性质改变、出现急性病情或辨证转实，应重新评估，不沿用本方向。\n\n适用前须核实：是否存在未记录的中药、保健品或其他处方药使用？\n\n"],
|
||
['tcm_complete_v43r13_openai_deadline_20261024_openai_next_full90_openai', 1, "六、中药方药及复核监测\n\n主方方向限一个：生脉散方向。本例气虚、津少、自汗证据并存（s1—s3、s9、s10），其益气、生津、敛汗方义依次对应第五节目标，不作气阴两虚或肺气虚的反向确诊。\n\n方义上，补气针对神疲、动则气短、语声低微及脉弱；养津针对口干少量频饮、舌面少津；收敛仅对应白天及活动后自汗。不得据此自行确定药味、剂量、频次或疗程。\n\n反证与局限：寒热、阴阳及脏腑定位尚未充分确定，不能将本方向解释为滋阴清热或温阳；全天饮水量、口干昼夜差异及汗出量未记录。若核心表现复诊时不再并存，应撤回该方向并重新辨证。\n\n适用前须核实：是否存在未记录的其他处方药、保健品或近期中药暴露？\n\n适用前须核实：是否存在吞咽困难、胃肠耐受问题，或拟用具体药物的既往不良反应？\n\n当前用药原文为2026-10-23“二甲双胍0.5g，每日2次，既有医嘱；未使用胰岛素或中药。”（s6）；不得擅停换。既有过敏询问见s5，拟用中药仍须逐味核实。\n\n"],
|
||
];
|
||
foreach ($r14Units as [$stem, $index, $unit]) {
|
||
$path = dirname(__DIR__, 2) . '/app/artifacts/ai_concurrency/' . $stem . '.rejected.json';
|
||
if (is_file($path)) {
|
||
$saved = json_decode((string) file_get_contents($path), true, 512, JSON_THROW_ON_ERROR);
|
||
$expect($saved['rejections'][$index]['unit'] === $unit, 'Exact r14 retained whole unit: ' . $stem . ':' . $index);
|
||
}
|
||
$check($unit, true, 'The whole retained r14 unit preserves source and grammatical roles.');
|
||
}
|
||
foreach ([['明显', '腹胀', true], ['剧烈', '腹痛', true], ['大量', '皮疹', true],
|
||
['频繁', '心悸', true], ['持续', '咳嗽', true], ['淋漓', '汗出', false], ['严重', '腹泻', false]] as [$degree, $finding, $prefix]) {
|
||
$qualifiedFinding = $prefix ? $degree . $finding : $finding . $degree;
|
||
$qualifiedLedger = Guard::build(['diagnosis_date' => '2026-10-23', 'present_illness' => '无' . $qualifiedFinding . '；未记录固定刺痛。']);
|
||
$broadLedger = Guard::build(['diagnosis_date' => '2026-10-23', 'present_illness' => '无' . $finding . '；未记录固定刺痛。']);
|
||
$check('患者有' . $finding . '。', true, 'Qualified absence does not deny every degree of the broader finding.', '', $qualifiedLedger);
|
||
$check('患者有' . $qualifiedFinding . '。', false, 'The complete qualified absence remains binding.', 'NEGATIVE_TO_POSITIVE', $qualifiedLedger);
|
||
$check('患者有' . $qualifiedFinding . '。', false, 'A broad negative still forbids a specific qualified positive.', 'NEGATIVE_TO_POSITIVE', $broadLedger);
|
||
$check('无' . $finding . '。', false, 'Degree removal from a patient negative still widens scope.', 'NEGATION_SCOPE_WIDENED', $qualifiedLedger);
|
||
$check('患者有固定刺痛。', false, 'Unknown observations are independent of degree entailment.', 'UNKNOWN_TO_POSITIVE', $qualifiedLedger);
|
||
}
|
||
$compoundNegative = Guard::build(['diagnosis_date' => '2026-10-23', 'present_illness' => '无胸痛心悸、咳嗽咯痰。']);
|
||
foreach (['胸痛', '心悸', '咳嗽', '咯痰'] as $finding) $check('患者有' . $finding . '。', false,
|
||
'A compound component is not a removable degree modifier.', 'NEGATIVE_TO_POSITIVE', $compoundNegative);
|
||
foreach (['未记录', '尚未采集', '未提供', '待核实', '不详', '未知'] as $gap) {
|
||
foreach (['中药、保健品或其他处方药', '设备或外用制剂'] as $target) {
|
||
foreach (['使用', '服用', '应用', '启用'] as $action) {
|
||
foreach (['', '情况', '记录', '史'] as $noun) $check('适用前须核实：是否存在' . $gap . '的' . $target . $action . $noun . '？',
|
||
true, 'A record-gap adjective and nominal action remain a pending inquiry.');
|
||
}
|
||
}
|
||
}
|
||
foreach (['拟用', '待选', '计划使用', '准备采用'] as $planned) {
|
||
foreach (['逐项核实', '逐味复核', '进一步审核'] as $review) {
|
||
$check('既有过敏询问见s5，' . $planned . '方案仍须' . $review . '。', true,
|
||
'A postfix prospective review action does not inherit prior presence.');
|
||
foreach ($assertions as [$assertion, $code]) $check('既有过敏询问见s5，' . $planned . '方案仍须' . $review . '且' . $assertion . '。', false,
|
||
'Prospective review owns only its target, retaining the actual tail.', $code);
|
||
}
|
||
}
|
||
foreach ([
|
||
['患者有汗出淋漓。', 'NEGATIVE_TO_POSITIVE'],
|
||
['患者有心悸。', 'NEGATIVE_TO_POSITIVE'],
|
||
['舌质紫暗。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
['舌苔黄腻。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
['舌苔少而非腻。', 'NEGATION_SCOPE_WIDENED'],
|
||
['无五心烦热。', 'NEGATION_SCOPE_WIDENED'],
|
||
['适用前须核实：是否存在未记录的患者使用中药？', 'NEGATIVE_TO_POSITIVE'],
|
||
['适用前须核实：是否存在未记录的中药已使用？', 'NEGATIVE_TO_POSITIVE'],
|
||
['中药未记录。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['二甲双胍0.5g未记录。', 'POSITIVE_TO_UNKNOWN'],
|
||
['适用前须核实：是否存在未记录的中药使用；患者使用中药。', 'NEGATIVE_TO_POSITIVE'],
|
||
['既有过敏询问见s5，拟用正在使用中药仍须逐味核实。', 'NEGATIVE_TO_POSITIVE'],
|
||
['既有过敏询问见s5，拟用方案已确认患者有心悸。', 'NEGATIVE_TO_POSITIVE'],
|
||
] as [$text, $code]) $check($text, false, 'Degree/query/review handling retains actual violations.', $code);
|
||
foreach (['，', ',', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check('适用前须核实：是否存在未记录的中药使用' . $joiner . $assertion . '？', false,
|
||
'The nominal action query retains its actual adjoining assertion.', $code);
|
||
$check('既有过敏询问见s5，拟用中药仍须逐味核实' . $joiner . $assertion . '。', false,
|
||
'The prospective postfix action retains its actual adjoining assertion.', $code);
|
||
}
|
||
}
|
||
$medicationReference = '当前用药原文为2026-10-23“' . $ledger['sources']['s6']['quote'] . '”（s6）；不得擅停换。既有过敏询问见s5，拟用中药仍须逐味核实。';
|
||
$check($medicationReference, true, 'The exact known medication baseline remains explicit beside the pending action.');
|
||
$check(str_replace('（s6）', '（s999）', $medicationReference), false,
|
||
'A future action cannot repair an invalid baseline citation.', 'SOURCE_ANNOTATION_INVALID');
|
||
$check(str_replace('（s6）', '（2026-10-22，s6）', $medicationReference), false,
|
||
'A future action cannot repair the wrong baseline date.', 'SOURCE_ANNOTATION_INVALID');
|
||
// r14 medication aliases: complete field references use source provenance.
