feat: W3 末部署准备包 — deploy 基建 + 增量同步 + 前端 polish

- deploy/: deploy.sh + systemd units + README(staging/prod 通用)
- 增量同步: sync-incremental scheduler + CLI + dw-lag-monitor 告警
- assemblers: jvs-dw 全套 yaml 字段对齐 + tooth-position 解析
- plan-detail: chain-viz / facts-timeline / drawer / outcome-form 改版
- auth: mock-login dialog(staging 用) + auth-gate 调整
- parsers: diagnosis/treatment/image/recommendation 解析增强
- CLI: verify-chain 调试工具
- docs: deployment-data-ingest + w3-report

apps/pac-service/.env.example

+# ═══════════════════════════════════════════════════════════════════════
+# PAC Service — Environment Variables(对照模板)
+#
+# 三套环境:
+#   local       本地开发(你 Mac + docker compose)
+#   staging     试部署 / 演示(云服务器,客服试用)
+#   production  正式生产(云服务器,真客服上线)
+#
+# 部署:
+#   - 复制本文件 → .env(本地)/ /opt/pac/.env(服务器)
+#   - 服务器侧 chmod 600 .env
+#   - .env 永远不进 git(.gitignore 已守)
+#
+# 上线前必检:JWT_SECRET / JWT_REFRESH_SECRET / DEEPSEEK_API_KEY / DW_CLICKHOUSE_PASSWORD
+# 必须 per-env 不同(staging / prod 各一份强随机)
+# ═══════════════════════════════════════════════════════════════════════
+
+# ─── 基础 ────────────────────────────────────────────────────────────
+#   local:       development
+#   staging:     staging
+#   production:  production           ⚠️ 必须设 production,关掉一些开发兜底
 NODE_ENV=development
+
 PORT=3001
+
+#   local: debug | staging+prod: info
 LOG_LEVEL=info
 
+
+# ─── 数据库 / 缓存 ────────────────────────────────────────────────────
+#   local:       postgresql://pac:pac@localhost:5432/pac?schema=public
+#   staging:     postgresql://pac:<staging-pwd>@<staging-pg-host>:5432/pac?schema=public
+#   production:  postgresql://pac:<prod-pwd>@<prod-pg-host>:5432/pac?schema=public
 DATABASE_URL=postgresql://pac:pac@localhost:5432/pac?schema=public
+
+#   local: redis://localhost:6379
+#   staging+prod: redis://<host>:6379  (BullMQ 队列用,丢了会丢未消费的 plan-asset-generate 任务)
 REDIS_URL=redis://localhost:6379
 
+
+# ─── JWT(per-env 必须不同强随机)────────────────────────────────────
+# 生成命令:openssl rand -hex 32
+# ⚠️ staging / production 必须分别生成 — 同一份 secret 跨环境会让 staging token 在 prod 通过验证
 JWT_SECRET=replace-with-strong-random-secret-min-32-chars
 JWT_REFRESH_SECRET=replace-with-another-strong-secret-min-32-chars
 JWT_EXPIRES_IN=2h
 JWT_REFRESH_EXPIRES_IN=7d
 
-# AI — DeepSeek 国内 endpoint 直连(合规);key 从 https://platform.deepseek.com/api_keys 取
+
+# ─── AI(DeepSeek 国内直连)─────────────────────────────────────────
+# Key 从 https://platform.deepseek.com/api_keys 取
+#   local + staging: 团队共享 key(开发额度)
+#   production:      独立 prod key(独立配额 / 账单)
 DEEPSEEK_API_KEY=
 DEEPSEEK_BASE_URL=https://api.deepseek.com
-AI_DEFAULT_MODEL=deepseek-v4-pro
+
+# 默认主力模型
+#   local:      deepseek-v4-flash  (省钱开发)
+#   staging:    deepseek-v4-flash
+#   production: deepseek-v4-pro    (质量优先)
+AI_DEFAULT_MODEL=deepseek-v4-flash
+
 AI_REQUEST_TIMEOUT_SEC=60
-# 价格表(¥/M tokens)— vendor 调价时改这里重启即可;不配则用默认值。
-# inHit=cache 命中价 / inMiss=未命中(全价) / out=输出价(含 thinking)
+
+# 价格表(¥/M tokens)— 调价时改这里重启;不配走默认
 # AI_PRICE_TABLE_JSON={"deepseek-v4-pro":{"inHit":0.5,"inMiss":3.6,"out":25},"deepseek-v4-flash":{"inHit":0.07,"inMiss":0.5,"out":2}}
 
