feat(recall+ingest): 召回质量收口 + 联系人/影像AI/回访 三个新信号源

召回质量(摄入层 yaml + 召回 scenario,host 无关引擎增强):
- C.10 治疗痕迹覆盖扩(治疗后/术中/X后/粘结中 + 修复/备牙/取模/根尖/植骨/错颌 keyword)
- treat_plan/dispose 定向合并(real_no_tooth 闸 path2:治疗无牙位→dispose 找回牙位)
- 牙位归一:全角字母数字折叠(ＲＣＴ→RCT)、裸象限数字过滤(笔误 16→1 幽灵召回清零)
- keyword none 排除 + 切段含全角标点 + 若条件从句 strip
- 治疗家族 resolver / 同牙取代 / oracle 对账(差分 0)

联系人(patient↔patient 自关联,替代 primaryContactType):
- 新 PatientRelation 边表(referee → 关系人即 patient,姓名/电话现取零冗余)
- 删 primaryContactType 全链路;详情页"联系人"行

影像 AI 信号源(image_analysis → diagnosis_record,code_source=image_ai):
- 源 SQL pivot+炸牙位(病种→K码),独立 subject,去重靠召回 (subKey,tooth) 聚类

回访展示(独立表,5 试点):
- 新 PatientReturnVisit 表(org∈5试点 + customer_id→patient),详情页"历史联系"滚动卡

裁决:referee/image/returnvisit 已接(天然试点 scope);complain/consult 全集团覆盖不全,不接。
本地 191/200/1000/2000 四样本对抗验证:幽灵召回 0、resolver 漏判 0。

Co-Authored-By: Claude Opus 4.8 (1M context) <noreply@anthropic.com>

apps/pac-service/data/jvs-dw/assemblers/diagnosis.yaml

@@ -261,5 +261,22 @@ enum_mapping:
     骨性Ⅱ类: K07
     骨性Ⅲ类: K07
 
-    # 兜底:翻不出 → 空 → parser 落 code=null(不丢 fact)
+    # 兜底:翻不出 → 交下面 keyword_mapping 含词兜底;再不中 → 空 → code=null(不丢 fact)
     _default: ""
+
+# ─────────────────────────────────────────────────────────
+# 含词兜底 —— 精确 enum 未命中时,按序含词匹配 → K 码。
+# 治本长尾:诊断常是复合/变体("埋伏阻生;"、"前倾位阻生,颌面龋"、"牙齿缺失"、"窝沟龋"…),
+# 精确白名单永远漏(沈建锋 28/38 阻生智齿 → null → 漏召)。引擎按 canonicalKey 通用。
+# 顺序=优先级:阻生/缺失/牙髓 在 龋 之前 → 复合"阻生+龋"判 K01(智齿该评估拔除,非补)。
+# ⚠️ 龋:any=[龋] + none=[风险,可疑,脱矿] —— 排除"高龋风险/可疑龋"(=风险,非龋洞,同深窝沟不召);
+#    深窝沟/食物嵌塞/牙本质敏感 不含上述关键词 → 仍落 null,故意不召(无回归)。
+keyword_mapping:
+  code:
+    - { value: K08, any: [缺失, 缺牙, 牙列缺损] }
+    - { value: K01, any: [阻生, 埋伏, 智齿] }
+    - { value: K09, any: [颌骨囊肿, 含牙囊肿, 根尖囊肿] }
+    - { value: K04, any: [牙髓炎, 牙髓坏死, 根尖周, 根尖炎, 牙髓] }
+    - { value: K03, any: [楔状, 残根, 残冠, 隐裂, 牙体缺损, 牙折] }
+    - { value: K05, any: [牙周炎, 龈炎, 牙周袋] }
+    - { value: K02, any: [龋], none: [风险, 可疑, 脱矿] }

apps/pac-service/data/jvs-dw/assemblers/image_finding.yaml

+# image_finding — 影像 AI 分析 → 诊断信号源(独立 subject,code_source=image_ai)
+#
+# 消费 sql_source.image_finding_rows(源 SQL 已 pivot + 炸牙位成长表:
+#   patient_id / brand / organization_id / emr_id / rq / code(K码) / code_source / tooth / diag_external_id)
+#
+# 复用 diagnosis canonical + diagnosis.parser → 落 diagnosis_record fact(跟医生诊断同类型,
+#   召回 scenario 自动消费)。externalId 带 |imgai| → 跟医生诊断不同 subject(不合并,保留来源)。
+# 去重:不靠 subject 合并,靠召回层 (subKey, tooth) 聚类(AI cavity@16 与 医生 K02@16 → 一条召回)。
+canonical: diagnosis
+
+emits:
+  action: diagnosis_recorded
+  subjectType: diagnosis
+  occurredAtField: occurredAt
+
+primary:
+  table: image_finding_rows
+  key: diag_external_id
+  dedup_by: diag_external_id   # 同 emr×code×tooth 去重(AI 多次拍片同发现)
+
+field_mapping:
+  externalId:                diag_external_id
+  updatedAt:                 rq            # AI 分析日(进 source_event_id 幂等键)
+  createdAt:                 rq
+  patientExternalId:         patient_id
+  clinicId:                  organization_id   # 患者 EMR 诊所代理(image 无诊所)
+  occurredAt:                rq
+  sourceEncounterExternalId: emr_id
+  code:                      code          # 已是 K 码(源 SQL pivot 给定)
+  codeSource:                code_source   # 'image_ai' → diagnosis.parser 显式优先
+  toothPosition:             tooth
+
+# code 已是 K 码,直通校验(parser PACDiagnosisCodeSchema 闭集)。仍给 K 大类 passthrough 防意外。
+enum_mapping:
+  code:
+    K00: K00
+    K01: K01
+    K02: K02
+    K03: K03
+    K04: K04
+    K05: K05
+    K08: K08
+    K09: K09
+    _default: ""

apps/pac-service/data/jvs-dw/assemblers/patient_relation.yaml

+# patient_relation — 患者-患者关系边(联系人/亲属/转介绍人)
+#
+# 消费 fact_customer_referee_out(一行 = 本人 与 一个 referee 的关系)。
+# upsert 资源(无 emits,同 patient):落 PatientRelation 表,不进 transaction/fact。
+#   patientExternalId = referee.patient_id          (本人,须解析到 PAC patient)
+#   relatedExternalId = referee.referee_patient_id  (关系人 host id,始终保留)
+#   relationship      = referee_relationship_name 归一到枚举(本人视角:relatedPatient 是本人的 X)
+#
+# 关系人姓名/电话不在此存 —— 关系人本身也是 patient,读时从 relatedPatient 现取(零冗余)。
+canonical: patient_relation
+
+primary:
+  table: fact_customer_referee_out
+  key: patient_id            # 非真 PK;去重靠 PatientRelation @@unique(patientId, relatedExternalId, relationship)
+
+field_mapping:
+  patientExternalId:  patient_id
+  relatedExternalId:  referee_patient_id
+  relationship:       referee_relationship_name   # 中文关系名 → enum_mapping 归一
+
+# host 中文关系名 → PAC 枚举(本人视角:对方是本人的 X)。全量摄入,不过滤关系类型。
+enum_mapping:
+  relationship:
+    配偶:     spouse
+    爸爸:     father
+    妈妈:     mother
+    子女:     child
+    爷爷:     grandparent
+    奶奶:     grandparent
+    外公:     grandparent
+    外婆:     grandparent
+    孙子女:   grandchild
+    外孙子女: grandchild
+    兄弟:     sibling
+    姊妹:     sibling
+    姐弟:     sibling
+    兄妹:     sibling
+    朋友:     friend
+    其他亲属: other
+    其他:     other
+    _default: other

apps/pac-service/data/jvs-dw/assemblers/patient_return_visit.yaml

+# patient_return_visit — 诊所回访任务记录(展示用,5 试点)
+#
+# 消费 sql_source.fact_returnvisit_out(已 customer_id→patient_id + org∈5试点过滤)。
+# upsert 资源(无 emits,同 patient/relation):落 PatientReturnVisit 表,不进 transaction/fact、不进召回。
+canonical: patient_return_visit
+
+primary:
+  table: fact_returnvisit_out
+  key: id
+  dedup_by: id
+
+field_mapping:
+  externalId:        id
+  patientExternalId: patient_id          # = customer_id(源 SQL 已 alias)
+  clinicId:          organization_id
+  taskDate:          task_date
+  type:              return_visit_type_name
+  status:            return_visit_status_name
+  taskStatus:        task_status_name
+  treatmentItems:    treatment_items
+  followContent:     follow_content
+  result:            return_visit_result

apps/pac-service/data/jvs-dw/assemblers/recommendation.yaml

@@ -74,4 +74,23 @@ enum_mapping:
     建议正畸:           ORTHO_CONSULT_RECOMMENDED
     建议矫正:           ORTHO_CONSULT_RECOMMENDED
 
-    _default: ""    # 未识别"建议X" → 丢弃(后续 Layer C LLM 抽取增强)
+    _default: ""    # 未识别"建议X" → 交下面 keyword_mapping 含词兜底;再不中 → 丢弃
+
+# ─────────────────────────────────────────────────────────
+# 含词兜底 —— 精确 enum 未命中时,按序含词匹配 → 召回码。
+# 治本长尾:"建议X"变体太多(建议充填治疗/建议根管治疗后冠修复/建议拔除后种植…),
+# 精确白名单永远漏(谢玉兰 44 "建议充填治疗" 漏配 → null → 44 漏召)。引擎按 canonicalKey 通用。
+# 顺序=优先级:高价值/主操作在前(种植>冠、根管>冠、拔除独立)。错配最坏=_default(现状),无回归。
+keyword_mapping:
+  code:
+    - { value: IMPLANT_RECOMMENDED,             any: [种植, 植体] }
+    - { value: RCT_RECOMMENDED,                 any: [根管, RCT, 牙髓] }
+    - { value: EXTRACTION_RECOMMENDED,          any: [拔除, 拔牙] }
+    - { value: CROWN_RECOMMENDED,               any: [冠, 桥, 桩核] }
+    - { value: FILLING_RECOMMENDED,             any: [充填, 补牙, 树脂] }
+    - { value: HARD_TISSUE_REPAIR_RECOMMENDED,  any: [楔状, 牙体, 嵌体, 缺损] }
+    - { value: SRP_RECOMMENDED,                 any: [洁治, 洗牙, 牙周, 龈下, 刮治] }
+    - { value: ORTHO_CONSULT_RECOMMENDED,       any: [正畸, 矫正, 矫治] }
+    - { value: GUM_TREATMENT_RECOMMENDED,       any: [牙龈, 牙槽嵴, 系带] }
+    - { value: JAW_CYST_REMOVAL_RECOMMENDED,    any: [囊肿] }
+    - { value: ERUPTION_INTERVENTION_RECOMMENDED, any: [萌出, 乳牙滞留, 多生牙] }

apps/pac-service/data/jvs-dw/assemblers/treatment_actual.yaml

@@ -445,19 +445,27 @@ keyword_mapping:
     # ⚠️ "二期" 必须限定到「种植二期」:裸"二期"会误吞"二期隐形矫正"(正畸)等 → 误判 implant。
     #    种植语境的二期都带"种植"(种植二期);ortho 的"二期隐形矫正/二期矫正"靠下面 orthodontic 兜住。
     - { value: implant,       any: [种植, 即拔即种, 植体, 种植二期] }
-    - { value: endodontic,    any: [根管, RCT, 牙髓, 开髓, 根备, 根充, 盖髓, 摘髓] }
-    - { value: orthodontic,   any: [正畸, 矫治, 矫正, 托槽, 保持器, 粘附件, 隐适美, 隐形矫, 扩弓] }
+    - { value: endodontic,    any: [根管, RCT, 牙髓, 开髓, 根备, 根充, 盖髓, 摘髓, 根尖] }
+    - { value: orthodontic,   any: [正畸, 矫治, 矫正, 托槽, 保持器, 粘附件, 隐适美, 隐形矫, 扩弓, 错颌, 错合] }
     - { value: cosmetic,      any: [贴面, 漂白, 美白] }
-    - { value: prosthodontic, any: [冠, 桥, 义齿, 修复体, 桩核, 桩冠, 戴牙, 全瓷, 烤瓷, 重新粘接] }
-    # 窝沟封闭提到 restorative 前:玻璃离子常作封闭剂材料("玻璃离子窝沟封闭"≠充填)
+    # 修复/备牙/取模:收 C.10 治疗痕迹(修复后/修复术后/全瓷桥修复后/备牙后/重新取模后)。
+    #   排在 implant/endo/ortho/cosmetic 之后 → 种植修复→implant、根管…修复→endo 仍被前面抢走。
+    #   "嵌体修复"等 restorative 已由上方精确 enum 先命中,不受裸"修复"影响。
+    - { value: prosthodontic, any: [冠, 桥, 义齿, 修复体, 修复, 备牙, 取模, 桩核, 桩冠, 戴牙, 全瓷, 烤瓷, 重新粘接] }
+    # ⭐ 明确充填动作(充填/去腐/备洞/嵌体/垫底/补牙)压过 preventive:
+    #   "去腐,备洞,...树脂充填,窝沟封闭"(dispose 散文)是补牙(restorative),不能因含"窝沟封闭"
+    #   被误判 preventive → 非 resolver → 误召(马思煦@46)。注:"开髓去腐"等根管语境已被上方 endodontic 先收。
+    - { value: restorative,   any: [充填, 补牙, 去腐, 备洞, 嵌体, 垫底] }
+    # 纯封闭(无充填动作)→ preventive:玻璃离子常作封闭剂材料("玻璃离子窝沟封闭"≠充填)
     - { value: preventive,    any: [窝沟封闭, 封闭剂, 点隙封闭] }
-    - { value: restorative,   any: [充填, 补牙, 树脂, 玻璃离子, 嵌体, 垫底] }
+    # 材料弱词:放 preventive 后 —— "玻璃离子窝沟封闭" 已被上面 preventive 收;裸"树脂/玻璃离子"→ restorative
+    - { value: restorative,   any: [树脂, 玻璃离子] }
     # 牙周去裸"洁牙"(避开自由文本"清洁牙面"误命中);洁牙/全口洁牙等精确词由上方 enum_mapping 兜
     - { value: periodontic,   any: [洁治, 洗牙, 龈上, 龈下, 刮治, 牙周, 喷砂, 细洁] }
     - { value: preventive,    any: [涂氟, 防龋, OHI, 口腔卫生宣教] }
-    - { value: surgical,      any: [拔除, 拔牙, 切开, 翻瓣, 切除, 系带, 脓肿, 囊肿] }
+    - { value: surgical,      any: [拔除, 拔牙, 切开, 翻瓣, 切除, 系带, 脓肿, 囊肿, 植骨] }
     - { value: pediatric,     any: [乳牙, 儿童, 年轻恒牙] }
 