|
||
$medicationAliasMinimal = Guard::build(['id' => 1, 'diagnosis_date' => '2026-10-23',
|
||
'current_medications' => '甲药1g，每日2次；未使用乙药。']);
|
||
$medicationAliases = ['用药', '现用药', '在用药', '当前用药', '目前用药', '本次用药', '现用药物', '在用药物',
|
||
'用药情况', '用药记录', '用药信息', '现用药情况', '当前用药情况', '目前用药情况', '用药史', '药物使用史'];
|
||
foreach ($medicationAliases as $alias) {
|
||
foreach (['未记录', '未采集', '不详'] as $gap) {
|
||
foreach (['', '拟用中药仍须逐味核实，', '既有过敏询问见s5，拟用中药仍须逐味核实，'] as $prefix) {
|
||
$check($prefix . $alias . $gap . '。', false, 'A complete known medication field cannot be erased through an alias.', 'RECORDED_TO_UNKNOWN');
|
||
}
|
||
$check($alias . $gap . '。', false, 'A minimal medication field needs no unrelated source topic to retain its state.',
|
||
'RECORDED_TO_UNKNOWN', $medicationAliasMinimal);
|
||
}
|
||
}
|
||
foreach (['现用药剂量未记录。', '当前用药频次未采集。', '用药起始日期未记录。', '首次用药时间未记录。',
|
||
'既往用药不良反应史未采集。', '其他合并用药未记录。', '额外用药未记录。', '拟用中药剂量未记录。'] as $specific) {
|
||
$check($specific, true, 'A specific uncollected medication detail is not a whole-field alias.');
|
||
$check('拟用中药仍须逐味核实，' . $specific, true, 'A planned-review prefix retains a genuine specific data gap.');
|
||
}
|
||
foreach ([null, '', '无', '未记录'] as $missing) {
|
||
$missingMedication = Guard::build(['diagnosis_date' => '2026-10-23', 'current_medications' => $missing]);
|
||
foreach ($medicationAliases as $alias) {
|
||
$check($alias . '未记录。', true, 'Missing medication fields remain unknown.', '', $missingMedication);
|
||
$check('拟用中药仍须逐味核实，' . $alias . '未记录。', true, 'Pending review does not fill an unknown medication field.', '', $missingMedication);
|
||
foreach ([$alias . '：无。', '无' . $alias . '。', '拟用中药仍须逐味核实，' . $alias . '：无。'] as $denial) {
|
||
$check($denial, false, 'An unknown medication alias cannot become a patient denial.', 'UNKNOWN_TO_NEGATIVE', $missingMedication);
|
||
}
|
||
}
|
||
$check('当前用药：甲药。', false, 'A missing field cannot acquire an invented active drug.', 'UNKNOWN_TO_POSITIVE', $missingMedication);
|
||
$check("现用药：\n\n未记录。", true, 'An unknown medication field stays unknown across a heading boundary.', '', $missingMedication);
|
||
foreach (['，', '且', '但', '并', '同时'] as $joiner) {
|
||
$check('无现用药' . $joiner . '另有资料。', false,
|
||
'An adjacent statement cannot hide an unknown whole-field denial.', 'UNKNOWN_TO_NEGATIVE', $missingMedication);
|
||
}
|
||
}
|
||
$oldMedicationRows = ['required_content' => [['key' => 'prescriptions', 'value' => [['id' => 9,
|
||
'prescription_date' => '2020-05-02', 'prescription_name' => '旧方甲', 'usage_instruction' => '已停用']]]]];
|
||
$oldOnlyMedication = Guard::build(['id' => 1, 'diagnosis_date' => '2026-10-23'], $oldMedicationRows);
|
||
$mixedMedication = Guard::build(['id' => 1, 'diagnosis_date' => '2026-10-23', 'current_medications' => '甲药1g；未使用乙药。'], $oldMedicationRows);
|
||
$check('现用药未记录。', true, 'An old prescription does not create a known current medication field.', '', $oldOnlyMedication);
|
||
$check('当前用药：无。', false, 'An old prescription cannot turn missing current medications into a denial.', 'UNKNOWN_TO_NEGATIVE', $oldOnlyMedication);
|
||
$check('用药史未记录。', false, 'An unqualified whole medication history cannot erase a known old record.', 'RECORDED_TO_UNKNOWN', $oldOnlyMedication);
|
||
$check('2019年既往用药史未记录。', true, 'A specific uncollected historical period is distinct from a known later record.', '', $oldOnlyMedication);
|
||
$check('既往用药史未采集。', true, 'A current medication field alone does not fill specific historical collection.', '', $medicationAliasMinimal);
|
||
$check('现用药未记录。', false, 'Historical material cannot erase the known current medication field.', 'RECORDED_TO_UNKNOWN', $mixedMedication);
|
||
$check('现用药未记录（2020-05-02，s2）。', false, 'An old citation cannot change an explicitly current field reference.', 'RECORDED_TO_UNKNOWN', $mixedMedication);
|
||
$check('现用药：无。', false, 'A recorded active medication field cannot become a blanket denial.', 'POSITIVE_TO_NEGATIVE', $medicationAliasMinimal);
|
||
$partialNegativeMedication = Guard::build(['diagnosis_date' => '2026-10-23', 'current_medications' => '未使用乙药。']);
|
||
$wholeNegativeMedication = Guard::build(['diagnosis_date' => '2026-10-23', 'current_medications' => '未使用任何药物。']);
|
||
$check('现用药：无。', false, 'Non-use of one item cannot establish an empty whole medication field.', 'NEGATION_SCOPE_WIDENED', $partialNegativeMedication);
|
||
$check('现用药：无。', true, 'An explicit whole-current-field denial retains its original negative meaning.', '', $wholeNegativeMedication);
|
||
$check('用药史：无。', false, 'Current non-use does not establish a whole lifetime medication-history denial.', 'NEGATION_SCOPE_WIDENED', $wholeNegativeMedication);
|
||
foreach (['，', ',', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check('现用药剂量未记录' . $joiner . $assertion . '。', false,
|
||
'A specific data gap does not exempt adjacent actual assertions.', $code);
|
||
$check('拟用中药仍须逐味核实' . $joiner . '现用药未记录。', false,
|
||
'An action joiner cannot exempt whole-field medication erasure.', 'RECORDED_TO_UNKNOWN');
|
||
}
|
||
}
|
||
if (!$guardOnly) {
|
||
foreach ([$ledger, $medicationAliasMinimal, $oldOnlyMedication] as $caseIndex => $caseLedger) {
|
||
foreach ([1, 2, 7, 31] as $size) {
|
||
$header = "现用药：\n\n";
|
||
$tail = ($caseIndex < 2 ? '未记录' : '无') . "。\n\n";
|
||
$visible = '';
|
||
$stream = new TcmClinicalReportStream($caseLedger, static function (string $delta) use (&$visible): bool { $visible .= $delta; return true; });
|
||
$pushed = true;
|
||
foreach (str_split($header . $tail, $size) as $chunk) if (!$stream->push($chunk)) { $pushed = false; break; }
|
||
$expect(!$pushed && $stream->rejected(), 'A carried medication field rejects the invalid value, chunk ' . $size);
|
||
$expect($visible === $header && $stream->acceptedContent() === $header,
|
||
'The accepted heading is exact and zero rejected value bytes become visible, chunk ' . $size);
|
||
}
|
||
}
|
||
}
|
||
// Medication note provenance: a same-time explicit field value is still a source.