+
+# ─── CORS / iframe ───────────────────────────────────────────────────
+#   local:       http://localhost:3000
+#   staging:     https://pac-staging.<your-domain>
+#   production:  https://pac.<your-domain>  (多个用逗号)
 CORS_ORIGINS=http://localhost:3000
+
+# iframe 一次性 code TTL(默认 60s)
 EXCHANGE_CODE_TTL_SECONDS=60
+
+
+# ─── 远程 DW(瑞尔 jvs-dw)ClickHouse 直连 ──────────────────────────
+# manifest.yaml 里 sql_source.connection 是 dev 默认(localhost:8123);
+# 这几个 env 覆盖之,无需改 manifest
+#
+#   local:       不设 → 走 manifest 默认本地 docker CH
+#   staging+prod: 必须设 → 远程瑞尔 ADS
+#
+# 生产示例:
+#   DW_CLICKHOUSE_URL=http://cc-2zen8w29e49076o83.public.clickhouse.ads.aliyuncs.com:8123
+#   DW_CLICKHOUSE_DATABASE=dw_group
+#   DW_CLICKHOUSE_USERNAME=jvs_pac
+#   DW_CLICKHOUSE_PASSWORD=<vendor 给的密码>
+DW_CLICKHOUSE_URL=
+DW_CLICKHOUSE_DATABASE=
+DW_CLICKHOUSE_USERNAME=
+DW_CLICKHOUSE_PASSWORD=
+
+
+# ─── 数据接入 cron / 监控 ────────────────────────────────────────────
+# 不设 → 该 cron 不跑(本地默认不跑,避免开发时自动消耗 DW 流量)
+# 设了 → 走 standard cron 5 字段(分 时 日 月 周)
+#
+#   local:      不设(留空)
+#   staging:    30 3 * * *       (03:30 错峰,避免跟生产撞)
+#   production: 30 2 * * *       (02:30 — DW 02:00 完成全量后 30 分钟)
+PAC_INCREMENTAL_CRON=
+
+# 多 host 用逗号分隔(目前只一个 jvs-dw)
+PAC_INCREMENTAL_HOSTS=jvs-dw
+
+# 其他 cron(同步策略:env 不设 → 不跑)
+#   local: 全部不设
+#   staging/prod:
+#     PAC_LAG_MONITOR_CRON=0 * * * *      (每小时检查 DW 是否滞后)
+#     PAC_STALE_SCAN_CRON=0 2 * * *       (凌晨 02:00 扫 stale persona 补算)
+#     PAC_SYNC_HOURLY_CRON=               (W5+ host pull 通道接通后启用)
+PAC_LAG_MONITOR_CRON=
+PAC_STALE_SCAN_CRON=
+PAC_SYNC_HOURLY_CRON=
+
+# 数据目录(manifest.yaml 所在位置)
+#   local:      默认(代码相对路径)
+#   staging:    /opt/pac/apps/pac-service/data
+#   production: 同
+# PAC_INCREMENTAL_DATA_DIR=/opt/pac/apps/pac-service/data
+
+# DW 数据滞后告警阈值(小时)
+#   local:      999  (不告警)
+#   staging+prod: 24 warn / 48 error
+PAC_LAG_WARN_HOURS=999
+PAC_LAG_ERROR_HOURS=999
+
+
+# ─── 告警通道(W5+ 接钉钉 / 飞书 webhook)──────────────────────────
+#   local:      空
+#   staging:    测试群 webhook
+#   production: 真值班群 webhook
+ALERT_WEBHOOK_URL=
+
+
+# ─── Mock Login(开发 / 试部署快速登录)──────────────────────────────
+# 控制 /pac/v1/auth/mock-login endpoint:
+#   true   强制启用
+#   false  强制禁用
+#   (空)  按 NODE_ENV 走(prod 默认禁用,非 prod 默认启用)
+#
+#   local:      不设(自动启用)
+#   staging:    true       (演示 / 客服试用必须开)
+#   production: false ⭐    (生产关掉,走 host SSO)
+PAC_ENABLE_MOCK_LOGIN=