 # actual 语义:这些词开头的从句 = 本次没做(条件/未来/建议)→ 切段丢弃后再匹配。
 # 例 "充填,必要时根管治疗" → 丢"必要时根管治疗" → "充填" → restorative(不误判成 endodontic)。
-keyword_strip_clauses: [必要时, 如需, 择期, 建议, 推荐, 考虑]
+keyword_strip_clauses: [必要时, 如需, 择期, 建议, 推荐, 考虑, 若]   # 若…=条件从句(若牙面脱矿,建议充填),非本次实际治疗

apps/pac-service/data/jvs-dw/manifest.yaml

@@ -176,6 +176,59 @@ sql_source:
           WHERE last_visit_time IS NOT NULL
         )
 
+    # ── 影像 AI 分析(fact_emr_image_analysis_out)→ 诊断信号源(image_finding) ──
+    # 结构化 AI 源,例外地在源 SQL 一次性 pivot+炸牙位(下游零 transform):
+    #   ① join file_num→client 取 patient_id+brand(image 表无 patient_id);
+    #   ② LEFT JOIN 取患者 EMR 的 organization_id 作诊所(image 无诊所,clinic 是 transaction 立柱必填;覆盖 ~98%);
+    #   ③ ARRAY JOIN 把 10 个病种列(每列一个牙位数组字符串 "['38']")pivot 成 (code, 数组);
+    #   ④ replaceRegexpAll 去括号引号 + splitByChar + arrayJoin 炸成每颗牙一行;
+    #   ⑤ code_source='image_ai' 标来源(diagnosis.parser 显式优先);externalId 带 |imgai| → 独立 subject。
+    # 病种→K 码映射(host 数据形态,留在 manifest yaml):cavity→K02 / 阻生·埋伏→K01 / 根尖周→K04 /
+    #   残根·残冠·楔状→K03 / 囊肿→K09 / 缺失→K08 / 乳牙滞留→K00。去重靠召回层 (subKey,tooth) 聚类。
+    image_finding_rows: |
+      SELECT patient_id, brand, organization_id, emr_id, rq, code, code_source, tooth,
+             concat(emr_id, '|imgai|', code, '|', tooth) AS diag_external_id
+      FROM (
+        SELECT c.patient_id AS patient_id, c.brand AS brand, po.org AS organization_id,
+               ia.emr_id AS emr_id, ia.rq AS rq, cm.1 AS code, 'image_ai' AS code_source,
+               arrayJoin(splitByChar(',', replaceRegexpAll(cm.2, '[\[\] '']', ''))) AS tooth
+        FROM dw_group.fact_emr_image_analysis_out ia
+        INNER JOIN dw_group.fact_client_out c ON c.file_num = ia.file_num AND c.brand = ia.brand
+        LEFT JOIN (
+          SELECT patient_id, brand, any(organization_id) AS org
+          FROM dw_group.fact_emr_treatment_out WHERE notEmpty(organization_id)
+          GROUP BY patient_id, brand
+        ) po ON po.patient_id = c.patient_id AND po.brand = c.brand
+        ARRAY JOIN [('K02', ia.cavity), ('K01', ia.impacted_tooth), ('K01', ia.embedded_tooth),
+                    ('K04', ia.root_periodontitis), ('K03', ia.root_remnant), ('K03', ia.crown_remnant),
+                    ('K03', ia.wedge_shaped_defect), ('K09', ia.cyst), ('K08', ia.tooth_loss),
+                    ('K00', ia.retained_primary_tooth)] AS cm
+        WHERE c.last_visit_time IS NOT NULL AND notEmpty(po.org) AND cm.2 != '[]' AND cm.2 != ''
+      )
+      WHERE tooth != ''
+
+    # ── 诊所回访任务(fact_returnvisit_out)→ patient_return_visit upsert(展示用,5 试点)──
+    # customer_id AS patient_id(让 cohort 过滤生效);WHERE org ∈ 5 试点(= EMR 表的 org)→ 只摄 5 家。
+    # 非召回信号,详情页"回访记录"块展示(常规/术后/咨询回访)。
+    fact_returnvisit_out: |
+      SELECT id, customer_id AS patient_id, brand, organization_id, task_date,
+             return_visit_type_name, return_visit_status_name, task_status_name,
+             treatment_items, follow_content, return_visit_result
+      FROM dw_group.fact_returnvisit_out
+      WHERE organization_id IN (SELECT DISTINCT organization_id FROM dw_group.fact_emr_treatment_out)
+
+    # ── 客户-推荐人关系(联系人/亲属边)→ patient_relation upsert ──
+    # 一行 = 本人 与 一个关系人(referee)的关系;referee_patient_id=0 = 无关系人,剔除。
+    # 本人(patient_id)限 active client(= PAC patient 才能挂靠);关系人不限(解析得到则填 link)。
+    fact_customer_referee_out: |
+      SELECT patient_id, referee_patient_id, referee_relationship, referee_relationship_name, brand
+      FROM dw_group.fact_customer_referee_out
+      WHERE referee_patient_id != 0
+        AND (patient_id, brand) IN (
+          SELECT patient_id, brand FROM dw_group.fact_client_out
+          WHERE last_visit_time IS NOT NULL
+        )
+
 # ─────────────────────────────────────────────────────────────
 # Layer A.5 transforms(SQL 干过的事搬这里,yaml 声明式)
 # ─────────────────────────────────────────────────────────────
@@ -356,9 +409,10 @@ transforms:
           starts_with: ['建议', '推荐']
       # 流程性 / 复查 / 行政事项 → treatment_review_rows(本次非治疗事件;chain S4 信号)
       # 注:equals 关键词都是 normalize 后的 ASCII 形态(中标点已折叠);不要在这里写中括号/中逗号
+      # &review_terms:YAML anchor — C.9 dispose gate 复用此表(单一真理源,判"treat_plan 无真治疗")
       - output: _treatment_review_raw
         when:
-          equals:
+          equals: &review_terms
             # 复查 / 检查 / 复诊
             - 常规复查
             - 复查
@@ -513,19 +567,21 @@ transforms:
         from: treat_name
         value: ''
 
-  # ── C.9 dispose(处置自由文本)→ 补 actual 治疗(仅 treat_plan 空时)──
-  # 背景:~15% EMR 只有处置、treat_plan 空,处置里其实已做治疗(充填/拔除/根管…)。
-  # 思路(最简):treat_plan 空时拆 dispose,把 message 当作 treat_name **直接 union 进
-  #   treatment_actual_rows** → 复用 treatment_actual.yaml 的 keyword_mapping(含词分类)
-  #   + treatment.parser → 落普通 treatment_completed。不加 assembler/parser/置信度。
-  # gate(treat_plan 空,含 "[]")避免与结构化重复(全量实测 treat_plan 非空时处置 ~63% 是同次重复叙述)。
+  # ── C.9 dispose(处置自由文本)→ 补 actual 治疗(仅 treat_plan 无真治疗时)──
+  # 背景:处置里常已做治疗(充填/拔除/根管…)。两种关键场景:
+  #   ① treat_plan 空 / 仅复查:处置是唯一真治疗源(陈昱天 17:treat_plan=["常规复查"],dispose 树脂充填@17)
+  #   ② treat_plan 有真治疗:处置 ~63% 是同次重复叙述(同牙同类)→ 不能再抽(否则双计)
+  # gate:treat_plan **空 或 全是复查类**(blank_or_all_in &review_terms)才抽 dispose。
+  #   —— 比旧「空才抽」放宽:场景①(treat_plan 仅"常规复查")现在也抽 → 找回被丢的真治疗(解陈昱天误召);
+  #      场景②(treat_plan 有真治疗)仍不抽 → 源头不产生重复(fact-writer 终态不去重,必须源头防)。
+  # 为何不在 parser 去重:treat_plan/dispose 双记是 host 录入习惯(host 差异)→ 处置归 yaml,parser 保持宿主无关。
   - kind: filter
     input: fact_emr_treatment_out
-    output: _emr_dispose_only
+    output: _emr_dispose_gate
     where:
-      treat_plan: { empty: true }
+      treat_plan: { blank_or_all_in: *review_terms }
   - kind: split_json_array
-    input: _emr_dispose_only
+    input: _emr_dispose_gate
     output: _dispose_raw
     array_field: dispose
     parent_keys:
@@ -550,15 +606,102 @@ transforms:
       treat_external_id:
         op: concat
         parts: ['${emr_id}', '|disp|', '${tooth_position}', '|', '${treat_name}']
-      category_raw:           # = message;treatment_actual.yaml enum 未命中 → keyword_mapping 含词分类
-        op: default
+      category_raw:           # = message 归一;normalize 折叠 CJK 标点 → keyword strip 切段(建议/必要时)生效
+        op: normalize         #   否则 "待观察,若…,建议充填治疗" 全角逗号不切段 → strip 失效 → 误判 restorative
         from: treat_name
-        value: ''
   # union 进现有 treatment_actual_rows → 走同一 assembler + parser,落 treatment_completed
   - kind: union
     inputs: ['treatment_actual_rows', '_dispose_tx']
     output: treatment_actual_rows
 