|
||
$noteMedicationData = ['id' => 900000044, 'diagnosis_date' => strtotime('2026-10-23'),
|
||
'current_medications' => null, 'remark' => '当前用药：使用甲药。'];
|
||
$noteMedication = Guard::build($noteMedicationData);
|
||
$expect($noteMedication['sources']['s1']['quote'] === $noteMedicationData['remark']
|
||
&& $noteMedication['sources']['s1']['path'] === 'current.remark'
|
||
&& $noteMedication['sources']['s1']['scope'] === 'current'
|
||
&& $noteMedication['sources']['s1']['date'] === '2026-10-23', 'The exact root reproduction retains its original source ID/quote/scope/date.');
|
||
$check('当前用药：使用甲药。', true, 'Exact root reproduction: an explicit same-time remark remains valid.', '', $noteMedication);
|
||
foreach (['remark', 'doctor_advice', 'present_illness'] as $noteField) {
|
||
foreach (['使用甲药', '服用甲药', '甲药1g'] as $value) {
|
||
$case = Guard::build(['id' => 1, 'diagnosis_date' => '2026-10-23', 'current_medications' => null,
|
||
$noteField => '当前用药：' . $value . '，每日2次。']);
|
||
$check('当前用药：' . $value . '。', true, 'An explicit actual field value can occur in another submitted source.', '', $case);
|
||
foreach (['现用药未记录。', '当前用药未记录。', '用药史未记录。'] as $erasure) $check($erasure, false,
|
||
'A known labelled note cannot be erased by another whole-field alias.', 'RECORDED_TO_UNKNOWN', $case);
|
||
}
|
||
}
|
||
$negativeMedicationNote = Guard::build(array_replace($noteMedicationData, ['remark' => '当前用药：未使用乙药。']));
|
||
$emptyMedicationNote = Guard::build(array_replace($noteMedicationData, ['remark' => '当前用药：无。']));
|
||
$check('当前用药：未使用乙药。', true, 'A bounded negative note value keeps its exact original meaning.', '', $negativeMedicationNote);
|
||
$check('当前用药：使用乙药。', false, 'Explicit non-use in a labelled note still forbids use of that item.', 'NEGATIVE_TO_POSITIVE', $negativeMedicationNote);
|
||
$check('当前用药：无。', false, 'A partial non-use note cannot establish a blanket denial.', 'NEGATION_SCOPE_WIDENED', $negativeMedicationNote);
|
||
$check('现用药：无。', true, 'A labelled whole-field negative is an actual negative source.', '', $emptyMedicationNote);
|
||
$check('当前用药未记录。', false, 'A labelled negative cannot become missing information.', 'RECORDED_TO_UNKNOWN', $emptyMedicationNote);
|
||
foreach (['当前用药：未记录。', '当前用药：不详。', '当前用药：暂无。',
|
||
'当前用药：未记录，患者有心悸。', '当前用药：未记录；患者有心悸。',
|
||
'当前用药：未记录。使用甲药。', "当前用药：\n患者有心悸。", '当前用药：需核实甲药。',
|
||
'当前用药：拟用甲药。', '当前用药：医生建议使用甲药。', '当前用药：可考虑使用甲药。',
|
||
'医师建议复核当前用药。使用甲药。', '当前用药相关问题待核实。神疲口干。'] as $unknownNote) {
|
||
$case = Guard::build(array_replace($noteMedicationData, ['remark' => $unknownNote]));
|
||
$check('当前用药：使用甲药。', false, 'A missing/plan/mention/unrelated note does not establish an active medication field.', 'UNKNOWN_TO_POSITIVE', $case);
|
||
$check('现用药未记录。', true, 'A label without an actual value remains unknown.', '', $case);
|
||
$check('当前用药未记录。', true, 'A metadata heading is not a phantom positive medication fact.', '', $case);
|
||
$check('当前用药：无。', false, 'Unknown note labels cannot become observed medication absence.', 'UNKNOWN_TO_NEGATIVE', $case);
|
||
}
|
||
foreach (['当前用药：既往使用甲药。', '当前用药：2026-10-22使用甲药。'] as $datedNote) {
|
||
$case = Guard::build(array_replace($noteMedicationData, ['remark' => $datedNote]));
|
||
$check('当前用药：使用甲药。', false, 'Historical or mismatched-time note content cannot prove current medication state.', 'UNKNOWN_TO_POSITIVE', $case);
|
||
}
|
||
$historyMedicationNote = Guard::build(['id' => 1, 'diagnosis_date' => '2026-10-23'], ['required_content' => [['key' => 'doctor_image_notes',
|
||
'value' => [['diagnosis_id' => 2, 'note_date' => '2020-05-02', 'content' => '当前用药：使用甲药。']]]]]);
|
||
$check('当前用药：使用甲药。', false, 'A historical source with a current-looking label remains historical.', 'UNKNOWN_TO_POSITIVE', $historyMedicationNote);
|
||
$check('现用药未记录。', true, 'An old labelled note does not fill the current field.', '', $historyMedicationNote);
|
||
$check('用药史未记录。', false, 'A generic history label still retains a known historical note.', 'RECORDED_TO_UNKNOWN', $historyMedicationNote);
|
||
$sameDayMedicationNote = Guard::build(['id' => 1, 'diagnosis_date' => '2026-10-23'], ['required_content' => [['key' => 'doctor_image_notes',
|
||
'value' => [['note_date' => '2026-10-23', 'content' => '当前用药：使用甲药。']]]]]);
|
||
$check('当前用药：使用甲药。', true, 'An explicitly labelled same-day source remains eligible without changing its unspecified scope.', '', $sameDayMedicationNote);
|
||
$expect($sameDayMedicationNote['sources']['s1']['scope'] === 'unspecified', 'Recognizing a note does not rewrite its stored scope.');
|
||
$wrongDayMedicationNote = Guard::build(['id' => 1, 'diagnosis_date' => '2026-10-23'], ['required_content' => [['key' => 'doctor_image_notes',
|
||
'value' => [['diagnosis_id' => 1, 'note_date' => '2026-10-22', 'content' => '当前用药：使用甲药。']]]]]);
|
||
$check('当前用药：使用甲药。', false, 'A mismatched note date cannot prove current medication state even with a matching visit ID.', 'UNKNOWN_TO_POSITIVE', $wrongDayMedicationNote);
|
||
$historyLabelOnly = Guard::build(array_replace($noteMedicationData, ['remark' => '用药史：使用甲药。']));
|
||
$check('当前用药：使用甲药。', false, 'A history-only label is not a current-field label.', 'UNKNOWN_TO_POSITIVE', $historyLabelOnly);
|
||
$check('用药史未记录。', false, 'An actual history-labelled source remains recorded.', 'RECORDED_TO_UNKNOWN', $historyLabelOnly);
|
||
$qualifiedMedicationNote = Guard::build(array_replace($noteMedicationData, ['remark' => '当前用药：未使用其他药物。']));
|
||
$check('当前用药：未使用其他药物。', true, 'The exact negative qualifier in a note stays usable.', '', $qualifiedMedicationNote);
|
||
$check('当前用药：未使用药物。', false, 'A note-source qualifier cannot be widened into blanket non-use.', 'NEGATION_SCOPE_WIDENED', $qualifiedMedicationNote);
|
||
$expect($qualifiedMedicationNote['sources']['s1']['quote'] === '当前用药：未使用其他药物。', 'Field recognition retains the full original qualified quote.');
|
||
$noteClinicalLedger = Guard::build(array_replace(CompleteTcmCase::current(), ['current_medications' => null,
|
||
'remark' => '当前用药：使用甲药。']), $submission);
|
||
foreach (['，', '且', '但', '并', '同时'] as $joiner) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check('当前用药：使用甲药' . $joiner . $assertion . '。', false,
|
||
'Actual statements adjacent to a known note value remain independently checked.', $code, $noteClinicalLedger);
|
||
}
|
||
$check('拟用中药仍须逐味核实' . $joiner . '现用药未记录。', false,
|
||
'A planned-role prefix cannot erase an explicitly labelled known source.', 'RECORDED_TO_UNKNOWN', $noteMedication);
|
||
}
|
||
// r15 record predicates and future causal criteria: retained model bytes are immutable.