apps/pac-service/.gitignore

+.env.bak.*

apps/pac-service/Dockerfile

 # syntax=docker/dockerfile:1.7
+# PAC Service Dockerfile — workspace monorepo build
 ARG NODE_VERSION=22-alpine
 
 # === base: workspace layout + pnpm ===
@@ -9,17 +10,17 @@ WORKDIR /app
 
 # === deps: install everything once, share across stages ===
 FROM base AS deps
-COPY pnpm-workspace.yaml pnpm-lock.yaml* package.json .npmrc ./
+COPY pnpm-workspace.yaml pnpm-lock.yaml package.json .npmrc* ./
 COPY turbo.json tsconfig.base.json ./
-COPY apps/recall-service/package.json apps/recall-service/
-COPY packages/shared-types/package.json packages/shared-types/
-COPY packages/shared-utils/package.json packages/shared-utils/
-RUN pnpm install --frozen-lockfile=false
+COPY apps/pac-service/package.json apps/pac-service/
+COPY packages/types/package.json packages/types/
+COPY packages/utils/package.json packages/utils/
+RUN pnpm install --frozen-lockfile
 
 # === dev: hot reload via nest start --watch ===
 FROM deps AS dev
 COPY . .
-WORKDIR /app/apps/recall-service
+WORKDIR /app/apps/pac-service
 RUN pnpm prisma generate
 EXPOSE 3001
 CMD ["pnpm", "dev"]
@@ -27,7 +28,8 @@ CMD ["pnpm", "dev"]
 # === build ===
 FROM deps AS build
 COPY . .
-WORKDIR /app/apps/recall-service
+RUN pnpm --filter @pac/types build
+WORKDIR /app/apps/pac-service
 RUN pnpm prisma generate
 RUN pnpm build
 
@@ -39,10 +41,11 @@ WORKDIR /app
 ENV NODE_ENV=production
 COPY --from=build /app/node_modules ./node_modules
 COPY --from=build /app/packages ./packages
-COPY --from=build /app/apps/recall-service/node_modules ./apps/recall-service/node_modules
-COPY --from=build /app/apps/recall-service/dist ./apps/recall-service/dist
-COPY --from=build /app/apps/recall-service/prisma ./apps/recall-service/prisma
-COPY --from=build /app/apps/recall-service/package.json ./apps/recall-service/
-WORKDIR /app/apps/recall-service
+COPY --from=build /app/apps/pac-service/node_modules ./apps/pac-service/node_modules
+COPY --from=build /app/apps/pac-service/dist ./apps/pac-service/dist
+COPY --from=build /app/apps/pac-service/prisma ./apps/pac-service/prisma
+COPY --from=build /app/apps/pac-service/data ./apps/pac-service/data
+COPY --from=build /app/apps/pac-service/package.json ./apps/pac-service/
+WORKDIR /app/apps/pac-service
 EXPOSE 3001
-CMD ["node", "dist/main.js"]
+CMD ["node", "--enable-source-maps", "dist/main.js"]

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

@@ -13,6 +13,9 @@ primary:
 
 field_mapping:
   externalId:        id
+  # W4 末 DW upsert:updatedAt 进 source_event_id 幂等键,host UPDATE → 新 transaction(否则永久 dedup 漏 update)
+  updatedAt:         updated_date
+  createdAt:         created_date
   patientExternalId: patient_id
   clinicId:          organization_id
   scheduledAt:       scheduled_at_ts    # transforms 拼好的精确时刻(日期 + 起始时分)

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

@@ -16,6 +16,9 @@ primary:
 
 field_mapping:
   externalId:                   diag_external_id
+  # W4 末 DW upsert:updatedAt 进 source_event_id 幂等键,host UPDATE → 新 transaction(否则永久 dedup 漏 update)
+  updatedAt:         updated_date
+  createdAt:         created_date
   patientExternalId:            patient_id
   clinicId:                     organization_id
   occurredAt:                   rq

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

@@ -14,6 +14,9 @@ primary:
 
 field_mapping:
   externalId:           id
+  # W4 末 DW upsert:updatedAt 进 source_event_id 幂等键,host UPDATE → 新 transaction(否则永久 dedup 漏 update)
+  updatedAt:         updated_date
+  createdAt:         created_date
   patientExternalId:    patient_id
   clinicId:             organization_id
   submittedAt:          rq