+  # ── C.9b dispose path 2:treat_plan 有真治疗但【全无牙位】→ 去 dispose 找回牙位 ──
+  # 背景:医生在 treat_plan 写了治疗名(充填)却漏填 toothPosition,而牙位写进了 dispose
+  #   (刘小源:treat_plan=[{treatName:"充填",toothPosition:""}],dispose 16;26 树脂充填)。
+  #   path 1(blank_or_all_in)不命中(treat_plan 非空非复查)→ 牙位丢失 → 落无牙位充填,解不了任何牙。
+  # gate:real_no_tooth —— 有真治疗(treatName ∉ review)且所有元素都无牙位。
+  #   排除空/全复查(path 1 已处理,不重复抽 dispose 双计);排除任一元素已带牙位(treat_plan 牙位齐 → 不抽)。
+  # ⭐ dispose 只留【带牙位】条目(tooth_position not_empty)→ 全口牙周/正畸(dispose 多无牙位)不被抽,
+  #   避免与 treat_plan 全口治疗双计;只把结构治疗(充填@16;26)的牙位找回。host 录入习惯归 yaml。
+  - kind: filter
+    input: fact_emr_treatment_out
+    output: _emr_dispose_gate2
+    where:
+      treat_plan: { real_no_tooth: *review_terms }
+  - kind: split_json_array
+    input: _emr_dispose_gate2
+    output: _dispose_raw2
+    array_field: dispose
+    parent_keys:
+      emr_id: id
+      patient_id: patient_id
+      organization_id: organization_id
+      brand: brand
+      rq: rq
+      user_id: user_id
+      doctor_name: doctor_name
+      created_date: created_date
+      updated_date: updated_date
+    element_fields:
+      treat_name: message
+      tooth_position: toothPosition
+    where:
+      treat_name: { not_empty: true }
+      tooth_position: { not_empty: true }   # ⭐ 只留带牙位的 dispose(限制双计)
+  - kind: derive
+    input: _dispose_raw2
+    output: _dispose_tx2
+    fields:
+      treat_external_id:
+        op: concat
+        parts: ['${emr_id}', '|disp2|', '${tooth_position}', '|', '${treat_name}']
+      category_raw:           # 归一(同 C.9/C.10):CJK 标点折叠 → strip 切段(建议/必要时/若…)生效
+        op: normalize
+        from: treat_name
+  - kind: union
+    inputs: ['treatment_actual_rows', '_dispose_tx2']
+    output: treatment_actual_rows
+
+  # ── C.10 ⭐ diag 里的"已治疗状态"(X术后/已充填)→ 补 actual 治疗【证据】 ──
+  # 背景:医生 charting 常把"已补/已根管/已种植"等【已完成治疗的状态】记进 diag 字段
+  #   (谢玉兰 24;25 = "充填术后")。它们 code=null,作为信号本就不召;
+  #   但【必须 resolve 之前同牙的诊断】(如 2023 深龋),否则旧诊断永远无 resolver → 误召。
+  #   ⚠️ 关键:不是"当噪音丢掉"(丢掉=旧深龋还在召),而是"认成已治疗"→ 去解决旧诊断。
+  # 思路(复用 dispose 同款机器):message 当 treat_name → treatment_actual.yaml keyword_mapping
+  #   (充填术后→restorative、根管术后→endodontic、种植术后→implant、拔牙术后→surgical)
+  #   → 落 treatment_completed(occurredAt=本次到访)→ ≥ 之前诊断 → family resolver 自然解决。
+  #   host charting 习惯归 yaml,召回算法零改动。
+  - kind: route_by_pattern
+    input: _diagnosis_raw
+    field: message
+    routes:
+      - output: _post_treatment_raw
+        when:
+          # 已完成态(术后/已X/X后)+ 进行态(治疗中/术中/粘结中)都收:
+          #   本场景=treatment_initiation_recall(未启动),"根管治疗中"=已启动 → 不该召"未启动"。
+          #   ⚠️ 必须用【复合安全词】,避开裸"后/中"误伤(后牙/中切牙/不良修复体/下颌后缩)。
+          #   "修复后"≠"不良修复体"(后 vs 体),特意不用裸"修复"。
+          contains: ['术后', '已充填', '充填后', '治疗后', '治疗中', '术中',
+                     '修复后', '备牙后', '拔牙后', '戴牙后', '取模后', '粘结中', '修整后']
+      - output: _post_treatment_discard   # 其余诊断不在此处理(走上面 B → diagnosis_rows)
+        when:
+          default: true
+  - kind: derive
+    input: _post_treatment_raw
+    output: _post_tx
+    fields:
+      treat_name:                # diag 的 message 当治疗名 → 交 keyword_mapping 含词分类
+        op: normalize            # 对齐主路径 C.2.5:全角→半角 + 标点折叠(ＲＣＴ治疗后→RCT…)
+        from: message
+      treat_external_id:
+        op: concat
+        parts: ['${emr_id}', '|post|', '${tooth_position}', '|', '${message}']
+      category_raw:              # ⭐ 真正喂分类器的字段(treatment_actual.yaml: category←category_raw)
+        op: normalize            # 必须归一,否则全角/中标点变体 enum+keyword 全漏 → category 空 → 丢
+        from: message
+  - kind: union
+    inputs: ['treatment_actual_rows', '_post_tx']
+    output: treatment_actual_rows
+
   # ── E. EMR.file_url JSON 拆行 → 影像 metadata(image_record) ──
   # file_url 元素:{ check_name(影像类型), file_url(存储路径), created_gmt_at(拍摄时间) }
   # PAC 不持文件本体,只落 metadata:类型 / 时间 / 关联接诊 → "拍过 CBCT=种植意向" 类信号
@@ -692,9 +835,12 @@ transforms:
 # ─────────────────────────────────────────────────────────────
 assemblers:
   - { file: assemblers/patient.yaml }
+  - { file: assemblers/patient_relation.yaml }   # 联系人/亲属边(referee → PatientRelation upsert)
+  - { file: assemblers/patient_return_visit.yaml }  # 诊所回访(展示用,5 试点 → PatientReturnVisit upsert)
   - { file: assemblers/encounter.yaml }
   - { file: assemblers/appointment.yaml }
   - { file: assemblers/diagnosis.yaml }
+  - { file: assemblers/image_finding.yaml }   # 影像 AI 分析 → diagnosis_record(code_source=image_ai)
   - { file: assemblers/treatment_planned.yaml }
   - { file: assemblers/treatment_review.yaml }
   - { file: assemblers/treatment_actual.yaml }

apps/pac-service/prisma/migrations/20260604131236_add_patient_relations_drop_primary_contact_type/migration.sql

+/*
+  Warnings:
+
+  - You are about to drop the column `primary_contact_type` on the `patient_profiles` table. All the data in the column will be lost.
+
+*/
+-- AlterTable
+ALTER TABLE "patient_profiles" DROP COLUMN "primary_contact_type";
+
+-- CreateTable
+CREATE TABLE "patient_relations" (
+    "id" UUID NOT NULL,
+    "host_id" UUID NOT NULL,
+    "tenant_id" TEXT NOT NULL,
+    "patient_id" UUID NOT NULL,
+    "related_external_id" TEXT NOT NULL,
+    "related_patient_id" UUID,
+    "relationship" TEXT NOT NULL,
+    "created_at" TIMESTAMPTZ(3) NOT NULL DEFAULT CURRENT_TIMESTAMP,
+    "updated_at" TIMESTAMPTZ(3) NOT NULL,
+
+    CONSTRAINT "patient_relations_pkey" PRIMARY KEY ("id")
+);
+
+-- CreateIndex
+CREATE INDEX "patient_relations_patient_id_idx" ON "patient_relations"("patient_id");
+
+-- CreateIndex
+CREATE INDEX "patient_relations_related_patient_id_idx" ON "patient_relations"("related_patient_id");
+
+-- CreateIndex
+CREATE UNIQUE INDEX "patient_relations_patient_id_related_external_id_relationsh_key" ON "patient_relations"("patient_id", "related_external_id", "relationship");
+
+-- AddForeignKey
+ALTER TABLE "patient_relations" ADD CONSTRAINT "patient_relations_patient_id_fkey" FOREIGN KEY ("patient_id") REFERENCES "patients"("id") ON DELETE CASCADE ON UPDATE CASCADE;
+
+-- AddForeignKey
+ALTER TABLE "patient_relations" ADD CONSTRAINT "patient_relations_related_patient_id_fkey" FOREIGN KEY ("related_patient_id") REFERENCES "patients"("id") ON DELETE SET NULL ON UPDATE CASCADE;

apps/pac-service/prisma/migrations/20260604143103_add_patient_return_visits/migration.sql

+-- CreateTable
+CREATE TABLE "patient_return_visits" (
+    "id" UUID NOT NULL,
+    "host_id" UUID NOT NULL,
+    "tenant_id" TEXT NOT NULL,
+    "patient_id" UUID NOT NULL,
+    "external_id" TEXT NOT NULL,
+    "clinic_id" TEXT,
+    "task_date" DATE,
+    "type" TEXT,
+    "status" TEXT,
+    "task_status" TEXT,
+    "treatment_items" TEXT,
+    "follow_content" TEXT,
+    "result" TEXT,
+    "created_at" TIMESTAMPTZ(3) NOT NULL DEFAULT CURRENT_TIMESTAMP,
+    "updated_at" TIMESTAMPTZ(3) NOT NULL,
+
+    CONSTRAINT "patient_return_visits_pkey" PRIMARY KEY ("id")
+);
+
+-- CreateIndex
+CREATE INDEX "patient_return_visits_patient_id_task_date_idx" ON "patient_return_visits"("patient_id", "task_date" DESC);
+
+-- CreateIndex
+CREATE UNIQUE INDEX "patient_return_visits_host_id_tenant_id_external_id_key" ON "patient_return_visits"("host_id", "tenant_id", "external_id");
+
+-- AddForeignKey
+ALTER TABLE "patient_return_visits" ADD CONSTRAINT "patient_return_visits_patient_id_fkey" FOREIGN KEY ("patient_id") REFERENCES "patients"("id") ON DELETE CASCADE ON UPDATE CASCADE;

apps/pac-service/prisma/schema.prisma

@@ -201,6 +201,12 @@ model Patient {
   facts        PatientFact[]
   personas     Persona[]
   plans        FollowupPlan[]
+  /// 我的联系人/亲属边(本人 → 关系人);关系人本身也是 patient
+  relationsOut PatientRelation[]    @relation("PatientRelationsOut")
+  /// 把我当联系人的边(别人 → 我)
+  relationsIn  PatientRelation[]    @relation("PatientRelationsIn")
+  /// 诊所回访任务记录(展示用,5 试点;非召回信号)
+  returnVisits PatientReturnVisit[]
 
   /// 跨同步 upsert 去重:同一物理人在集团内共享一行
   @@unique([hostId, tenantId, externalId])
@@ -217,7 +223,8 @@ model Patient {
 ///
 /// 拆出来的理由:
 ///   - 主表 Patient 只装"身份"(identity:name/phone/dob 等)— 跨表查询时 JOIN 主表更轻
-///   - 合规字段(doNotContact / deceased / DNC)+ 描述字段(tags / notes / primaryContactType)集中
+///   - 合规字段(doNotContact / deceased / DNC)+ 描述字段(tags / notes)集中
+///   - 联系人/亲属:不在此(已废 primaryContactType)→ 走 PatientRelation 边表
 ///   - 召回池硬过滤走 patient_profiles JOIN(逻辑独立、维护清晰)
 model PatientProfile {
   /// 1:1 用 patientId 作 PK(也兼 FK)
@@ -242,10 +249,6 @@ model PatientProfile {
   ///   notes — 单段长文本(客服备注 / 诊所自由描述)
   notes String?  @db.Text
 
-  /// 产品收集:主要联系人身份(谁接电话):self / spouse / parent / child / guardian / other。
-  /// 儿童/老年患者触达流程不同,Plan 路由要看这个字段。应用层 zod enum 校验。
-  primaryContactType String? @map("primary_contact_type")
-
   createdAt DateTime @default(now()) @map("created_at") @db.Timestamptz(3)
   updatedAt DateTime @updatedAt @map("updated_at") @db.Timestamptz(3)
 
@@ -256,6 +259,84 @@ model PatientProfile {
   @@map("patient_profiles")
 }
 
+/// PatientRelation — 患者-患者关系边(联系人/亲属/转介绍人)。
+///
+/// 第一性:联系人本身也是一个 patient(FHIR RelatedPerson / Patient link)。所以建成
+/// 自关联边,而不是把姓名/电话快照塞进 patient —— 关系人的姓名/电话从 relatedPatient 现取,零冗余。
+///
+/// 来源:host 的"客户-推荐人关系"(referee)。一条 referee = 一条边。
+///   patientId         = 本人(referee.patient_id → PAC patient,必须能解析,否则无处挂靠 → skip)
+///   relatedExternalId = 关系人 host id(referee.referee_patient_id);**始终保留**,唯一稳定引用 + 晚绑定
+///   relatedPatientId  = 关系人 PAC id;关系人本身也是 active patient 时才填(给姓名/电话);否则 null
+///   relationship      = 本人视角:relatedPatient 是本人的 X(mother/father/grandparent/...)
+///
+/// primaryContactType(原 PatientProfile 单字符串)已废弃 —— "谁主要联系"是这张表的派生投影(读时按
+/// relationship + 本人年龄算),不再立柱。
+model PatientRelation {
+  id       String @id @default(uuid()) @db.Uuid
+  hostId   String @map("host_id") @db.Uuid
+  tenantId String @map("tenant_id")
+
+  /// 本人(FK → patients)
+  patientId         String  @map("patient_id") @db.Uuid
+  /// 关系人 host 侧 id(始终有)
+  relatedExternalId String  @map("related_external_id")
+  /// 关系人 PAC id(关系人也是 patient 时填;给姓名/电话)。落不到则 null
+  relatedPatientId  String? @map("related_patient_id") @db.Uuid
+  /// 关系类型(mother/father/grandparent/spouse/child/sibling/friend/other)
+  relationship      String
+
+  createdAt DateTime @default(now()) @map("created_at") @db.Timestamptz(3)
+  updatedAt DateTime @updatedAt @map("updated_at") @db.Timestamptz(3)
+
+  patient        Patient  @relation("PatientRelationsOut", fields: [patientId], references: [id], onDelete: Cascade)
+  relatedPatient Patient? @relation("PatientRelationsIn", fields: [relatedPatientId], references: [id])
+
+  /// 同本人 × 同关系人 × 同关系 唯一(治 host 重复边,如两条"妈妈")
+  @@unique([patientId, relatedExternalId, relationship])
+  @@index([patientId])
+  @@index([relatedPatientId])
+  @@map("patient_relations")
+}
+
+/// PatientReturnVisit — 诊所回访任务记录(展示用,仅 5 试点 org)。
+///
+/// 性质 = 诊所自己的外呼/回访运营记录(常规/术后/咨询回访),**不是临床 fact,不进召回信号**。
+/// 详情页"回访记录"块按 taskDate 倒序展示,让客服看到诊所已做/已排的回访 → 避免重复外呼 + 上下文。
+/// 独立表(非 transaction/fact):摄入按 organization_id ∈ 5 试点 + customer_id→patient 解析 upsert。
+model PatientReturnVisit {
+  id             String    @id @default(uuid()) @db.Uuid
+  hostId         String    @map("host_id") @db.Uuid
+  tenantId       String    @map("tenant_id")
+  patientId      String    @map("patient_id") @db.Uuid
+  /// host 回访记录 id(幂等键)
+  externalId     String    @map("external_id")
+  clinicId       String?   @map("clinic_id")
+  /// 回访任务日期(含未来排程)
+  taskDate       DateTime? @map("task_date") @db.Date
+  /// 类型:常规回访 / 术后回访 / 咨询回访(host 原文)
+  type           String?
+  /// 回访状态:已回访 / 未回访
+  status         String?
+  /// 任务状态:已完成 / 未完成 / 创建新回访
+  taskStatus     String?   @map("task_status")
+  /// 关联治疗项(如 种植)
+  treatmentItems String?   @map("treatment_items")
+  /// 回访内容(术后年度复查 / 洁牙提醒 / 活动邀约…)
+  followContent  String?   @map("follow_content")
+  /// 回访结果
+  result         String?
+
+  createdAt DateTime @default(now()) @map("created_at") @db.Timestamptz(3)
+  updatedAt DateTime @updatedAt @map("updated_at") @db.Timestamptz(3)
+
+  patient Patient @relation(fields: [patientId], references: [id], onDelete: Cascade)
+
+  @@unique([hostId, tenantId, externalId])
+  @@index([patientId, taskDate(sort: Desc)])
+  @@map("patient_return_visits")
+}
+
 /// 患者操作账本(append-only)。
 /// 一条记录回答:**"在哪个宿主、哪个 tenant、哪个诊所、对哪个主体,做了什么动作"**。
 /// 原始证据存在 rawPayload(宿主原文),canonical 化和事实视图在 patient_facts 层做。