|
||
$r15RecordUnit = "寒热：口干、少津、苔少仅提示津液受损，不能单独成立热证；寒热相关限制见s2。舌质淡红且未记红绛，现有资料不足以确定寒或热。\n\n";
|
||
$r15CausalParagraph = "适用条件：复核后仍以气虚为主、津亏为兼，且汗出并非低血糖、感染、心肺疾病或药物因素所致；若口渴、多尿或乏力随血糖明显波动，应先评估代谢原因。\n\n";
|
||
$r15DeadlineUnit = "六、中药方药及复核监测\n\n主方方向限一个：生脉散方向，须由医师面诊审核后方可决定，不给出新增剂量、频次或疗程。本例取其益气、生津、敛汗的整体方义，与第五节治法次序一致。\n\n支持点：气短乏力、自汗、语声低微、脉细弱无力构成益气依据；口干少量频饮、舌面少津苔少构成生津依据；活动汗增支持兼顾敛汗（s1、s2、s3、s9、s10）。\n\n局限与反证：阴虚、虚热及明确肺脏证名均未充分成立；寒热限制信息见s2，舌脉限制信息见s9、s10。因此该方向只覆盖“气虚津亏、汗出”层面，不据此扩写阴虚方证。\n\n" . $r15CausalParagraph;
|
||
foreach ([
|
||
['tcm_complete_v43r14_single_openai_20261024_0_openai', 0, $r15RecordUnit],
|
||
['tcm_complete_v43r14_openai_deadline_20261024_openai_next_full90_openai', 1, $r15DeadlineUnit],
|
||
] as [$name, $index, $unit]) {
|
||
$artifact = dirname(__DIR__, 2) . '/app/artifacts/ai_concurrency/' . $name . '.rejected.json';
|
||
if (is_file($artifact)) {
|
||
$saved = json_decode((string) file_get_contents($artifact), true, 512, JSON_THROW_ON_ERROR);
|
||
$expect($saved['rejections'][$index]['unit'] === $unit, 'r15 portable retained unit equals the original artifact byte for byte.');
|
||
}
|
||
$expect(Guard::validate($ledger, $unit)['valid'], 'r15 exact whole retained unit has no old-Guard contradiction; this does not complete the report contract.');
|
||
}
|
||
$check($r15RecordUnit, true, 'The exact retained record-predicate paragraph preserves its complete wire bytes.');
|
||
$check($r15CausalParagraph, true, 'The exact retained future-causal paragraph preserves its complete wire bytes.');
|
||
foreach (['舌质淡红且未记红绛。', '舌质淡红，未记裂纹。', '脉细弱，未记结代。',
|
||
'未记固定刺痛。', '固定刺痛未记。', '未记载固定刺痛。'] as $text) {
|
||
$check($text, true, 'An abbreviated record predicate expresses missing information, not observed absence.');
|
||
}
|
||
foreach ([
|
||
['口干未记。', 'POSITIVE_TO_UNKNOWN'], ['未记淡红。', 'POSITIVE_TO_UNKNOWN'],
|
||
['心悸未记。', 'NEGATIVE_TO_UNKNOWN'], ['未记紫暗。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['未记舌象。', 'RECORDED_TO_UNKNOWN'], ['脉象未记。', 'RECORDED_TO_UNKNOWN'],
|
||
['现用药未记。', 'RECORDED_TO_UNKNOWN'], ['药物过敏史未记。', 'RECORDED_TO_UNKNOWN'],
|
||
['舌质淡红且未见红绛。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
['舌质红绛且未记裂纹。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
['舌质淡红且未记红绛（s999）。', 'SOURCE_ANNOTATION_INVALID'],
|
||
] as [$text, $code]) $check($text, false, 'An abbreviated record predicate cannot erase known values or create an observed denial.', $code);
|
||
$recordPredicate = new ReflectionMethod(Guard::class, 'reportRecordPredicateProse');
|
||
foreach (['未记录固定刺痛', '未记得固定刺痛', '未记忆固定刺痛', '未记住固定刺痛', '未记清固定刺痛'] as $text) {
|
||
$expect($recordPredicate->invoke(null, $text) === $text, 'A complete record predicate or distinct recollection verb is not rewritten.');
|
||
}
|
||
$r15Generic = Guard::build(['diagnosis_date' => '2026-10-23',
|
||
'present_illness' => '无明显甲因素诱因。有乙症。未记录丙项。']);
|
||
$r15CausalFrame = '适用条件：复核后仍以丁判断为主，且乙症并非甲因素或其他因素所致';
|
||
$check($r15CausalFrame . '。', true, 'A future causal criterion has the same role with unrelated subject/cause vocabulary.', '', $r15Generic);
|
||
foreach (['复查', '复诊确认', '复诊复核', '重新核实'] as $review) {
|
||
$check(str_replace('复核后', $review . '后', $r15CausalFrame) . '。', true,
|
||
'An explicit future reassessment operator scopes only its closed causal criterion.', '', $r15Generic);
|
||
}
|
||
foreach ([
|
||
'乙症并非甲因素或其他因素所致。',
|
||
'适用条件：乙症并非甲因素或其他因素所致。',
|
||
'适用条件：目前乙症并非甲因素或其他因素所致。',
|
||
'适用条件：复核后仍以丁判断为主，且目前乙症并非甲因素或其他因素所致。',
|
||
'适用条件：复核后仍以丁判断为主，且患者乙症并非甲因素或其他因素所致。',
|
||
'适用条件：复核后仍以丁判断为主，且已经确认乙症并非甲因素或其他因素所致。',
|
||
] as $text) $check($text, false, 'A label, present subject or completed confirmation cannot borrow a future operator.', 'NEGATION_SCOPE_WIDENED', $r15Generic);
|
||
$futureCriterion = new ReflectionMethod(Guard::class, 'futureCausalCriterionProse');
|
||
foreach ([
|
||
'适用条件：复核后仍以患者有固定刺痛为主，且汗出并非感染所致',
|
||
'适用条件：复核后仍以舌质红绛为主，且汗出并非感染所致',
|
||
'适用条件：复核后仍以气虚为主，且汗出并非患者有心悸所致',
|
||
'适用条件：复核后仍以气虚为主，且汗出并非口干未记录所致',
|
||
'适用条件：复核后仍以气虚为主，且舌质红绛并非感染所致',
|
||
'适用条件：复核后仍以气虚为主，且汗出并非感染所致的现症',
|
||
'适用条件：复核后仍以气虚为主，目前患者有心悸，且汗出并非感染所致',
|
||
'适用条件：复核后仍以气虚为主，口干未记录，且汗出并非感染所致',
|
||
] as $text) $expect($futureCriterion->invoke(null, $text) === $text,