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

@@ -13,6 +13,9 @@ primary:
 
 field_mapping:
   externalId:        id
+  # W4 末 DW upsert:updatedAt 进 source_event_id 幂等键,host UPDATE → 新 transaction(否则永久 dedup 漏 update)
+  updatedAt:         updated_date
+  createdAt:         created_date
   patientExternalId: patient_id
   clinicId:          organization_id
   startedAt:         in_time

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

@@ -14,6 +14,9 @@ primary:
 
 field_mapping:
   externalId:           image_external_id
+  # W4 末 DW upsert:updatedAt 进 source_event_id 幂等键,host UPDATE → 新 transaction(否则永久 dedup 漏 update)
+  updatedAt:         updated_date
+  createdAt:         created_date
   patientExternalId:    patient_id
   clinicId:             organization_id
   uploadedAt:           captured_at

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

@@ -8,6 +8,9 @@ primary:
 
 field_mapping:
   externalId:           patient_id    # Int64 → ColdImportService 入库时 String 化
+  # W4 末 DW upsert:updatedAt 进 source_event_id 幂等键,host UPDATE → 新 transaction(否则永久 dedup 漏 update)
+  updatedAt:         last_visit_time
+  createdAt:         first_visit_time
   name:                 client_name
   gender:               client_gender
   birthDate:            birthday

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

@@ -13,6 +13,9 @@ primary:
 
 field_mapping:
   externalId:        id
+  # W4 末 DW upsert:updatedAt 进 source_event_id 幂等键,host UPDATE → 新 transaction(否则永久 dedup 漏 update)
+  updatedAt:         updated_date
+  createdAt:         created_date
   patientExternalId: patient_id
   clinicId:          organization_id
   paidAt:            created_date    # W3 末从 billing_date 升级 — 跟 treatment_actual 口径一致。

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

@@ -14,6 +14,9 @@ primary:
 
 field_mapping:
   externalId:        rec_external_id
+  # W4 末 DW upsert:updatedAt 进 source_event_id 幂等键,host UPDATE → 新 transaction(否则永久 dedup 漏 update)
+  updatedAt:         updated_date
+  createdAt:         created_date
   patientExternalId: patient_id
   clinicId:          organization_id
   occurredAt:        rq

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

@@ -15,6 +15,9 @@ primary:
 
 field_mapping:
   externalId:           referral_external_id
+  # W4 末 DW upsert:updatedAt 进 source_event_id 幂等键,host UPDATE → 新 transaction(否则永久 dedup 漏 update)
+  updatedAt:         last_visit_time
+  createdAt:         first_visit_time
   patientExternalId:    patient_id              # 被推荐人(referee)= 该行的 patient_id
   # clinicId 不映射:fact_client_out(ADS 聚合)无 organization_id 列,referral 来自主档无明确 clinic
   recordedAt:           first_visit_time        # 近似:推荐发生时间 ≈ 被推荐人首次到诊

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

@@ -25,6 +25,9 @@ primary:
 
 field_mapping:
   externalId:        id
+  # W4 末 DW upsert:updatedAt 进 source_event_id 幂等键,host UPDATE → 新 transaction(否则永久 dedup 漏 update)
+  updatedAt:         updated_date
+  createdAt:         created_date
   patientExternalId: patient_id
   clinicId:          organization_id
   # 退费时间 = created_date(结算记录入库时间)— 跟 payment / treatment 口径一致

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

@@ -25,6 +25,9 @@ primary:
 