apps/pac-service/src/modules/persona/features/feature.interface.ts

@@ -29,7 +29,6 @@ export interface FeatureExtractorContext {
     deceased: boolean;
     tags: string[];
     notes: string | null;
-    primaryContactType: string | null;
   } | null;
   /// 该 patient 的所有 active facts(按 type 索引方便查)
   factsByType: Map<string, ActiveFact[]>;

apps/pac-service/src/modules/persona/persona.service.ts

@@ -168,7 +168,6 @@ export class PersonaService {
               deceased: patient.profile.deceased,
               tags: patient.profile.tags,
               notes: patient.profile.notes,
-              primaryContactType: patient.profile.primaryContactType,
             }
           : null,
         factsByType,

apps/pac-service/src/modules/plan-aggregate/plan-aggregate.service.ts

@@ -37,7 +37,15 @@ export class PlanAggregateService {
     }
     const patient = await this.prisma.patient.findUnique({
       where: { id: plan.patientId },
-      include: { profile: true },
+      include: {
+        profile: true,
+        // 联系人/亲属边 → 关系人姓名/电话从 relatedPatient 现取(patient↔patient,零冗余)
+        relationsOut: {
+          include: { relatedPatient: { select: { name: true, phone: true } } },
+        },
+        // 诊所回访记录(展示用,按时间倒序,封顶 100;每患者 p99=19,够用)
+        returnVisits: { orderBy: { taskDate: 'desc' }, take: 100 },
+      },
     });
     if (!patient) throw new NotFoundException(`Patient ${plan.patientId} not found`);
 
@@ -70,7 +78,13 @@ export class PlanAggregateService {
 
   private async assemble(
     scope: TenantScopeContext,
-    patient: Prisma.PatientGetPayload<{ include: { profile: true } }>,
+    patient: Prisma.PatientGetPayload<{
+      include: {
+        profile: true;
+        relationsOut: { include: { relatedPatient: { select: { name: true; phone: true } } } };
+        returnVisits: true;
+      };
+    }>,
     plan: Prisma.FollowupPlanGetPayload<{ include: { reasons: true } }> | null,
   ) {
     const persona = await this.loadCurrentPersona(patient.id);
@@ -143,6 +157,15 @@ export class PlanAggregateService {
       facts: facts.map(serializeFact),
       script: script ? serializeScript(script) : null,
       recallHistory,
+      returnVisits: (patient.returnVisits ?? []).map((r) => ({
+        taskDate: r.taskDate ? r.taskDate.toISOString().slice(0, 10) : null,
+        type: r.type,
+        status: r.status,
+        taskStatus: r.taskStatus,
+        treatmentItems: r.treatmentItems,
+        followContent: r.followContent,
+        result: r.result,
+      })),
     };
   }
 
@@ -276,9 +299,14 @@ function serializeProfile(
     profile: {
       doNotContact: boolean;
       deceased: boolean;
-      primaryContactType: string | null;
       notes: string | null;
     } | null;
+    relationsOut?: Array<{
+      relationship: string;
+      relatedExternalId: string;
+      relatedPatientId: string | null;
+      relatedPatient: { name: string | null; phone: string | null } | null;
+    }>;
   },
   allFacts: Array<{ type: string; content: Prisma.JsonValue; occurredAt: Date | null }>,
   encounters: Array<{ occurredAt: Date | null; content: Prisma.JsonValue }>,
@@ -312,10 +340,21 @@ function serializeProfile(
     ),
   ).slice(0, 2);
 
+  // 联系人/亲属:本人视角(relatedPatient 是本人的 X)。姓名/电话从 relatedPatient 现取。
+  //   linked=false(关系人未建档)→ 无姓名,前端展示时跳过。已建档的排前。
+  const contacts = (patient.relationsOut ?? [])
+    .map((r) => ({
+      relationship: r.relationship,
+      relationshipLabel: RELATIONSHIP_LABEL[r.relationship] ?? r.relationship,
+      name: r.relatedPatient?.name ?? null,
+      phone: r.relatedPatient?.phone ?? null,
+      linked: !!r.relatedPatientId,
+    }))
+    .sort((a, b) => Number(b.linked) - Number(a.linked));
+
   return {
     doNotContact: patient.profile.doNotContact,
     deceased: patient.profile.deceased,
-    primaryContactType: patient.profile.primaryContactType,
     notes: patient.profile.notes,
     ltvCents,
     paymentCount: payments.length,
@@ -325,9 +364,23 @@ function serializeProfile(
     lastVisit: latestEncounter?.occurredAt?.toISOString().slice(0, 10) ?? null,
     daysSinceLatestVisit,
     doctors,
+    contacts,
   };
 }
 
+/// 关系枚举 → 中文展示标签(本人视角:对方是本人的 X)
+const RELATIONSHIP_LABEL: Record<string, string> = {
+  mother: '妈妈',
+  father: '爸爸',
+  grandparent: '祖辈',
+  spouse: '配偶',
+  child: '子女',
+  sibling: '兄弟姐妹',
+  grandchild: '孙辈',
+  friend: '朋友',
+  other: '亲属',
+};
+
 function serializePlan(plan: {
   id: string;
   version: number;

apps/pac-service/src/modules/plan/engine/scenarios/treatment-initiation-recall.scenario.ts

@@ -7,6 +7,7 @@ import {
   RESTORATION_INELIGIBLE_DX_NAMES,
   lookupDxTreatment,
   resolverCategoriesFor,
+  STRUCTURAL_DX_CODE_LIST,
   diagnosisCodeNameZh,
   treatmentCategoryNameZh,
 } from '@pac/types';
@@ -280,12 +281,15 @@ export class TreatmentInitiationRecallScenario implements PlanScenarioPlugin {
     //       ② 去残留空格 ③ 按 ';' 拆。例:
     //      "1D;1E;2D"  → {1D,1E,2D}(乳牙保留)   "1D OD;17 D" → {1D,17}(剥面)   "16;46" → {16,46}
     //   注:JS 模板里反向引用要写 '\\1'(传到 SQL 为 '\1');用 POSIX [[:space:]] 避开 \s 转义坑。
+    //   ⭐ 合法牙过滤(口径同 util.isValidToothToken):只留【数字开头 + ≥2 字符】的 token。
+    //      裸单数字 1-8(象限号,医生把 "16" 笔误成 "1")非法 → 丢,否则造幽灵召回 caries@1。
+    //      `x ~ '^[0-9].'`:数字开头且其后还有字符(裸 "1" 仅 1 字符 → 不匹配 → 滤掉)。
     const toothArrSql = (expr: Prisma.Sql) =>
-      Prisma.sql`array_remove(string_to_array(
+      Prisma.sql`(SELECT COALESCE(array_agg(x), ARRAY[]::text[]) FROM unnest(array_remove(string_to_array(
         regexp_replace(
           regexp_replace(${expr}, '([0-9]+[A-Ea-e]?)[[:space:]]+[DMOBLPIdmoblpi]+', '\\1', 'g'),
           '[[:space:]]+', '', 'g'),
-        ';'), '')`;
+        ';'), '')) AS x WHERE x ~ '^[0-9].')`;
     // 该信号"已被解决"的牙位集合 = 诊断后同牙做了 resolverCats 家族里任一治疗(afterDx)。
     //   ⭐ 治疗家族 resolver(单一真理源 canonical-codes.resolverCategoriesFor):
     //     结构码 resolverCats = 局部结构治疗全集(充填/嵌体/冠桥/种植/牙髓/外科/美学/儿牙)—
@@ -299,15 +303,44 @@ export class TreatmentInitiationRecallScenario implements PlanScenarioPlugin {
       ? Prisma.empty
       : Prisma.sql`AND rtx.occurred_at >= COALESCE(sig.occurred_at, sig.planned_for)`;
     const resolvedTeethSql = Prisma.sql`
-      (SELECT COALESCE(array_agg(DISTINCT rtt), ARRAY[]::text[])
+      (SELECT COALESCE(array_agg(DISTINCT t), ARRAY[]::text[]) FROM (
+        -- (a) 治疗家族 resolver(afterDx):同牙诊断后做了 resolverCats 家族里任一治疗
+        SELECT rtt AS t
           FROM patient_facts rtx
           CROSS JOIN unnest(${toothArrSql(Prisma.sql`rtx.content->>'tooth_position'`)}) AS rtt
          WHERE rtx.patient_id = p.id
            AND rtx.type = 'treatment_record' AND rtx.kind = 'actual'
            AND rtx.status IN ('active', 'fulfilled')
            AND COALESCE(NULLIF(trim(rtx.content->>'tooth_position'), ''), '') != ''
-          AND rtx.content->>'category' = ANY(${resolverCats}::text[])   -- 治疗家族 resolver(afterDx)
-          ${afterDxFragRtx})`;
+           AND rtx.content->>'category' = ANY(${resolverCats}::text[])
+           ${afterDxFragRtx}
+        UNION
+        -- (b) ⭐ 同牙位以【最新诊断】为准:某牙存在比本信号更晚的真实诊断 → 旧诊断对该牙失效。
+        --   解:深龋(2023)→ 缺失(2024)缺失取代龋(牙没了,补龋/拔牙都 moot);龋→牙髓炎(进展)只召根管;
+        --       复发同病只认最新那次(daysSince 从最新算)。证据是【诊断】本身,无需治疗记录。
+        --   只算"真实码"(非空码,排除深窝沟等 null 噪音);严格更晚(> 不含同刻,避免自我取代)。
+        --   wholeMouth 码(K05/K07)走 category 级、sig_teeth 空 → 不经此路径,不受影响。
+        SELECT ldt AS t
+          FROM patient_facts ldx
+          CROSS JOIN unnest(${toothArrSql(Prisma.sql`ldx.content->>'tooth_position'`)}) AS ldt
+         WHERE ldx.patient_id = p.id
+           AND ldx.type = 'diagnosis_record' AND ldx.status = 'active'
+           AND ldx.content->>'code' = ANY(${[...STRUCTURAL_DX_CODE_LIST]}::text[])  -- 仅结构码取代(牙周/正畸不 moot 结构病)
+           AND ldx.occurred_at > COALESCE(sig.occurred_at, sig.planned_for)
+        UNION
+        -- (c) ⭐ 诊断 vs 建议冲突,以【建议】为准(医生治疗决定 > 诊断):
+        --   某牙存在 ≥ 本诊断时间的真实建议(建议拔除/种植…)→ 该诊断对该牙失效,听医生的决定。
+        --   18:深龋(诊断)+ 建议拔除(同日)→ 龋失效,只留拔除。只作用于本 sig 是【诊断】时
+        --   (建议本身不被同牙建议取代;建议被更晚诊断取代已由 (b) 覆盖)。
+        SELECT rdt AS t
+          FROM patient_facts rdx
+          CROSS JOIN unnest(${toothArrSql(Prisma.sql`rdx.content->>'tooth_position'`)}) AS rdt
+         WHERE rdx.patient_id = p.id
+           AND rdx.type = 'recommendation_record' AND rdx.status = 'active'
+           AND rdx.content->>'code' = ANY(${[...STRUCTURAL_DX_CODE_LIST]}::text[])  -- 仅结构建议(拔除/种植/充填…)取代;牙周/正畸建议不 moot 结构病
+           AND COALESCE(rdx.occurred_at, rdx.planned_for) >= COALESCE(sig.occurred_at, sig.planned_for)
+           AND sig.type = 'diagnosis_record'
+      ) u)`;
 