|
||
'An actual/unknown/examination assertion or incomplete causal complement is never removed as a future criterion.');
|
||
$r15Future = '适用条件：复核后仍以气虚为主、津亏为兼，且汗出并非低血糖、感染、心肺疾病或药物因素所致';
|
||
foreach (['，', ',', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check('舌质淡红且未记红绛' . $joiner . $assertion . '。', false,
|
||
'A record predicate cannot swallow any adjoining actual assertion.', $code);
|
||
$check($r15Future . $joiner . $assertion . '。', false,
|
||
'A closed future causal relation cannot swallow any adjoining actual assertion.', $code);
|
||
}
|
||
$check($r15Future . $joiner . '固定刺痛不存在。', false,
|
||
'An adjacent postfix absence remains an actual assertion after a removed future relation.', 'UNKNOWN_TO_POSITIVE');
|
||
$check($r15Future . $joiner . '现用药未记录。', false,
|
||
'Future causal criteria cannot erase the known medication field.', 'RECORDED_TO_UNKNOWN');
|
||
}
|
||
$check($r15Future . '（s999）。', false, 'Future role parsing cannot repair an invalid source ID.', 'SOURCE_ANNOTATION_INVALID');
|
||
$check($r15Future . '，“本次询问无已知药物过敏史”（2026-10-22，s5）。', false,
|
||
'Future role parsing cannot repair a mismatched source date.', 'SOURCE_ANNOTATION_INVALID');
|
||
$expect(hash('sha256', json_encode($ledger, JSON_UNESCAPED_UNICODE | JSON_UNESCAPED_SLASHES))
|
||
=== '2ebbec0b558347bf4ee128dfb5a9e63fc4e355d58f7226486a2ae96098bd57f6',
|
||
'r15 leaves every actual fixture source ID, quote, field, date, role and ledger byte unchanged.');
|
||
// r16 assertion/reference boundaries: no diagnostic-term exceptions or changed source ledger.
|
||
$r16SingleUnit = "主证可暂拟“气虚津少证，偏肺气不足、卫外不固”。“气虚、津少”分别由s1、s2、s3、s9、s10支持；“肺气不足、卫外不固”仅为功能定位倾向，主要依据气短、低声及自汗，尚缺更完整肺系资料。\n\n";
|
||
$r16C2Unit = "表里：自汗、活动后加重可涉及卫表不固，但病程三个月、神疲及脉按之无力更支持内在功能不足。缺少外感起病及表证阳性依据，故以内证倾向为主，表证现有资料不足以确定（s1、s2、s10）。\n\n";
|
||
$r16ReferenceParagraph = "现用药记录见s6；仅复核依从性、胃肠反应及血糖变化，不擅自停换二甲双胍。既有过敏询问见s5，但拟用中药及辅料的个体暴露仍须逐项核实。\n\n";
|
||
$r16SingleFinal = "六、中药方药及复核监测\n\n本次暂不列具体主方、药味或新剂量。虽有益气固表、生津的治疗方向，但脾肺定位尚未完全落实，寒热未定，且津少尚不足成立阴虚；直接套用益气固表方或益气养阴方，均可能超出本例证据。\n\n适用前须核实：是否存在反复易感、畏风及汗出后的冷热感，以复核卫表不固的范围？\n\n适用前须核实：是否有腹胀便溏、食后困倦等脾气不足特征，或咳嗽、声音持续低弱等肺系表现？\n\n适用前须核实：全天饮水量、口干昼夜差异及汗量是否可量化，近期体重变化与血糖波动是否同步？\n\n" . $r16ReferenceParagraph;
|
||
foreach ([
|
||
['tcm_complete_v43r15_single_openai_20261024_0_openai', 0, $r16SingleUnit],
|
||
['tcm_complete_v43r15_single_openai_20261024_0_openai', 1, $r16SingleFinal],
|
||
['tcm_complete_v43r15_supplement_ooc2_20261024_1_openai', 0, $r16C2Unit],
|
||
] as [$name, $index, $unit]) {
|
||
$artifact = dirname(__DIR__, 2) . '/app/artifacts/ai_concurrency/' . $name . '.rejected.json';
|
||
if (is_file($artifact)) {
|
||
$saved = json_decode((string) file_get_contents($artifact), true, 512, JSON_THROW_ON_ERROR);
|
||
$expect($saved['rejections'][$index]['unit'] === $unit, 'r16 portable unit is exactly the retained original model output.');
|
||
}
|
||
$expect(Guard::validate($ledger, $unit)['valid'], 'r16 whole retained unit clears only old-Guard lexical rejection, not final/clinical acceptance.');
|
||
}
|
||
foreach ([$r16SingleUnit, $r16C2Unit, $r16ReferenceParagraph] as $unit) {
|
||
$check($unit, true, 'r16 exact affected paragraph preserves all original bytes at every chunk size.');
|
||
}
|
||
$r16Generic = Guard::build(['diagnosis_date' => '2026-10-23',
|
||
'present_illness' => '有甲项及乙项。无丙项及丁项。戊项未记录。']);
|
||
foreach (['但', '但是', '然而', '不过'] as $adversative) {
|
||
$check('甲类不定，' . $adversative . '甲项及乙项。', true,
|
||
'Adversative boundary restarts assertion polarity with unrelated vocabulary.', '', $r16Generic);
|
||
$check('无丙项及丁项，' . $adversative . '甲项及乙项。', true,
|
||
'A genuine inherited negative list ends at the adversative operator.', '', $r16Generic);
|
||
foreach ([['无甲项及乙项', 'POSITIVE_TO_NEGATIVE'], ['有丙项', 'NEGATIVE_TO_POSITIVE'],
|
||
['有戊项', 'UNKNOWN_TO_POSITIVE'], ['无戊项', 'UNKNOWN_TO_NEGATIVE'],
|
||
['甲项未记录', 'POSITIVE_TO_UNKNOWN'], ['丙项未记录', 'NEGATIVE_TO_UNKNOWN']] as [$assertion, $code]) {
|
||
$check('甲类不定，' . $adversative . $assertion . '。', false,
|
||
'Every independent actual assertion retains its own polarity after an adversative.', $code, $r16Generic);
|
||
}