 field_mapping:
   externalId:                  treat_external_id
+  # W4 末 DW upsert:updatedAt 进 source_event_id 幂等键,host UPDATE → 新 transaction(否则永久 dedup 漏 update)
+  updatedAt:         updated_date
+  createdAt:         created_date
   patientExternalId:           patient_id
   clinicId:                    organization_id
   occurredAt:                  rq               # treat_plan 已发生,rq=就诊日,actual 时点
@@ -57,14 +60,35 @@ enum_mapping:
     根管预备: canal_preparation
     根充: canal_filling
     根管充填: canal_filling
+    # 牙髓切断术 / 活髓保存(pulpotomy 类 — VPT 终末术式)
+    # 临床等价:活髓切断 / 部分活髓切断 / 部分牙髓切断 / 冠髓切断 / 干髓 / 盖髓 / 牙髓血运重建
+    活髓切断: pulpotomy
+    部分活髓切断: pulpotomy
+    部分牙髓切断: pulpotomy
+    冠髓切断: pulpotomy
+    干髓术: pulpotomy
+    干髓治疗: pulpotomy
+    盖髓术: pulpotomy
+    间接盖髓: pulpotomy
+    直接盖髓: pulpotomy
+    牙髓血运重建: pulpotomy
+    活髓保存: pulpotomy
     # 种植
     植入: implant_placement
     种植体植入: implant_placement
     种植一期: implant_placement
+    种植I期: implant_placement       # 罗马数字版(host 实测)
+    简单种植: implant_placement
+    复杂种植: implant_placement
+    即刻种植: implant_placement
+    延期种植: implant_placement
     基台: abutment_placement
+    种植二期: abutment_placement
+    种植II期: abutment_placement      # 罗马数字版(host 实测)
     上部修复: crown_placement
     种植冠修复: crown_placement
     种植戴牙: crown_placement
+    种植三期: crown_placement
     # 牙周
     龈上洁治: supragingival_scaling
     龈下刮治: subgingival_scaling
@@ -161,6 +185,22 @@ enum_mapping:
     嵌体:                                            restorative
     戴嵌体:                                          restorative
     龋齿充填:                                        restorative
+    # W4 末补 — 玻璃离子(GIC)类充填(临床: 等价于树脂充填,主要用于乳牙/年轻恒牙/暂封)
+    玻璃离子充填:                                    restorative
+    玻璃离子充填术:                                  restorative
+    "玻璃离子充填术。":                              restorative
+    "玻璃离子充填。":                                restorative
+    进口玻璃离子充填:                                restorative
+    "进口玻璃离子充填术。":                          restorative
+    "充填治疗(玻璃离子)":                            restorative
+    玻璃离子暂封:                                    restorative
+    玻璃离子预充填:                                  restorative
+    # 其他高频补全
+    充填或嵌体修复:                                  restorative
+    "充填治疗(乳牙复面洞)":                          restorative
+    "恒牙充填治疗(儿科)":                            restorative
+    高嵌体修复:                                      restorative
+    预防性树脂充填:                                  restorative
 
     # ── 牙髓 / 根管(endodontic)
     根管治疗:                                        endodontic
@@ -186,6 +226,64 @@ enum_mapping:
     # W4 末补
     根管治疗后冠修复:                                endodontic
     "RCT+冠修复":                                    endodontic
+    # W4 末补 — pulpotomy 类(VPT 终末术式,等价于完整 RCT;chain-composer 走 terminalSteps 走闭环)
+    # 已在前面列出的 干髓术 / 盖髓术 / 直接盖髓 / 间接盖髓 / MTA盖髓 / 拔髓 / 开髓 / 牙髓治疗 不再重复
+    活髓切断术:                                      endodontic
+    部分活髓切断术:                                  endodontic
+    部分牙髓切断术:                                  endodontic
+    "活髓切断术+预成冠修复":                         endodontic
+    "活髓切断术+预成冠":                             endodontic
+    "活髓切断+预成冠修复":                           endodontic
+    "活髓切断+预成冠":                               endodontic
+    "活髓切断术+全瓷冠冠修复":                       endodontic
+    "活髓切断术+全瓷预成冠修复":                     endodontic
+    "活髓,活髓切断术":                              endodontic
+    活髓切断:                                        endodontic
+    乳牙活髓切断术:                                  endodontic
+    "乳牙活髓切断术+冠修复":                         endodontic
+    "乳牙活髓保存+冠修复":                           endodontic
+    "活髓保存+冠修复":                               endodontic
+    乳牙活髓保存术:                                  endodontic
+    "乳牙活髓保存术+冠修复":                         endodontic
+    冠髓切断术:                                      endodontic
+    "冠髓切断术(乳牙)":                              endodontic
+    "冠髓切断术(乳牙)+预成冠修复":                   endodontic
+    "冠髓切断术+预成冠修复":                         endodontic
+    "恒牙冠髓切断术(儿科)":                          endodontic
+    干髓治疗:                                        endodontic
+    直接盖髓术:                                      endodontic
+    间接盖髓术:                                      endodontic
+    "间接盖髓术+预成冠修复":                         endodontic
+    牙髓血运重建:                                    endodontic
+    # 牙髓相关其他术式(中间步骤,subtype 词根 fallback,无终末效力)
+    开髓引流:                                        endodontic
+    开髓失活:                                        endodontic
+    开髓开放:                                        endodontic
+    开髓封药:                                        endodontic
+    "开髓,封药":                                    endodontic
+    开髓封失活剂:                                    endodontic
+    "开髓,封失活剂":                                endodontic
+    牙髓失活:                                        endodontic
+    封失活剂:                                        endodontic
+    放失活剂:                                        endodontic
+    放置失活剂:                                      endodontic
+    失活:                                            endodontic
+    乳牙牙髓治疗:                                    endodontic
+    "乳牙牙髓治疗+冠修复":                           endodontic
+    髓腔消毒:                                        endodontic
+    髓腔封药:                                        endodontic
+    髓腔预备:                                        endodontic
+    髓腔换药:                                        endodontic
+    保髓治疗:                                        endodontic
+    牙髓保留:                                        endodontic
+    根管治疗术:                                      endodontic
+    "根管治疗术(乳磨牙封失活剂法)":                  endodontic
+    "根管治疗术(乳磨牙直接拔髓多步法)":              endodontic
+    "根管治疗术(复杂乳牙封失活剂法)":                endodontic
+    "根管治疗术(复杂乳牙直接拔髓多次法)":            endodontic
+    "根管治疗术(乳前牙直接拔髓多步法)":              endodontic
+    "根管治疗(封失活剂)":                            endodontic
+    复杂根管治疗:                                    endodontic
 