     // ╔═════════════════════════════════════════════════════════════════════╗
     // ║ 召回 SQL 完整解读(initiation = 潜在治疗新链召回)                  ║

apps/pac-service/src/modules/sync/assembler/assembler-engine.ts

@@ -338,14 +338,19 @@ export function classifyByKeyword(
   let text = value;
   if (stripClauses && stripClauses.length) {
     text = value
-      .split(/[,;。]/)
+      .split(/[,;。，；]/) // 含全角逗号/分号:防御未归一输入,strip 切段不漏(否则整句一段 → 建议/若 没剥)
       .map((s) => s.trim())
       .filter((seg) => seg && !stripClauses.some((p) => seg.startsWith(p)))
       .join(',');
   }
   if (!text) return undefined;
   for (const rule of rules) {
-    if (rule.any.some((kw) => kw && text.includes(kw))) return rule.value;
+    const hit = rule.any.some((kw) => kw && text.includes(kw));
+    if (!hit) continue;
+    // none:排除词(命中 any 但也含 none 中任一 → 不算命中,继续下一规则)。
+    //   用于"含词但语义反转"——如 龋 any=[龋] none=[风险,可疑](高龋风险/可疑龋是风险/可疑,非龋洞)。
+    if (rule.none && rule.none.some((kw) => kw && text.includes(kw))) continue;
+    return rule.value;
   }
   return undefined;
 }

apps/pac-service/src/modules/sync/assembler/assembler.schema.ts

@@ -37,6 +37,8 @@ const KeywordRuleSchema = z.object({
   value: z.string(),
   /// 含任一词即命中(子串 includes)
   any: z.array(z.string().min(1)).min(1),
+  /// 排除词:命中 any 但也含 none 中任一 → 不算命中(语义反转,如 龋 any=[龋] none=[风险,可疑])
+  none: z.array(z.string().min(1)).optional(),
 });
 export type KeywordRule = z.infer<typeof KeywordRuleSchema>;
 const keywordMappingForField = z.array(KeywordRuleSchema);

apps/pac-service/src/modules/sync/cold-import/cold-import.service.ts

@@ -193,7 +193,15 @@ export class ColdImportService {
       // 5. 加载 assembler configs(一次,全 cohort batch 共用)
       const assemblerConfigs = this.loadAllAssemblers(absDir, manifest);
       const patientCfg = assemblerConfigs.find((c) => c.canonical === 'patient');
-      const subjectCfgs = assemblerConfigs.filter((c) => c.canonical !== 'patient');
+      const patientRelationCfg = assemblerConfigs.find((c) => c.canonical === 'patient_relation');
+    const patientReturnVisitCfg = assemblerConfigs.find((c) => c.canonical === 'patient_return_visit');
+      // patient + patient_relation 都是 upsert 资源(非 transaction)→ 排除出 subjectCfgs
+      const subjectCfgs = assemblerConfigs.filter(
+        (c) =>
+        c.canonical !== 'patient' &&
+        c.canonical !== 'patient_relation' &&
+        c.canonical !== 'patient_return_visit',
+      );
       const normalize = { amountUnit: manifest.amount_unit, timezone: manifest.timezone };
 
       // 6. 决定 cohort 模式:
@@ -246,6 +254,8 @@ export class ColdImportService {
               seenTenants,
               normalize,
               patientCfg,
+              patientRelationCfg,
+              patientReturnVisitCfg,
               subjectCfgs,
               syncLogId: syncLog?.id,
               dryRun: options.dryRun ?? false,
@@ -312,6 +322,8 @@ export class ColdImportService {
           seenTenants,
           normalize,
           patientCfg,
+          patientRelationCfg,
+          patientReturnVisitCfg,
           subjectCfgs,
           syncLogId: syncLog?.id,
           dryRun: options.dryRun ?? false,
@@ -463,7 +475,14 @@ export class ColdImportService {
     // 4. Assemblers
     const assemblerConfigs = this.loadAllAssemblers(absDir, manifest);
     const patientCfg = assemblerConfigs.find((c) => c.canonical === 'patient');
-    const subjectCfgs = assemblerConfigs.filter((c) => c.canonical !== 'patient');
+    const patientRelationCfg = assemblerConfigs.find((c) => c.canonical === 'patient_relation');
+    const patientReturnVisitCfg = assemblerConfigs.find((c) => c.canonical === 'patient_return_visit');
+    const subjectCfgs = assemblerConfigs.filter(
+      (c) =>
+        c.canonical !== 'patient' &&
+        c.canonical !== 'patient_relation' &&
+        c.canonical !== 'patient_return_visit',
+    );
 
     // 5. SyncLog — resource='patient_refresh' ⭐ 跟增量隔离 ⭐
     //    tenantId 用 resolver 已知的(单 brand → 唯一 tenant);若动态 pass-through 用 sentinel
@@ -497,6 +516,22 @@ export class ColdImportService {
       if (!firstError && stats.failed > 0) firstError ||= `patient: ${stats.failed} rows failed`;
     }
 
+    if (patientRelationCfg) {
+      const stats = await this.processPatientRelations(
+        tables, patientRelationCfg, host.id, tenantResolver, normalize, false,
+      );
+      perResource.push(stats);
+      totals.failed += stats.failed;
+    }
+
+    if (patientReturnVisitCfg) {
+      const stats = await this.processPatientReturnVisits(
+        tables, patientReturnVisitCfg, host.id, tenantResolver, normalize, false,
+      );
+      perResource.push(stats);
+      totals.failed += stats.failed;
+    }
+
     for (const cfg of subjectCfgs) {
       try {
         const stats = await this.processSubject(
@@ -576,6 +611,8 @@ export class ColdImportService {
     seenTenants: Set<string>;
     normalize: { amountUnit: 'fen' | 'yuan'; timezone: string };
     patientCfg: AssemblerConfig | undefined;
+    patientRelationCfg: AssemblerConfig | undefined;
+    patientReturnVisitCfg: AssemblerConfig | undefined;
     subjectCfgs: AssemblerConfig[];
     syncLogId: string | undefined;
     dryRun: boolean;
@@ -637,6 +674,40 @@ export class ColdImportService {
       );
     }
 
+    // 3.5 patient_relation(联系人/亲属边)— 须在 patients 之后(两端解析靠 patient 索引)
+    if (args.patientRelationCfg) {
+      const stats = await this.processPatientRelations(
+        tables,
+        args.patientRelationCfg,
+        args.host.id,
+        args.tenantResolver,
+        args.normalize,
+        args.dryRun,
+      );
+      args.perResource.push(stats);
+      args.totals.failed += stats.failed;
+      this.logger.log(
+        `patient_relation: upserted=${stats.patientsUpserted} failed=${stats.failed}`,
+      );
+    }
+
+    // 3.6 patient_return_visit(诊所回访,展示用)— 同样在 patients 之后(靠 patient 索引解析)
+    if (args.patientReturnVisitCfg) {
+      const stats = await this.processPatientReturnVisits(
+        tables,
+        args.patientReturnVisitCfg,
+        args.host.id,
+        args.tenantResolver,
+        args.normalize,
+        args.dryRun,
+      );
+      args.perResource.push(stats);
+      args.totals.failed += stats.failed;
+      this.logger.log(
+        `patient_return_visit: upserted=${stats.patientsUpserted} failed=${stats.failed}`,
+      );
+    }
+
     // 4. 其他资源(transaction 合成 + parser 衍生 fact)
     for (const cfg of args.subjectCfgs) {
       try {
@@ -741,12 +812,10 @@ export class ColdImportService {
         doNotContact: (c.doNotContact as boolean) ?? false,
         deceased: (c.deceased as boolean) ?? false,
         // canonical 字段(若 host 没给 → null/默认)
-        // tags / notes / primaryContactType 需要从 canonical 拿;v2 canonical PatientSchema 暂不显式带
-        // host 通过 host_tags / host_notes 等字段 → assembler.yaml 映射到 canonical;此处兜底
+        // tags / notes 需要从 canonical 拿;host 通过 host_tags / host_notes → assembler.yaml 映射,此处兜底
+        // (primaryContactType 已废弃 → 联系人改走 PatientRelation 边表,processPatientRelations)
         tags: Array.isArray(c.tags) ? (c.tags as string[]) : [],
         notes: (c.notes as string | undefined) ?? null,
-        primaryContactType:
-          (c.primaryContactType as string | undefined) ?? null,
       };
 
       try {
@@ -784,6 +853,172 @@ export class ColdImportService {
   }
 
   // ─────────────────────────────────────────────────────────
+  // patient_relation 资源 → upsert 患者-患者关系边(联系人/亲属)
+  //   canonical: { patientExternalId, relatedExternalId, relationship }
+  //   本人(patientExternalId)必须能解析到 PAC patient(否则无处挂靠 → skip);
+  //   关系人(relatedExternalId)解析到 PAC patient 时填 relatedPatientId(给姓名/电话),否则 null。
+  // ─────────────────────────────────────────────────────────
+  private async processPatientRelations(
+    tables: Record<string, unknown[]>,
+    config: AssemblerConfig,
+    hostId: string,
+    tenantResolver: TenantResolver,
+    normalize: { amountUnit: 'fen' | 'yuan'; timezone: string },
+    dryRun: boolean,
+  ): Promise<PerResourceStats> {
+    const stats: PerResourceStats = this.zeroPerResource(config.canonical);
+    const assembled = this.assembler.assemble({ tables, config, normalize, hostId });
+    stats.fetched = assembled.stats.fetched;
+    stats.failed = assembled.stats.failed;
+    if (assembled.rows.length > 0)
+      stats.sampleCanonical.push(assembled.rows[0]!.canonical);
+    if (dryRun) return stats;
+
+    // 本租户 externalId → PAC patient id 索引(本人 + 关系人解析共用)
+    const indexByTenant = new Map<string, Map<string, string>>();
+    const getIndex = async (tenantId: string) => {
+      let idx = indexByTenant.get(tenantId);
+      if (!idx) {
+        idx = await this.buildPatientIndex(hostId, tenantId);
+        indexByTenant.set(tenantId, idx);
+      }
+      return idx;
+    };
+
+    for (const { canonical, rawSource } of assembled.rows) {
+      const c = canonical as Record<string, unknown>;
+      const patientExternalId = String(c.patientExternalId ?? '').trim();
+      const relatedExternalId = String(c.relatedExternalId ?? '').trim();
+      const relationship = String(c.relationship ?? '').trim();
+      if (!patientExternalId || !relatedExternalId || !relationship) {
+        stats.failed++;
+        continue;
+      }
+      const tenantId = tenantResolver.resolve(rawSource);
+      if (!tenantId) {
+        stats.failed++;
+        continue;
+      }
+      const idx = await getIndex(tenantId);
+      const patientId = idx.get(patientExternalId);
+      if (!patientId) continue; // 本人不在 PAC(非 active client)→ 无处挂靠,跳过
+      const relatedPatientId = idx.get(relatedExternalId) ?? null;
+
+      try {
+        await this.withDbRetry(
+          () =>
+            this.prisma.patientRelation.upsert({
+              where: {
+                patientId_relatedExternalId_relationship: {
+                  patientId,
+                  relatedExternalId,
+                  relationship,
+                },
+              },
+              create: {
+                hostId,
+                tenantId,
+                patientId,
+                relatedExternalId,
+                relatedPatientId,
+                relationship,
+              },
+              update: { relatedPatientId }, // 关系人后来才入库 → 回填 link
+            }),
+          'patientRelation upsert',
+        );
+        stats.patientsUpserted++; // 复用计数字段(resource 标签区分);不并入 totals.patients
+      } catch (err) {
+        stats.failed++;
+        this.logger.error(
+          `patientRelation upsert failed ${patientExternalId}→${relatedExternalId}: ${err instanceof Error ? err.message : err}`,
+        );
+      }
+    }
+    return stats;
+  }
+
+  // ─────────────────────────────────────────────────────────
+  // patient_return_visit 资源 → upsert 诊所回访记录(展示用,5 试点)
+  //   本人(patientExternalId=customer_id)须解析到 PAC patient(否则无处挂靠 → skip)。
+  // ─────────────────────────────────────────────────────────
+  private async processPatientReturnVisits(
+    tables: Record<string, unknown[]>,
+    config: AssemblerConfig,
+    hostId: string,
+    tenantResolver: TenantResolver,
+    normalize: { amountUnit: 'fen' | 'yuan'; timezone: string },
+    dryRun: boolean,
+  ): Promise<PerResourceStats> {
+    const stats: PerResourceStats = this.zeroPerResource(config.canonical);
+    const assembled = this.assembler.assemble({ tables, config, normalize, hostId });
+    stats.fetched = assembled.stats.fetched;
+    stats.failed = assembled.stats.failed;
+    if (assembled.rows.length > 0)
+      stats.sampleCanonical.push(assembled.rows[0]!.canonical);
+    if (dryRun) return stats;
+
+    const indexByTenant = new Map<string, Map<string, string>>();
+    const getIndex = async (tenantId: string) => {
+      let idx = indexByTenant.get(tenantId);
+      if (!idx) {
+        idx = await this.buildPatientIndex(hostId, tenantId);
+        indexByTenant.set(tenantId, idx);
+      }
+      return idx;
+    };
+
+    for (const { canonical, rawSource } of assembled.rows) {
+      const c = canonical as Record<string, unknown>;
+      const externalId = String(c.externalId ?? '').trim();
+      const patientExternalId = String(c.patientExternalId ?? '').trim();
+      if (!externalId || !patientExternalId) {
+        stats.failed++;
+        continue;
+      }
+      const tenantId = tenantResolver.resolve(rawSource);
+      if (!tenantId) {
+        stats.failed++;
+        continue;
+      }
+      const idx = await getIndex(tenantId);
+      const patientId = idx.get(patientExternalId);
+      if (!patientId) continue; // 本人不在 PAC → skip
+
+      const data = {
+        clinicId: (c.clinicId as string | undefined) ?? null,
+        taskDate: c.taskDate ? new Date(c.taskDate as string) : null,
+        type: (c.type as string | undefined) ?? null,
+        status: (c.status as string | undefined) ?? null,
+        taskStatus: (c.taskStatus as string | undefined) ?? null,
+        treatmentItems: (c.treatmentItems as string | undefined) ?? null,
+        followContent: (c.followContent as string | undefined) ?? null,
+        result: (c.result as string | undefined) ?? null,
+      };
+      try {
+        await this.withDbRetry(
+          () =>
+            this.prisma.patientReturnVisit.upsert({
+              where: {
+                hostId_tenantId_externalId: { hostId, tenantId, externalId },
+              },
+              create: { hostId, tenantId, externalId, patientId, ...data },
+              update: { patientId, ...data },
+            }),
+          'patientReturnVisit upsert',
+        );
+        stats.patientsUpserted++;
+      } catch (err) {
+        stats.failed++;
+        this.logger.error(
+          `patientReturnVisit upsert failed ${externalId}: ${err instanceof Error ? err.message : err}`,
+        );
+      }
+    }
+    return stats;
+  }
+
+  // ─────────────────────────────────────────────────────────
   // Subject 资源 → 合成 transaction → parser 衍生 fact
   // ─────────────────────────────────────────────────────────
 