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check('卫外不固，' . $adversative . $assertion . '。', false,
|
||
'An inference label cannot shield an adjacent actual fixture assertion.', $code);
|
||
$check('适用前须核实：是否有固定刺痛，' . $adversative . '须复核，' . $assertion . '。', false,
|
||
'An adversative boundary does not end the strict scope of an earlier question.', $code);
|
||
}
|
||
}
|
||
foreach (['及', '以及', '、', '或', '，'] as $listJoiner) {
|
||
$check('无丙项' . $listJoiner . '丁项。', true, 'Genuine inherited negative lists retain their scope.', '', $r16Generic);
|
||
$check('无甲项' . $listJoiner . '乙项。', false, 'A denied positive list remains a contradiction.', 'POSITIVE_TO_NEGATIVE', $r16Generic);
|
||
}
|
||
foreach (['主要依据', '具体依据', '直接依据', '主要根据', '具体根据', '直接根据'] as $intro) {
|
||
$check('甲类不定，' . $intro . '甲项及乙项。', true,
|
||
'An affirmative evidence introducer starts an independent finding list.', '', $r16Generic);
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check('卫外不固，' . $intro . $assertion . '。', false,
|
||
'The evidence introducer preserves negative/unknown/value and qualifier checks.', $code);
|
||
}
|
||
$check('卫外不固，' . $intro . '无口干及乏力。', false,
|
||
'An explicit denial after an evidence introducer keeps its true negative meaning.', 'POSITIVE_TO_NEGATIVE');
|
||
}
|
||
foreach (['用药', '现用药', '在用药', '当前用药', '目前用药', '本次用药', '现用药物', '在用药物',
|
||
'用药情况', '用药记录', '用药信息', '现用药情况', '当前用药情况', '目前用药情况'] as $alias) {
|
||
$check($alias . '记录见s6。', true, 'A complete medication field alias can locate its actual schema source.');
|
||
$check($alias . '记录见s5。', false, 'A medication alias cannot bind an allergy source.', 'SOURCE_ANNOTATION_INVALID');
|
||
$check($alias . '记录见s23。', false, 'An incidental medication mention cannot supply medication-field provenance.', 'SOURCE_ANNOTATION_INVALID');
|
||
}
|
||
foreach (['现用药记录见s999。', '现用药记录见s16。', '现用药记录见s30。', '2026-10-22现用药记录见s6。',
|
||
'现用药记录见s6（2026-10-22，s6）。'] as $text) {
|
||
$check($text, false, 'A medication field locator requires an existing same-time source with matching provenance.', 'SOURCE_ANNOTATION_INVALID');
|
||
}
|
||
foreach (['拟用中药及辅料的个体暴露仍须逐项核实', '待选材料及辅料的相关暴露仍需逐项复核',
|
||
'计划使用甲材料及乙材料的记录仍应审核'] as $plan) {
|
||
$check('既有过敏询问见s5，但' . $plan . '。', true,
|
||
'A neutral planned nominal target with an extended data head retains its postfix review role.');
|
||
foreach (['，', ',', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check('既有过敏询问见s5，但' . $plan . $joiner . $assertion . '。', false,
|
||
'A planned target cannot swallow any actual assertion after a joiner.', $code);
|
||
}
|
||
$check('现用药记录见s6' . $joiner . '现用药未记录。', false,
|
||
'A neutral locator cannot erase the medication baseline in its adjoining prose.', 'RECORDED_TO_UNKNOWN');
|
||
}
|
||
}
|
||
foreach ([
|
||
['但拟用目前已使用中药的个体暴露仍须逐项核实。', 'NEGATIVE_TO_POSITIVE'],
|
||
['但拟用患者有固定刺痛的资料仍须逐项核实。', 'UNKNOWN_TO_POSITIVE'],
|
||
['但拟用患者无固定刺痛的资料仍须逐项核实。', 'UNKNOWN_TO_NEGATIVE'],
|
||
['但拟用已诊见舌质红绛的资料仍须逐项核实。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
['但拟用中药的个体暴露仍须逐项核实，现用药未记录。', 'RECORDED_TO_UNKNOWN'],
|
||
] as [$text, $code]) $check($text, false, 'Current/completed/embedded predicates cannot become a neutral planned target.', $code);
|
||
$check('**表里：偏里证。**症状已持续3个月并逐渐出现，以“神疲乏力”“轻微活动后气短”“白天自汗”为主；本次又记录“无恶寒发热”，脉“不浮”，现有证据更支持内在功能失调，而非急性表证。但这只反映本次接诊状态，后续若新出现恶寒、发热、咽痛等，仍须重新判断。', true,
|
||
'The original portable v15 full paragraph retains its exact source facts and future qualification.');
|
||
$check('舌脉未呈黄腻、滑、紧等所见，但不能仅凭这些否定完全排除夹实。', true,
|
||
'A complete negative exam list remains complete before an adversative commentary boundary.');
|
||
$check('舌脉未呈黄腻、滑、紧等所见，但不能仅凭这些否定完全排除夹实，患者有固定刺痛。', false,
|
||
'Commentary after a complete negative exam list cannot exempt an adjoining patient assertion.', 'UNKNOWN_TO_POSITIVE');
|
||
$expect(hash('sha256', json_encode($ledger, JSON_UNESCAPED_UNICODE | JSON_UNESCAPED_SLASHES))
|
||
=== '2ebbec0b558347bf4ee128dfb5a9e63fc4e355d58f7226486a2ae96098bd57f6',
|
||
'r16 keeps every immutable ledger source ID, quote, field, date, role and schema byte unchanged.');
|
||
// r17 exact-atom triage: questions already pass; record locator and future trigger roles were missing.