     # ── 种植(implant)
     种植:                                            implant

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

@@ -24,6 +24,9 @@ primary:
 
 field_mapping:
   externalId:                  treat_external_id
+  # W4 末 DW upsert:updatedAt 进 source_event_id 幂等键,host UPDATE → 新 transaction(否则永久 dedup 漏 update)
+  updatedAt:         updated_date
+  createdAt:         created_date
   patientExternalId:           patient_id
   clinicId:                    organization_id
   occurredAt:                  rq               # rq=就诊日(医生当天写的计划);plannedFor 由 parser 用此填
@@ -49,13 +52,33 @@ enum_mapping:
     根管预备: canal_preparation
     根充: canal_filling
     根管充填: canal_filling
+    # 牙髓切断术 / 活髓保存(pulpotomy 类 — VPT 终末术式)
+    活髓切断: pulpotomy
+    部分活髓切断: pulpotomy
+    部分牙髓切断: pulpotomy
+    冠髓切断: pulpotomy
+    干髓术: pulpotomy
+    干髓治疗: pulpotomy
+    盖髓术: pulpotomy
+    间接盖髓: pulpotomy
+    直接盖髓: pulpotomy
+    牙髓血运重建: pulpotomy
+    活髓保存: pulpotomy
     植入: implant_placement
     种植体植入: implant_placement
     种植一期: implant_placement
+    种植I期: implant_placement       # 罗马数字版(host 实测)
+    简单种植: implant_placement
+    复杂种植: implant_placement
+    即刻种植: implant_placement
+    延期种植: implant_placement
     基台: abutment_placement
+    种植二期: abutment_placement
+    种植II期: abutment_placement      # 罗马数字版(host 实测)
     上部修复: crown_placement
     种植冠修复: crown_placement
     种植戴牙: crown_placement
+    种植三期: crown_placement
     龈上洁治: supragingival_scaling
     龈下刮治: subgingival_scaling
     刮治: subgingival_scaling
@@ -147,6 +170,22 @@ enum_mapping:
     嵌体:                                            restorative
     戴嵌体:                                          restorative
     龋齿充填:                                        restorative
+    # W4 末补 — 玻璃离子(GIC)类充填(临床: 等价于树脂充填,主要用于乳牙/年轻恒牙/暂封)
+    玻璃离子充填:                                    restorative
+    玻璃离子充填术:                                  restorative
+    "玻璃离子充填术。":                              restorative
+    "玻璃离子充填。":                                restorative
+    进口玻璃离子充填:                                restorative
+    "进口玻璃离子充填术。":                          restorative
+    "充填治疗(玻璃离子)":                            restorative
+    玻璃离子暂封:                                    restorative
+    玻璃离子预充填:                                  restorative
+    # 其他高频补全
+    充填或嵌体修复:                                  restorative
+    "充填治疗(乳牙复面洞)":                          restorative
+    "恒牙充填治疗(儿科)":                            restorative
+    高嵌体修复:                                      restorative
+    预防性树脂充填:                                  restorative
 