apps/pac-service/src/modules/sync/pipeline/fact-content-schemas.ts

@@ -81,9 +81,10 @@ const DiagnosisRecordContent = z
     // 翻不出的仍落 fact(保 name_zh 原文),code=null,留给 Layer C LLM 后续补码。
     // 算法 SQL `content->>'code'='K08'` 对 null 自然不命中,无副作用。
     code: PACDiagnosisCodeSchema.nullable(),
-    /// 码来源溯源:'std_code'(host ICD 码)/ 'name_map'(中文名白名单翻译)/ 'llm'(W5+ 抽取)/ null(未定码)
+    /// 码来源溯源:'std_code'(host ICD 码)/ 'name_map'(中文名白名单翻译)/ 'llm'(W5+ 抽取)/
+    ///   'image_ai'(影像 AI 分析,fact_emr_image_analysis_out)/ null(未定码)
     code_source: z
-      .enum(['std_code', 'name_map', 'llm'])
+      .enum(['std_code', 'name_map', 'llm', 'image_ai'])
       .nullable()
       .optional()
       .default(null),

apps/pac-service/src/modules/sync/pipeline/parsers/diagnosis.parser.ts

@@ -44,9 +44,13 @@ export class DiagnosisParser implements Parser {
     const codeParsed = PACDiagnosisCodeSchema.safeParse(rawCode);
     const code = codeParsed.success ? codeParsed.data : null;
 
-    // code_source 溯源
+    // code_source 溯源:① 上游显式声明(如影像 AI codeSource='image_ai')优先;
+    //   ② 否则按 stdCode 有无推断(std_code / name_map);③ 无码 → null。通用,非宿主特化。
+    const explicitSource = String(c.codeSource ?? '').trim();
     const hasStdCode = !!String(c.stdCodeRaw ?? '').trim();
-    const codeSource: 'std_code' | 'name_map' | null = code
+    const codeSource: string | null = explicitSource
+      ? explicitSource
+      : code
         ? hasStdCode
           ? 'std_code'
           : 'name_map'

apps/pac-service/src/modules/sync/pipeline/parsers/tooth-position.util.ts

@@ -60,8 +60,20 @@ export function normalizeToothPosition(input: string | null | undefined): string
  *   "11 M;21 M"       → Set { "11", "21" }
  *   "1A;1B;1C"        → Set { "1A", "1B", "1C" }
  */
+/**
+ * 合法牙位 token 判定:必须【数字开头 + 至少 2 字符】。
+ *   合法:FDI 恒牙 11-48 / FDI 乳牙 51-85(两位数字) · Palmer 乳牙 1A-8E(数字+字母)。
+ *   非法:裸单数字 1-8(象限号,医生笔误漏打,如 "16"→"1")—— 任何记号体系都不是合法牙,
+ *         留着会造永不可解的幽灵召回(caries@1)。丢弃 ≠ 解读(不猜它本该是哪颗),只是不对垃圾下手。
+ */
+export function isValidToothToken(t: string): boolean {
+  return t.length >= 2 && /^\d/.test(t);
+}
+
 export function toothSet(input: string | null | undefined): Set<string> {
   const norm = normalizeToothPosition(input);
   if (!norm) return new Set();
-  return new Set(norm.split(';').map((t) => t.trim()).filter(Boolean));
+  return new Set(
+    norm.split(';').map((t) => t.trim()).filter(Boolean).filter(isValidToothToken),
+  );
 }

apps/pac-service/src/modules/sync/pipeline/pipeline-dispatcher.service.ts

@@ -232,7 +232,6 @@ export class PipelineDispatcher {
       deceased: (row.deceased as boolean | undefined) ?? false,
       tags: Array.isArray(row.tags) ? (row.tags as string[]) : [],
       notes: (row.notes as string | undefined) ?? null,
-      primaryContactType: (row.primaryContactType as string | undefined) ?? null,
     };
 
     const patient = await this.prisma.patient.upsert({

apps/pac-service/src/modules/sync/transforms/operators/derive.op.ts

@@ -38,11 +38,17 @@ const CJK_PUNCT_MAP: Record<string, string> = {
 const CJK_PUNCT_KEYS = Object.keys(CJK_PUNCT_MAP).join('');
 const CJK_PUNCT_REGEX = new RegExp(`[${CJK_PUNCT_KEYS}]`, 'gu');
 
+/// 全角字母/数字 → 半角(ＲＣＴ→RCT、０-９→0-9、Ａ-Ｚ/ａ-ｚ→ASCII)。
+/// host EMR free-text 常夹全角英数(ＲＣＴ治疗后),不折叠则 enum/keyword 字典(半角)永远漏。
+/// FF10-19 数字 / FF21-3A 大写 / FF41-5A 小写,统一 -0xFEE0 落到 ASCII;通用,非宿主特化。
+const FULLWIDTH_ALNUM_REGEX = /[０-９Ａ-Ｚａ-ｚ]/gu;
+
 function normalizeText(s: string): string {
   return s
     .trim()
     .replace(TRAILING_NOISE, '')
     .replace(CJK_PUNCT_REGEX, (ch) => CJK_PUNCT_MAP[ch] ?? ch)
+    .replace(FULLWIDTH_ALNUM_REGEX, (ch) => String.fromCharCode(ch.charCodeAt(0) - 0xfee0))
     .trim();
 }
 

apps/pac-service/src/modules/sync/transforms/operators/filter.op.ts

@@ -50,6 +50,62 @@ function isBlankValue(v: unknown): boolean {
   }
 }
 
+/// blank_or_all_in:空,或 JSON 数组里**每个**元素的 treatName ∈ 列表(空 treatName 也算通过)。
+/// 用于 dispose gate:treat_plan 空 / 全是复查类(无真治疗)→ 才去 dispose 抽治疗(陈昱天案例)。
+/// 任一元素 treatName 不在列表(= 真治疗)→ false → 不抽 dispose(避免与结构化重复)。
+/// 匹配 = trim 后精确(对齐 C.3 route 的 equals 语义;review 词多无标点,raw≈normalize)。
+function isBlankOrAllIn(v: unknown, list: Array<string | number>): boolean {
+  if (isBlankValue(v)) return true;
+  if (typeof v !== 'string') return false;
+  const t = v.trim();
+  if (!t.startsWith('[')) return false;
+  let arr: unknown;
+  try {
+    arr = JSON.parse(t);
+  } catch {
+    return false;
+  }
+  if (!Array.isArray(arr)) return false;
+  if (arr.length === 0) return true;
+  const set = new Set(list.map((x) => String(x).trim()));
+  return arr.every((el) => {
+    if (!el || typeof el !== 'object') return true;
+    const name = String((el as Record<string, unknown>).treatName ?? '').trim();
+    return name === '' || set.has(name);
+  });
+}
+
+/// real_no_tooth:JSON 数组里【有 ≥1 个真治疗(treatName 非空且 ∉ review 列表)】
+///   **且 没有任何元素带牙位(toothPosition 全空)**。
+/// 用于 dispose gate 的 path 2:treat_plan 有真治疗(充填)但牙位漏填(刘小源"充填"无牙位)→
+///   treat_plan 给不出牙位 → 去 dispose 找回牙位。
+/// 刻意排除:① 空 / 全复查(交 path 1 的 blank_or_all_in 处理,避免两路重复抽 dispose 双计);
+///          ② 任一元素已带牙位(treat_plan 牙位齐全 → 不抽,避免同次重复)。
+function isRealNoTooth(v: unknown, list: Array<string | number>): boolean {
+  if (typeof v !== 'string') return false;
+  const t = v.trim();
+  if (!t.startsWith('[')) return false;
+  let arr: unknown;
+  try {
+    arr = JSON.parse(t);
+  } catch {
+    return false;
+  }
+  if (!Array.isArray(arr) || arr.length === 0) return false;
+  const review = new Set(list.map((x) => String(x).trim()));
+  let hasReal = false;
+  let anyTooth = false;
+  for (const el of arr) {
+    if (!el || typeof el !== 'object') continue;
+    const o = el as Record<string, unknown>;
+    const name = String(o.treatName ?? '').trim();
+    const tooth = String(o.toothPosition ?? '').trim();
+    if (name !== '' && !review.has(name)) hasReal = true;
+    if (tooth !== '') anyTooth = true;
+  }
+  return hasReal && !anyTooth;
+}
+
 function passAll(row: Row, where: Record<string, WhereRule>): boolean {
   for (const [field, rule] of Object.entries(where)) {
     const v = row[field];
@@ -60,6 +116,12 @@ function passAll(row: Row, where: Record<string, WhereRule>): boolean {
       //   [{treatName:"",toothPosition:null,toothPositionBak:"<base64>"}])。
       // 用于 gate "无结构化治疗" — treat_plan 空壳时也应去 dispose 找治疗。
       if (!isBlankValue(v)) return false;
+    } else if ('blank_or_all_in' in rule) {
+      // 空 或 JSON 数组每个元素 treatName ∈ 列表 → 通过(treat_plan 无真治疗 → 去 dispose 抽)。
+      if (!isBlankOrAllIn(v, rule.blank_or_all_in)) return false;
+    } else if ('real_no_tooth' in rule) {
+      // treat_plan 有真治疗但全无牙位 → 通过(去 dispose 找回牙位;path 2)。
+      if (!isRealNoTooth(v, rule.real_no_tooth)) return false;
     } else if ('in' in rule) {
       const set = new Set(rule.in.map((x) => String(x)));
       if (!set.has(String(v))) return false;

apps/pac-service/src/modules/sync/transforms/transforms.schema.ts

@@ -73,6 +73,13 @@ export type ProjectOp = z.infer<typeof ProjectOpSchema>;
 export const WhereRuleSchema = z.union([
   z.object({ not_empty: z.literal(true) }),
   z.object({ empty: z.literal(true) }), // 空:null/""/"[]"(空 JSON 数组也算空)— 用于 gate "无结构化字段"
+  // blank_or_all_in:JSON 数组字段"空 或 每个元素 treatName ∈ 列表"。用于 dispose gate:
+  //   treat_plan 空 / 全是复查类(无真治疗)→ 才去 dispose 抽治疗(陈昱天:treat_plan=["常规复查"])。
+  //   列表 = C.3 路由的 review 词表(YAML anchor 复用,单一真理源)。
+  z.object({ blank_or_all_in: z.array(z.union([z.string(), z.number()])).min(1) }),
+  // real_no_tooth:JSON 数组"有真治疗(treatName 非空且 ∉ 列表)但全无牙位"。dispose gate path 2:
+  //   treat_plan 有治疗名却漏填牙位(刘小源"充填"无牙位)→ 去 dispose 找回牙位。列表 = review 词表。
+  z.object({ real_no_tooth: z.array(z.union([z.string(), z.number()])).min(1) }),
   z.object({ in: z.array(z.union([z.string(), z.number()])).min(1) }),
   z.object({ equals: z.union([z.string(), z.number()]) }),
 ]);

apps/pac-web/src/components/plan-detail/adapt-data.ts

@@ -57,10 +57,11 @@ export function adaptData(real: PlanDetailData, dict?: TokenDictionary) {
       doNotContact: real.profile?.doNotContact ?? false,
       deceased: real.profile?.deceased ?? false,
       // host 没给 → null,UI 用 '—' 占位;不再前端硬兜底 '本人'(误导客服以为是本人)
-      primaryContactType: real.profile?.primaryContactType ?? null,
       ltv: Math.round((real.profile?.ltvCents ?? 0) / 100),
       firstVisit: real.profile?.firstVisit ?? '',
       lastVisit: real.profile?.lastVisit ?? '',
+      // 联系人/亲属(本人视角)— 关系人姓名/电话从 relatedPatient 现取(后端 serializeProfile)
+      contacts: real.profile?.contacts ?? [],
     },
   };
 