|
||
$r17RecordUnit = "血：面色少华可提示血分失养，但非特异；固定刺痛的资料状态见s2，舌质亦无足够血虚或血瘀阳性特征。血虚、血瘀均待定。\n\n";
|
||
$r17Questions = [
|
||
"适用前须核实：是否另有未记录的处方药、非处方药、保健品及肝肾疾病变化？是否存在吞咽困难、明显脱水或血糖急剧波动等需优先处理情况？\n\n",
|
||
"适用前须核实：是否还在使用其他处方药、保健品或中草药？是否存在肝肾功能近期变化？是否出现低血糖样不适或胃肠反应？是否有拟用药既往不耐受？\n\n",
|
||
];
|
||
$r17Triage = [
|
||
"监测乏力、气短、自汗、口干、饮水及二便变化，并继续记录空腹与餐后血糖；若启用中药，复核血糖趋势、胃肠耐受及肝肾指标。出现意识异常、持续明显气短或其他急性变化时，应及时按西医急症路径评估。\n\n",
|
||
"如医师采用该方向，应监测乏力、气短、汗出、口干、食欲、大便及血糖变化；症状加重或出现新的胸闷、心悸、意识改变等情况，应先行医学评估，不以中药替代必要检查。\n\n",
|
||
];
|
||
foreach (['tcm_complete_v43r16_supplement_ooc2_20261024_0_openai',
|
||
'tcm_complete_v43r16_openai_deadline_20261024_openai_next_full90_openai'] as $i => $name) {
|
||
$artifact = dirname(__DIR__, 2) . '/app/artifacts/ai_concurrency/' . $name . '.rejected.json';
|
||
if (is_file($artifact)) {
|
||
$saved = json_decode((string) file_get_contents($artifact), true, 512, JSON_THROW_ON_ERROR);
|
||
if ($i === 0) $expect($saved['rejections'][0]['unit'] === $r17RecordUnit,
|
||
'The r17 portable record-state paragraph is byte-identical to its retained unit.');
|
||
$unit = $saved['rejections'][1]['unit'];
|
||
$original = $unit;
|
||
$expect(str_contains($unit, $r17Questions[$i]) && str_contains($unit, $r17Triage[$i]),
|
||
'The exact supplied question list and actual offending triage paragraph remain in the original whole unit.');
|
||
$expect(Guard::validate($ledger, $unit)['valid'] && $unit === $original,
|
||
'The exact whole section clears only old-Guard lexical errors, with no source/model/output substitution.');
|
||
}
|
||
}
|
||
foreach (array_merge([$r17RecordUnit], $r17Questions, $r17Triage) as $text) {
|
||
$check($text, true, 'r17 retained paragraph passes lexical validation and, when enabled, exact wire checks.');
|
||
}
|
||
foreach (['资料状态', '记录状态', '信息状态', '资料的状态', '记录的状态'] as $role) {
|
||
$check('固定刺痛的' . $role . '见s2。', true, 'A neutral cited record-state locator does not assert its subject is present.');
|
||
$check('舌象的' . $role . '见s9。', true, 'A neutral named-exam locator points to its actual field without erasing its values.');
|
||
foreach (['，', ',', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check('固定刺痛的' . $role . '见s2' . $joiner . $assertion . '。', false,
|
||
'A record-state locator cannot consume an adjacent actual assertion.', $code);
|
||
}
|
||
$check('固定刺痛的' . $role . '见s2' . $joiner . '现用药未记录。', false,
|
||
'A locator cannot erase the current medication baseline.', 'RECORDED_TO_UNKNOWN');
|
||
}
|
||
}
|
||
foreach ([
|
||
['固定刺痛的资料状态见s999。', 'SOURCE_ANNOTATION_INVALID'],
|
||
['固定刺痛的资料状态见s5。', 'SOURCE_ANNOTATION_INVALID'],
|
||
['2026-10-22固定刺痛的资料状态见s2。', 'SOURCE_ANNOTATION_INVALID'],
|
||
['固定刺痛的资料状态见s2（2026-10-22，s2）。', 'SOURCE_ANNOTATION_INVALID'],
|
||
['舌象的资料状态见s10。', 'SOURCE_ANNOTATION_INVALID'],
|
||
['患者有固定刺痛的资料状态见s2。', 'UNKNOWN_TO_POSITIVE'],
|
||
['患者无固定刺痛的资料状态见s2。', 'UNKNOWN_TO_NEGATIVE'],
|
||
['舌质红绛的资料状态见s9。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
] as [$text, $code]) $check($text, false, 'Locator syntax cannot manufacture source provenance, dates or actual clinical values.', $code);
|
||
$r17Generic = Guard::build(['diagnosis_date' => '2026-10-23',
|
||
'present_illness' => '有甲项。无乙项。丙项未记录。']);
|
||
foreach (['甲项', '乙项', '丙项'] as $subject) {
|
||
$check($subject . '的记录状态见s1。', true,
|
||
'The same locator grammar preserves positive, negative and unknown record states with unrelated vocabulary.', '', $r17Generic);
|
||
}
|
||
foreach (['出现', '发生'] as $event) {
|
||
foreach (['时', '等情况'] as $ending) {
|
||
foreach (['应', '须', '需'] as $modal) {
|
||
foreach (['评估', '就医', '检查', '处理'] as $action) {
|
||
$check($event . '乙项' . $ending . '，' . $modal . '立即' . $action . '。', true,
|
||
'Only a closed event trigger linked to a mandatory future action is prospective.', '', $r17Generic);
|
||
}
|
||
}
|
||
}
|
||
}
|
||
$check('事件恶化或发生新的乙项等情况，应先行评估。', true,
|
||
'A neutral event progression can introduce an alternative future occurrence.', '', $r17Generic);
|
||
$check('出现固定刺痛时，应立即评估。', true, 'A future trigger does not turn unknown data into a current positive.');
|
||
$check('出现舌质红绛时，应立即评估。', true, 'An explicitly hypothetical trigger is distinct from a current examination value.');
|
||
foreach ([
|
||
['出现意识异常时。', 'NEGATIVE_TO_POSITIVE'],
|
||
['出现意识异常，应立即评估。', 'NEGATIVE_TO_POSITIVE'],
|
||
['出现意识异常时，已经评估。', 'NEGATIVE_TO_POSITIVE'],
|
||
['患者已出现意识异常时，应立即评估。', 'NEGATIVE_TO_POSITIVE'],
|
||
['目前出现意识异常时，应立即评估。', 'NEGATIVE_TO_POSITIVE'],
|
||
['出现已经确认意识异常时，应立即评估。', 'NEGATIVE_TO_POSITIVE'],
|
||
['患者症状已加重或出现意识异常等情况，应立即评估。', 'NEGATIVE_TO_POSITIVE'],
|
||
['出现意识异常且患者有固定刺痛时，应立即评估。', 'UNKNOWN_TO_POSITIVE'],
|
||
['患者已出现舌质红绛时，应立即评估。', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
|
||
] as [$text, $code]) $check($text, false,
|
||
'A current/completed/embedded assertion or incomplete future frame cannot borrow the event-trigger role.', $code);
|
||
foreach (['，', ',', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check('出现意识异常时，应立即评估' . $joiner . $assertion . '。', false,
|
||
'The future action cannot hide a factual assertion adjoining its trigger.', $code);
|
||
}
|
||
$check('出现意识异常时，应立即评估' . $joiner . '现用药未记录。', false,
|
||
'A prospective trigger/action pair cannot erase the known medication field.', 'RECORDED_TO_UNKNOWN');
|
||
}
|
||
$triggerRole = new ReflectionMethod(Guard::class, 'prospectiveTriggerProse');
|
||
foreach (['出现口干未记录时', '出现患者有固定刺痛时', '出现2026-10-22意识异常时',
|
||
'出现诊见舌质红绛时', '出现曾经意识异常时'] as $text) {
|
||
$expect($triggerRole->invoke(null, $text, '，应立即评估。') === $text,
|
||
'A record-state, attributed, dated or completed predicate is never removed as a neutral trigger.');
|
||
}
|
||
$check('出现意识异常时（s999），应立即评估。', false,
|
||
'A future trigger cannot repair an invalid source ID.', 'SOURCE_ANNOTATION_INVALID');
|
||
$check('出现意识异常时（2026-10-22，s2），应立即评估。', false,
|
||
'A future trigger cannot repair a mismatched source date.', 'SOURCE_ANNOTATION_INVALID');
|
||
$expect(hash('sha256', json_encode($ledger, JSON_UNESCAPED_UNICODE | JSON_UNESCAPED_SLASHES))
|
||
=== '2ebbec0b558347bf4ee128dfb5a9e63fc4e355d58f7226486a2ae96098bd57f6',
|
||
'r17 preserves every actual source ID, quote, field, scope, date and ledger schema byte.');
|
||
// r17 epistemic followup: a bounded absence of evidence is UNKNOWN, never a patient denial.