     # ── 牙髓 / 根管(endodontic)
     根管治疗:                                        endodontic
@@ -172,6 +211,61 @@ enum_mapping:
     # W4 末补
     根管治疗后冠修复:                                endodontic
     "RCT+冠修复":                                    endodontic
+    # W4 末补 — pulpotomy 类 + 牙髓相关术式(跟 treatment_actual.yaml 同源)
+    活髓切断术:                                      endodontic
+    部分活髓切断术:                                  endodontic
+    部分牙髓切断术:                                  endodontic
+    "活髓切断术+预成冠修复":                         endodontic
+    "活髓切断术+预成冠":                             endodontic
+    "活髓切断+预成冠修复":                           endodontic
+    "活髓切断+预成冠":                               endodontic
+    "活髓切断术+全瓷冠冠修复":                       endodontic
+    "活髓切断术+全瓷预成冠修复":                     endodontic
+    "活髓,活髓切断术":                              endodontic
+    活髓切断:                                        endodontic
+    乳牙活髓切断术:                                  endodontic
+    "乳牙活髓切断术+冠修复":                         endodontic
+    "乳牙活髓保存+冠修复":                           endodontic
+    "活髓保存+冠修复":                               endodontic
+    乳牙活髓保存术:                                  endodontic
+    "乳牙活髓保存术+冠修复":                         endodontic
+    冠髓切断术:                                      endodontic
+    "冠髓切断术(乳牙)":                              endodontic
+    "冠髓切断术(乳牙)+预成冠修复":                   endodontic
+    "冠髓切断术+预成冠修复":                         endodontic
+    "恒牙冠髓切断术(儿科)":                          endodontic
+    干髓治疗:                                        endodontic
+    直接盖髓术:                                      endodontic
+    间接盖髓术:                                      endodontic
+    "间接盖髓术+预成冠修复":                         endodontic
+    开髓引流:                                        endodontic
+    开髓失活:                                        endodontic
+    开髓开放:                                        endodontic
+    开髓封药:                                        endodontic
+    "开髓,封药":                                    endodontic
+    开髓封失活剂:                                    endodontic
+    "开髓,封失活剂":                                endodontic
+    牙髓失活:                                        endodontic
+    封失活剂:                                        endodontic
+    放失活剂:                                        endodontic
+    放置失活剂:                                      endodontic
+    失活:                                            endodontic
+    乳牙牙髓治疗:                                    endodontic
+    "乳牙牙髓治疗+冠修复":                           endodontic
+    髓腔消毒:                                        endodontic
+    髓腔封药:                                        endodontic
+    髓腔预备:                                        endodontic
+    髓腔换药:                                        endodontic
+    保髓治疗:                                        endodontic
+    牙髓保留:                                        endodontic
+    根管治疗术:                                      endodontic
+    "根管治疗术(乳磨牙封失活剂法)":                  endodontic
+    "根管治疗术(乳磨牙直接拔髓多步法)":              endodontic
+    "根管治疗术(复杂乳牙封失活剂法)":                endodontic
+    "根管治疗术(复杂乳牙直接拔髓多次法)":            endodontic
+    "根管治疗术(乳前牙直接拔髓多步法)":              endodontic
+    "根管治疗(封失活剂)":                            endodontic
+    复杂根管治疗:                                    endodontic
 
     # ── 种植(implant)— 注意"种植上部修复"算 prostho;"种植修复"在 host 文本是合并语,归 implant
     种植:                                            implant

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

@@ -16,6 +16,9 @@ primary:
 
 field_mapping:
   externalId:                  treat_external_id
+  # W4 末 DW upsert:updatedAt 进 source_event_id 幂等键,host UPDATE → 新 transaction(否则永久 dedup 漏 update)
+  updatedAt:         updated_date
+  createdAt:         created_date
   patientExternalId:           patient_id
   clinicId:                    organization_id
   occurredAt:                  rq

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

@@ -74,6 +74,19 @@ sql_source:
   # W3 末 demo 调到 500k,长期(生产)走增量 pull(cursor)替代一次性拉
   default_limit: 500000
 