@@ -202,6 +203,8 @@ export function adaptData(real: PlanDetailData, dict?: TokenDictionary) {
       : EMPTY_SCRIPT,
     // 召回历史(患者级)— 后端 plan-aggregate 透出;无则空数组
     recallHistory: real.recallHistory ?? [],
+    // 诊所回访记录(5 试点,展示用)— 后端透出;无则空数组
+    returnVisits: real.returnVisits ?? [],
     // outcomeOptions 已迁移到 @pac/types EXECUTION_OUTCOME_META,outcome-form 直接 import
     fmtRel,
   };

apps/pac-web/src/components/plan-detail/facts-timeline.tsx

@@ -621,8 +621,12 @@ function factSummary(f: AdaptedFact): { title: string; note: string } {
       };
     }
     case 'recommendation_record': {
-      const code = (c.code as string) ?? '?';
-      return { title: `建议 ${code}`, note: dr };
+      const code = (c.code as string) ?? '';
+      // 优先 host 原文中文(name_zh/name,如"建议种植修复"),再字典翻译(IMPLANT_RECOMMENDED→建议种植),
+      // 最后才裸 code 兜底 —— 不再直接展示英文枚举码。
+      const name = (c.name_zh as string) || (c.name as string) || '';
+      const zh = code ? diagnosisCodeNameZh(code) : '';
+      return { title: name || zh || (code ? `建议 ${code}` : '医生建议'), note: dr };
     }
     case 'encounter_record': {
       const etype = (c.encounter_type as string) ?? '';

apps/pac-web/src/components/plan-detail/mock-data.ts

@@ -49,10 +49,24 @@ export const mockPatient = {
   profile: {
     doNotContact: false,
     deceased: false,
-    primaryContactType: '本人' as string | null,
     ltv: 48200,
     firstVisit: '2022-06-08',
     lastVisit: fmtDate(daysAgo(38)),
+    contacts: [
+      {
+        relationship: 'mother',
+        relationshipLabel: '妈妈',
+        name: '伍晴晴',
+        phone: '13800000000',
+        linked: true,
+      },
+    ] as Array<{
+      relationship: string;
+      relationshipLabel: string;
+      name: string | null;
+      phone: string | null;
+      linked: boolean;
+    }>,
   },
 };
 

apps/pac-web/src/components/plan-detail/plan-detail-app.tsx

@@ -89,9 +89,22 @@ export type PlanDetailAppData = {
   script: typeof mockScript;
   /// 召回历史(患者级)— 可选,缺省空数组
   recallHistory?: RecallHistoryItem[];
+  /// 诊所回访记录(5 试点,展示用)— 可选,缺省空数组
+  returnVisits?: ReturnVisitItem[];
   fmtRel: typeof mockFmtRel;
 };
 
+/// 回访记录一条 — 后端 plan-aggregate.returnVisits
+export type ReturnVisitItem = {
+  taskDate: string | null;
+  type: string | null;
+  status: string | null;
+  taskStatus: string | null;
+  treatmentItems: string | null;
+  followContent: string | null;
+  result: string | null;
+};
+
 const FALLBACK_DATA: PlanDetailAppData = {
   patient: mockPatient,
   chains: mockChains,
@@ -118,6 +131,7 @@ export function PlanDetailApp({
   const { patient, chains, persona, plan, summaries, script, fmtRel } = data;
   const facts = data.facts ?? [];
   const recallHistory = data.recallHistory ?? [];
+  const returnVisits = data.returnVisits ?? [];
   const [drawerOpen, setDrawerOpen] = useState<DrawerKind>(null);
   const [scriptMode, setScriptMode] = useState<ScriptViewMode>('markdown');
   // 话术生成模型(具体型号);默认 deepseek-v4-flash
@@ -321,14 +335,11 @@ export function PlanDetailApp({
                 onOpenTeeth={() => setDrawerOpen('teeth')}
               />
               <TreatmentHistoryCard facts={facts} />
-              {/* 历史联系 — 预留卡片(以后接客服联系记录) */}
-              <SidebarCard title="历史联系">
-                <div className="text-[11.5px] italic text-slate-400">暂无联系记录(后续接入客服联系记录)</div>
-              </SidebarCard>
               {/* 召回建议 — 暂时隐藏(SuggestionCard) */}
               {recallHistory.length > 0 && (
                 <RecallHistoryCard history={recallHistory} fmtRel={fmtRel} />
               )}
+              {returnVisits.length > 0 && <ReturnVisitsCard visits={returnVisits} />}
               <SidebarCard
                 title="治疗链"
                 meta={`${chains.length} 条`}
@@ -1143,7 +1154,7 @@ function WhyCard({
 //   - 主治医生:从 facts 算 doctor_id 出现频次 top 1(同 chain-composer doctorMap),host 缺值 → '—'
 //   - 累计消费:profile.ltv(LTV cents 已扣 refund);右侧 hint 显示 persona.value description(画像评级)
 //   - 上次/首次到诊:profile.lastVisit / firstVisit
-//   - 联系人:profile.primaryContactType(host 暂无数据,统一 '—' 占位)
+//   - 联系人:改走 PatientRelation 边表(relationsOut),读时取关系人姓名/关系;暂 '—' 占位待接前端
 // hint 列:除累计消费用 persona value 外,其他用 facts 推断的主要治疗类目 top 1-2
 // ──────────────────────────────────────────
 function KeyFactsCard({
@@ -1214,11 +1225,20 @@ function KeyFactsCard({
     return { value: '-', hint: '' };
   })();
 
-  // 4 行(user 指定):主治医生 / 专属客服 / 累计消费 / 保险客户(显示保险名称)
+  // ─ 联系人 ─ 取已建档(linked,有姓名)的关系人,展示"关系 姓名";多于一位 hint 显示 +N
+  const namedContacts = (patient.profile.contacts ?? []).filter((c) => c.name);
+  const primaryContact = namedContacts[0];
+  const contactValue = primaryContact
+    ? `${primaryContact.relationshipLabel} ${primaryContact.name}`
+    : '—';
+  const contactHint =
+    namedContacts.length > 1 ? `+${namedContacts.length - 1} 位` : (primaryContact?.phone ?? '');
+
   const rows = [
     { label: '主治医生', value: attendingDoctor, hint: mainCategories || '' },
     { label: '专属客服', value: dedicatedCs, hint: '' },
     { label: '累计消费', value: `¥${ltvYuan}`, hint: valueHint },
+    { label: '联系人', value: contactValue, hint: contactHint },
     { label: '保险客户', value: insurance.value, hint: insurance.hint },
   ];
   return (
@@ -1487,6 +1507,45 @@ function RecallHistoryCard({
   );
 }
 
+/// ReturnVisitsCard — 诊所回访记录(5 试点,展示用)。标题"历史联系"(替代原占位卡)。
+/// 价值:客服看得到诊所已做/已排的回访(术后/常规/咨询)→ 避免重复外呼 + 拿上下文。
+function ReturnVisitsCard({ visits }: { visits: ReturnVisitItem[] }) {
+  return (
+    <SidebarCard title="历史联系" meta={`${visits.length} 条`}>
+      <div className="space-y-1.5 max-h-[260px] overflow-y-auto pr-1">
+        {visits.map((v, i) => {
+          const done = v.status === '已回访' || v.taskStatus === '已完成';
+          return (
+            <div key={i} className="flex items-start gap-2 text-[11px] py-0.5">
+              <span
+                className={`flex-none mt-[3px] w-1.5 h-1.5 rounded-full ${done ? 'bg-teal-400' : 'bg-slate-300'}`}
+              />
+              <div className="flex-1 min-w-0">
+                <div className="flex items-center gap-1.5 flex-wrap">
+                  <span className="font-medium text-slate-600">{v.type ?? '回访'}</span>
+                  {v.status && <span className="text-slate-400">· {v.status}</span>}
+                  {v.taskDate && <span className="text-slate-400 tabular-nums">{v.taskDate}</span>}
+                  {v.treatmentItems && (
+                    <span className="text-teal-700/70">· {v.treatmentItems}</span>
+                  )}
+                </div>
+                {v.followContent && (
+                  <div className="text-slate-500 leading-snug break-words mt-0.5">
+                    {v.followContent}
+                  </div>
+                )}
+                {v.result && (
+                  <div className="text-slate-400 leading-snug break-words mt-0.5">结果:{v.result}</div>
+                )}
+              </div>
+            </div>
+          );
+        })}
+      </div>
+    </SidebarCard>
+  );
+}
+
 /**
  * 计算风险规避提示 — PAC 已有数据驱动
  *

apps/pac-web/src/components/plan-detail/plan-detail-types.ts

@@ -26,7 +26,6 @@ export type PlanDetailData = {
   profile: {
     doNotContact: boolean;
     deceased: boolean;
-    primaryContactType: string | null;
     notes: string | null;
     ltvCents: number;
     paymentCount: number;
@@ -36,6 +35,13 @@ export type PlanDetailData = {
     lastVisit: string | null;
     daysSinceLatestVisit: number | null;
     doctors: string[];
+    contacts: Array<{
+      relationship: string;
+      relationshipLabel: string;
+      name: string | null;
+      phone: string | null;
+      linked: boolean;
+    }>;
   } | null;
   plan: {
     id: string;
@@ -191,4 +197,14 @@ export type PlanDetailData = {
     createdAt: string;
     planVersion: number | null;
   }>;
+  /// 诊所回访记录(5 试点,展示用)
+  returnVisits?: Array<{
+    taskDate: string | null;
+    type: string | null;
+    status: string | null;
+    taskStatus: string | null;
+    treatmentItems: string | null;
+    followContent: string | null;
+    result: string | null;
+  }>;
 };

apps/pac-web/src/components/plan-detail/recall-oracle.ts

@@ -28,8 +28,12 @@ import {
   APPT_COMPLAINT_TO_CATEGORY,
   isRestorationIneligibleDxName,
   resolverCategoriesFor,
+  STRUCTURAL_DX_CODE_LIST,
   treatmentCategoryNameZh,
 } from '@pac/types';
+
+/// 结构码集合 —— 同牙位"取代"只认结构码(牙周/正畸不 moot 结构病)
+const STRUCTURAL_CODES = new Set<string>(STRUCTURAL_DX_CODE_LIST);
 import type { AdaptedFact } from './adapt-data';
 
 export const WHOLE_PERIO = '全口 · 牙周';
@@ -66,7 +70,8 @@ const CODE_TO_SUB: Record<string, { subKey: string; primary: string; label: stri
 
 export type OracleVerdictKind =
   | 'recall' // 应召回
-  | 'resolved' // 已被同类/拔除/替代治疗解决
+  | 'resolved' // 已被【实际治疗】解决(同类/拔除/替代/术后证据)
+  | 'superseded' // 被【后续诊断/建议】取代并入(非治疗:深龋→缺失、楔缺→建议充填…)
   | 'cooldown' // 诊断未过冷静期
   | 'ineligible' // 废用牙/无功能牙,非修复对象
   | 'suppressed'; // 被患者级闸压制(未来预约/主诉预约/近期到诊)
@@ -86,7 +91,8 @@ export type OracleVerdict = {
 
 const VERDICT_META: Record<OracleVerdictKind, { zh: string; tone: string }> = {
   recall: { zh: '应召回', tone: 'bg-emerald-50 text-emerald-700 border-emerald-200' },
-  resolved: { zh: '已解决', tone: 'bg-slate-100 text-slate-500 border-slate-200' },
+  resolved: { zh: '已治疗', tone: 'bg-slate-100 text-slate-500 border-slate-200' },
+  superseded: { zh: '被取代', tone: 'bg-slate-100 text-slate-400 border-slate-200' },
   cooldown: { zh: '考虑期', tone: 'bg-amber-50 text-amber-700 border-amber-200' },
   ineligible: { zh: '非修复', tone: 'bg-slate-100 text-slate-400 border-slate-200' },
   suppressed: { zh: '被压制', tone: 'bg-slate-100 text-slate-500 border-slate-200' },
@@ -101,6 +107,11 @@ function toothBase(t: string): string {
   const m = /^(\d{1,2}[A-E]?)/i.exec(t.trim());
   return m ? m[1]!.toUpperCase() : t.trim().toUpperCase();
 }
+// 合法牙位 token:数字开头 + ≥2 字符(口径同后端 util.isValidToothToken)。
+// 裸单数字 1-8(象限号,医生把 "16" 笔误成 "1")丢弃 → 不造幽灵召回。
+function isValidTooth(t: string): boolean {
+  return t.length >= 2 && /^\d/.test(t);
+}
 function factTeeth(c: Record<string, unknown>): string[] {
   const tp = c.tooth_positions;
   const raw = Array.isArray(tp) ? tp.join(';') : String(c.tooth_position ?? tp ?? '');
@@ -108,7 +119,8 @@ function factTeeth(c: Record<string, unknown>): string[] {
     .split(/[;,]+/)
     .map((s) => s.trim())
     .filter(Boolean)
-    .map(toothBase);
+    .map(toothBase)
+    .filter(isValidTooth);
 }
 