|
||
$r17EpistemicUnit = "寒热：口干、少津、苔少及大便稍干（s2、s9）可提示津少，尚不足单独成立热证；寒象亦无本次独立阳性证据。寒热属性现有资料不足以确定。\n\n";
|
||
$artifact = dirname(__DIR__, 2) . '/app/artifacts/ai_concurrency/tcm_complete_v43r16_openai_deadline_20261024_openai_next_full90_openai.rejected.json';
|
||
if (is_file($artifact)) {
|
||
$saved = json_decode((string) file_get_contents($artifact), true, 512, JSON_THROW_ON_ERROR);
|
||
$expect($saved['rejections'][0]['unit'] === $r17EpistemicUnit,
|
||
'The epistemic followup uses the exact retained successor unit without substitution.');
|
||
}
|
||
$check($r17EpistemicUnit, true, 'The complete retained epistemic paragraph passes old-Guard validation without output rewriting.');
|
||
$check('寒象亦无本次独立阳性证据。', true, 'The exact bounded epistemic clause is not an observed clinical absence.');
|
||
$epistemicGeneric = Guard::build(['diagnosis_date' => '2026-10-23',
|
||
'present_illness' => '有甲项。无乙项。丙项未记录。']);
|
||
foreach (['', '亦', '也', '尚', '仍', '均', '并'] as $adverb) {
|
||
foreach (['无', '没有', '未见'] as $negative) {
|
||
foreach (['', '本次独立阳性', '明确可靠的', '现有充分相应'] as $modifier) {
|
||
foreach (['证据', '依据'] as $noun) {
|
||
$phrase = $adverb . $negative . $modifier . $noun . '。';
|
||
$check('丁诊断' . $phrase, true,
|
||
'A generic diagnostic noun plus closed evidential role asserts no patient absence.', '', $epistemicGeneric);
|
||
$check('甲项' . $phrase, false,
|
||
'Evidence-role wording cannot erase a recorded positive.', 'POSITIVE_TO_UNKNOWN', $epistemicGeneric);
|
||
$check('乙项' . $phrase, false,
|
||
'Evidence-role wording cannot erase a recorded negative.', 'NEGATIVE_TO_UNKNOWN', $epistemicGeneric);
|
||
$check('丙项' . $phrase, true,
|
||
'A source-unknown subject stays unknown, without becoming an observed absence.', '', $epistemicGeneric);
|
||
}
|
||
}
|
||
}
|
||
}
|
||
foreach ([
|
||
['口干亦无本次独立阳性证据。', 'POSITIVE_TO_UNKNOWN'],
|
||
['心悸亦无本次独立阳性证据。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['舌质淡红亦无本次独立阳性证据。', 'POSITIVE_TO_UNKNOWN'],
|
||
['舌质紫暗亦无本次独立阳性证据。', 'NEGATIVE_TO_UNKNOWN'],
|
||
['舌象亦无本次独立阳性证据。', 'RECORDED_TO_UNKNOWN'],
|
||
['脉象亦无本次独立阳性证据。', 'RECORDED_TO_UNKNOWN'],
|
||
['现用药亦无本次独立阳性证据。', 'RECORDED_TO_UNKNOWN'],
|
||
['寒象亦无恶寒、肢冷等证据。', 'NEGATION_SCOPE_WIDENED'],
|
||
['患者有心悸亦无本次独立阳性证据。', 'NEGATIVE_NOT_IN_SOURCE'],
|
||
['寒象亦无本次独立阳性证据（s999）。', 'SOURCE_ANNOTATION_INVALID'],
|
||
['寒象亦无本次独立阳性证据（2026-10-22，s2）。', 'SOURCE_ANNOTATION_INVALID'],
|
||
] as [$text, $code]) $check($text, false,
|
||
'Epistemic grammar preserves known facts, examination roles, qualifiers and source/date checks.', $code);
|
||
$check('固定刺痛亦无本次独立阳性证据。', true, 'Explicitly unrecorded clinical information remains unknown.');
|
||
$check('“无咳嗽咯痰、胸痛心悸、浮肿或腹泻”（s2）。', true,
|
||
'An exact source-backed current negative list keeps its original clinical meaning.');
|
||
foreach (['，', ',', '且', '但', '并', '并且', '同时', '还', '又', '另'] as $joiner) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check('寒象亦无本次独立阳性证据' . $joiner . $assertion . '。', false,
|
||
'A bounded evidence noun cannot consume an adjacent actual assertion.', $code);
|
||
}
|
||
$check('寒象亦无本次独立阳性证据' . $joiner . '现用药未记录。', false,
|
||
'A local epistemic statement cannot erase an adjoining known medication field.', 'RECORDED_TO_UNKNOWN');
|
||
}
|
||
foreach (['望诊', '闻诊', '问诊', '切诊', '舌象', '脉象'] as $role) {
|
||
foreach ($assertions as [$assertion, $code]) {
|
||
$check($role . '：寒象亦无本次独立阳性证据且' . $assertion . '。', false,
|
||
'A report-role heading cannot turn evidence-role grammar into an examination/factual waiver.', $code);
|
||
}
|
||
}
|
||
$epistemicRole = new ReflectionMethod(Guard::class, 'reportEvidenceGapProse');
|
||
foreach (['患者有心悸亦无本次独立阳性证据', '患者无固定刺痛', '寒象亦无恶寒、肢冷等证据',
|
||
'舌质红绛且寒象无独立证据', '诊见舌质红绛无独立证据',
|
||
'寒象无本次独立阳性证据支持患者无固定刺痛', '寒象无完整独立充分足够明确直接可靠相应阳性证据'] as $text) {
|
||
$expect($epistemicRole->invoke(null, $text) === $text,
|
||
'Clinical predicates, adjacent assertions and non-closed evidence syntax are never removed by this grammar.');
|
||
}
|
||
$unknownView = (new ReflectionMethod(Guard::class, 'reportClauses'))->invoke(null, $ledger, '固定刺痛亦无本次独立阳性证据');
|
||
$unknownParts = (new ReflectionMethod(Guard::class, 'parts'))->invoke(null, $unknownView[0]['text']);
|
||
$expect(count($unknownParts) === 1 && $unknownParts[0]['state'] === 'unknown',
|
||
'The evidence-absence validation view is explicitly UNKNOWN, never a negative observation.');
|
||
$expect(hash('sha256', json_encode($ledger, JSON_UNESCAPED_UNICODE | JSON_UNESCAPED_SLASHES))
|
||
=== '2ebbec0b558347bf4ee128dfb5a9e63fc4e355d58f7226486a2ae96098bd57f6',
|
||
'The epistemic followup leaves all actual source IDs, quotes, scopes, dates and schema bytes unchanged.');
|
||
if ($guardOnly) {
|
||
$expect(!class_exists('app\\adminapi\\logic\\tcm\\DiagnosisAiLogic', false)
|
||
&& !class_exists(TcmClinicalReportStream::class, false)
|
||
&& !class_exists('app\\adminapi\\service\\TcmClinicalEvidenceContract', false),
|
||
'Guard-only verification does not load mutable peer classes.');
|
||
}
|
||
|
||
echo "Clinical question/citation boundary: {$count} assertions passed (pure actual fixture; "
|
||
. ($guardOnly ? 'Guard only; streaming deferred' : 'exact 1/2/7/31-byte streaming') . ").\n";
|