 type Rule = {
@@ -144,6 +156,10 @@ export function runRecallOracle(facts: AdaptedFact[], now: Date): OracleVerdict[
     t: number;
     iso: string;
   }> = [];
+  // 每颗牙的"最晚真实诊断"时间戳 —— 用于"同牙位最新诊断取代旧诊断"。
+  const maxDxByTooth = new Map<string, number>();
+  // 每颗牙的"最晚真实建议"时间戳 —— 用于"诊断 vs 建议冲突,以建议(医生决定)为准"。
+  const maxRecByTooth = new Map<string, number>();
 
   for (const f of facts) {
     const c = (f.content ?? {}) as Record<string, unknown>;
@@ -180,6 +196,32 @@ export function runRecallOracle(facts: AdaptedFact[], now: Date): OracleVerdict[
         if (vt > daysAgoMs(POST_VISIT_COOLDOWN_DAYS)) recentVisit = true;
       }
     }
+    // ⭐ 同牙位最新诊断 —— 收每颗牙的【最晚真实诊断】时间(任意真实码,不止召回码)。
+    //   用于"后续诊断取代旧诊断":某牙存在比信号更晚的真实诊断 → 旧信号对该牙失效。
+    // 只收【结构码】的诊断/建议(牙周 K05/K06 / 正畸 K07 不取代结构病)
+    if (f.type === 'diagnosis_record' && f.status === 'active') {
+      const code = String(c.code ?? '').trim();
+      const iso = f.occurredAt ?? f.plannedFor;
+      if (STRUCTURAL_CODES.has(code) && iso) {
+        const ts = new Date(iso).getTime();
+        for (const t of factTeeth(c)) {
+          const cur = maxDxByTooth.get(t);
+          if (cur == null || ts > cur) maxDxByTooth.set(t, ts);
+        }
+      }
+    }
+    // 每颗牙最晚【结构建议】(医生治疗决定)→ 诊断 vs 建议冲突时压过诊断
+    if (f.type === 'recommendation_record' && f.status === 'active') {
+      const code = String(c.code ?? '').trim();
+      const iso = f.occurredAt ?? f.plannedFor;
+      if (STRUCTURAL_CODES.has(code) && iso) {
+        const ts = new Date(iso).getTime();
+        for (const t of factTeeth(c)) {
+          const cur = maxRecByTooth.get(t);
+          if (cur == null || ts > cur) maxRecByTooth.set(t, ts);
+        }
+      }
+    }
     // 信号(诊断 / 推荐)
     if (
       (f.type === 'diagnosis_record' || f.type === 'recommendation_record') &&
@@ -211,8 +253,21 @@ export function runRecallOracle(facts: AdaptedFact[], now: Date): OracleVerdict[
       let kind: OracleVerdictKind;
       let detail: string;
 
+      // ⭐ 同牙位取代规则(wholeMouth toothFilter=null 不走此路径):
+      //   (b) 该牙存在更晚的真实诊断 → 旧信号失效(深龋→缺失、龋→牙髓炎、复发只认最新)。
+      //   (c) 诊断 vs 建议冲突,以建议(医生决定)为准:本 sig 是诊断 且 该牙有 ≥ 本诊断时间的建议 → 诊断失效。
+      const sigIsDx = /^K\d/i.test(sig.code);
+      const laterDx = toothFilter != null ? maxDxByTooth.get(toothFilter) : undefined;
+      const recOnTooth = toothFilter != null ? maxRecByTooth.get(toothFilter) : undefined;
+      const supersededByDx = laterDx != null && laterDx > sig.t;
+      const supersededByRec = sigIsDx && recOnTooth != null && recOnTooth >= sig.t;
+      if (supersededByDx || supersededByRec) {
+        kind = 'superseded';
+        detail = supersededByRec
+          ? `被该牙建议(医生治疗决定)取代,非实际治疗`
+          : `被该牙后续诊断取代(同牙位以最新诊断为准),非实际治疗`;
+      } else if (isRestorationIneligibleDxName(nameZh)) {
         // ④' 废用牙
-      if (isRestorationIneligibleDxName(nameZh)) {
         kind = 'ineligible';
         detail = `「${nameZh}」非修复对象(该拔除/观察)`;
       } else {
@@ -334,7 +389,8 @@ export function reconcile(
       prodSet.add(`${s.subKey}|${wholeLaneForSub(s.subKey)}`);
     } else {
       for (const t of teethRaw.split(/[;,]+/).map((x) => x.trim()).filter(Boolean)) {
-        prodSet.add(`${s.subKey}|${toothBase(t)}`);
+        const tb = toothBase(t);
+        if (isValidTooth(tb)) prodSet.add(`${s.subKey}|${tb}`);
       }
     }
   }
@@ -345,6 +401,7 @@ export function reconcile(
     suppressed: 4,
     cooldown: 3,
     resolved: 2,
+    superseded: 2,
     ineligible: 1,
   };
   const oracleByKey = new Map<string, OracleVerdict>();

apps/pac-web/src/components/plan-detail/tooth-timeline.tsx

 'use client';
 
-import { diagnosisCodeNameZh, treatmentCategoryNameZh } from '@pac/types';
+import { diagnosisCodeNameZh, treatmentCategoryNameZh, lookupDxTreatment } from '@pac/types';
 import { cn } from '@/lib/utils';
 import type { AdaptedFact } from './adapt-data';
 import type { PlanReason } from './mock-data';
@@ -64,6 +64,13 @@ export function ToothTimeline({
     lanes.set(k, arr);
   };
   for (const f of clinical) {
+    // ⭐ 全口病(牙周 K05 / 正畸 K07 诊断、periodontic/orthodontic 治疗)无视 dx 自带牙位,
+    //   直接进全口泳道 —— 跟召回 wholeMouth 口径一致。否则慢性牙龈炎(全口诊断列了 28 颗牙)
+    //   会被拆进每颗牙,让 11/12/13 等只有全口病的牙位凭空出现单独泳道(显示假象)。
+    if (isWholeMouthFact(f)) {
+      push(wholeMouthLane(f), f);
+      continue;
+    }
     const teeth = factTeeth(f);
     if (teeth.length > 0) {
       for (const t of teeth) push(t, f);
@@ -313,3 +320,20 @@ function wholeMouthLane(f: AdaptedFact): string {
   if (cat === 'orthodontic' || code === 'K07') return WHOLE_ORTHO;
   return WHOLE_OTHER;
 }
+
+/// 全口病:无视 fact 自带牙位,归全口泳道(跟召回 wholeMouth 口径一致)。
+///   - 诊断/建议:code 的 wholeMouth 标志(K05 牙周 / K07 正畸 / SRP_/ORTHO_CONSULT_RECOMMENDED)
+///   - 治疗:category = periodontic / orthodontic(洁牙/刮治/正畸 全口性)
+/// K06(牙龈/牙槽嵴)非 wholeMouth → 仍按牙;K02 龋等结构病按牙。
+function isWholeMouthFact(f: AdaptedFact): boolean {
+  const c = (f.content ?? {}) as Record<string, unknown>;
+  if (f.type === 'treatment_record') {
+    const cat = String(c.category ?? '');
+    return cat === 'periodontic' || cat === 'orthodontic';
+  }
+  if (f.type === 'diagnosis_record' || f.type === 'recommendation_record') {
+    const code = String(c.code ?? '');
+    return !!lookupDxTreatment(code)?.wholeMouth;
+  }
+  return false;
+}

packages/types/src/canonical-codes.ts

@@ -274,7 +274,11 @@ export const STRUCTURAL_RESOLVER_CATEGORIES = [
 ] as const satisfies readonly PACTreatmentCategory[];
 
 /// 走"结构家族 resolver"的诊断码 / 推荐码(其余 K05/K06/K07 等沿用 rule.categories)
-const STRUCTURAL_DX_CODES = new Set<string>([
+/// 结构性诊断/推荐码(按牙的牙体/牙髓/缺牙/外科问题)。
+/// 用途①:resolverCategoriesFor 区分结构 vs 牙周/正畸。
+/// 用途②:同牙位"取代"规则 —— 只有【结构码】能取代结构诊断;牙周(K05/K06)/正畸(K07)
+///   是不同组织的并存病,不互相 moot(否则全口牙周诊断会误销一片龋齿)。
+export const STRUCTURAL_DX_CODE_LIST = [
   'K00',
   'K01',
   'K02',
@@ -290,6 +294,9 @@ const STRUCTURAL_DX_CODES = new Set<string>([
   'HARD_TISSUE_REPAIR_RECOMMENDED',
   'ERUPTION_INTERVENTION_RECOMMENDED',
   'JAW_CYST_REMOVAL_RECOMMENDED',
+] as const;
+const STRUCTURAL_DX_CODES = new Set<string>([
+  ...STRUCTURAL_DX_CODE_LIST,
 ]);
 
 /**

packages/types/src/schemas/canonical.ts

@@ -65,12 +65,41 @@ export const PatientCanonicalSchema = z
     tags: z.array(z.string()).optional().default([]),
     /// 产品收集:host 备注 / 客户描述自由文本
     notes: z.string().optional().nullable(),
-    /// 产品收集:主要联系人身份(self/spouse/parent/child/guardian/other)
-    primaryContactType: z.string().optional().nullable(),
   })
   .passthrough();
 export type PatientCanonical = z.infer<typeof PatientCanonicalSchema>;
 
+/// patient_relation canonical — 患者-患者关系边(联系人/亲属/转介绍人)。
+/// upsert 形态(无 emits,同 patient)。关系人本身也是 patient(FHIR RelatedPerson/link)。
+export const PatientRelationCanonicalSchema = z
+  .object({
+    /// 本人 host id(referee.patient_id)
+    patientExternalId: z.string().min(1),
+    /// 关系人 host id(referee.referee_patient_id)
+    relatedExternalId: z.string().min(1),
+    /// 关系类型(已归一:mother/father/grandparent/spouse/child/sibling/friend/other)
+    relationship: z.string().min(1),
+  })
+  .passthrough();
+export type PatientRelationCanonical = z.infer<typeof PatientRelationCanonicalSchema>;
+
+/// patient_return_visit canonical — 诊所回访任务记录(展示用,5 试点)。upsert 形态(无 emits)。
+export const PatientReturnVisitCanonicalSchema = z
+  .object({
+    externalId: z.string().min(1),
+    patientExternalId: z.string().min(1),
+    clinicId: z.string().optional().nullable(),
+    taskDate: z.string().optional().nullable(),
+    type: z.string().optional().nullable(),
+    status: z.string().optional().nullable(),
+    taskStatus: z.string().optional().nullable(),
+    treatmentItems: z.string().optional().nullable(),
+    followContent: z.string().optional().nullable(),
+    result: z.string().optional().nullable(),
+  })
+  .passthrough();
+export type PatientReturnVisitCanonical = z.infer<typeof PatientReturnVisitCanonicalSchema>;
+
 // ─────────────────────────────────────────────────────────
 // 3.4.2 appointments
 // ─────────────────────────────────────────────────────────
@@ -300,6 +329,8 @@ export const DiagnosisCanonicalSchema = z
     toothPosition: z.string().optional().nullable(),
     severity: z.string().optional().nullable(),
     onsetDate: z.string().optional().nullable(),
+    /// 显式来源声明(如影像 AI 'image_ai');parser 优先用它,否则按 stdCode 推断 std_code/name_map
+    codeSource: z.string().optional().nullable(),
   })
   .passthrough();
 export type DiagnosisCanonical = z.infer<typeof DiagnosisCanonicalSchema>;
@@ -427,6 +458,8 @@ export type ReferralCanonical = z.infer<typeof ReferralCanonicalSchema>;
  */
 export const CanonicalResourceSchemas = {
   patient: PatientCanonicalSchema,
+  patient_relation: PatientRelationCanonicalSchema,
+  patient_return_visit: PatientReturnVisitCanonicalSchema,
   consultation: ConsultationCanonicalSchema,
   appointment: AppointmentCanonicalSchema,
   visit_registration: VisitRegistrationCanonicalSchema,
@@ -472,6 +505,18 @@ export const CanonicalResourceMeta: Record<
     datetimeFields: ['createdAt', 'updatedAt'],
     booleanFields: ['doNotContact', 'deceased'],
   },
+  patient_relation: {
+    moneyFields: [],
+    moneyArrayFields: [],
+    datetimeFields: [],
+    booleanFields: [],
+  },
+  patient_return_visit: {
+    moneyFields: [],
+    moneyArrayFields: [],
+    datetimeFields: [],
+    booleanFields: [],
+  },
   consultation: {
     moneyFields: [],
     moneyArrayFields: [],