+  # W4 末:DW 增量配置(sync-incremental CLI 用)
+  # 跑全量(cold-import)时本段忽略;跑增量时按 per_query 注入 WHERE
+  # 首次增量(无 cursor)= 等价全量(跟 cold-import 不同点 = 增量模式去 dev cohort LIMIT,不限量)
+  # fact_client_out 没 updated_date,用 last_visit_time(主档变化 = 患者来诊新事件)
+  incremental:
+    per_query:
+      fact_client_out:           { cursor_column: last_visit_time }
+      fact_appointment_out:      { cursor_column: updated_date }
+      fact_emr_treatment_out:    { cursor_column: updated_date }
+      fact_settlement_out:       { cursor_column: updated_date }
+      fact_settlement_out_refund: { cursor_column: updated_date }
+      fact_settlement_mode_out:  { cursor_column: updated_date }
+
   # SQL 最朴素化 — host(DW)给的数据范围就是 PAC 该消化的范围。
   # PAC 这边不预设诊所 / brand / 时间过滤,数据来什么就是什么。
   # 仅保留 cohort LIMIT(测试期控量,真上量去掉)+ 必要业务过滤(退费状态)。
@@ -85,7 +98,7 @@ sql_source:
       FROM dw_group.fact_client_out
       WHERE last_visit_time IS NOT NULL
       ORDER BY last_visit_time DESC
-      LIMIT 100
+      LIMIT 100 OFFSET 100
 
     # ── 预约(全部状态;in_time NULL 的在 transforms.route 时分流跳过 encounter) ──
     fact_appointment_out: |
@@ -94,7 +107,7 @@ sql_source:
       WHERE (patient_id, brand) IN (
         SELECT patient_id, brand FROM dw_group.fact_client_out
         WHERE last_visit_time IS NOT NULL
-        ORDER BY last_visit_time DESC LIMIT 100
+        ORDER BY last_visit_time DESC LIMIT 100 OFFSET 100
       )
 
     # ── EMR 全字段(自由文本 + diag/treat_plan JSON,后续 transforms 拆) ──
@@ -102,12 +115,13 @@ sql_source:
       SELECT
         id, patient_id, organization_id, brand, rq, registration_id, user_id, doctor_name,
         illness_desc, pre_illness, past_hist, gen_cond, examine, dispose, doc_order,
-        diag, treat_plan, plan, file_url
+        diag, treat_plan, plan, file_url,
+        created_date, updated_date
       FROM dw_group.fact_emr_treatment_out
       WHERE (patient_id, brand) IN (
         SELECT patient_id, brand FROM dw_group.fact_client_out
         WHERE last_visit_time IS NOT NULL
-        ORDER BY last_visit_time DESC LIMIT 100
+        ORDER BY last_visit_time DESC LIMIT 100 OFFSET 100
       )
 
     # ── 结算明细(已做治疗反推;退费/未完成结算行 PAC 不消费) ──
@@ -116,7 +130,7 @@ sql_source:
     #   - 23% case 团购券/储值/挂号预付,billing_date 在治疗前几小时,created_date 才是医生录治疗的时点
     #   - 全量 244 万对验证:settlement.created vs EMR.created p50 差 5min,51% 在 5min 内
     fact_settlement_out: |
-      SELECT id, organization_id, brand, patient_id, rq, billing_date, created_date,
+      SELECT id, organization_id, brand, patient_id, rq, billing_date, created_date, updated_date,
              settlement_type, doctor_id,
              settlement_project_name, settlement_money, settlement_num, settlement_unit_name,
              registration_id, is_refund, settlement_status
@@ -126,7 +140,7 @@ sql_source:
         AND (patient_id, brand) IN (
           SELECT patient_id, brand FROM dw_group.fact_client_out
           WHERE last_visit_time IS NOT NULL
-          ORDER BY last_visit_time DESC LIMIT 100
+          ORDER BY last_visit_time DESC LIMIT 100 OFFSET 100
         )
 
     # ── 退费明细(独立 fact_type refund_record;LTV 算法 - refund;S5 闭环风控)──
@@ -135,7 +149,7 @@ sql_source:
     #   ② settlement_status=4    (反向结算单,settlement_money 通常 < 0 表示"金额冲减")
     # parser 侧 Math.abs(amount) 统一成正 cents(语义 = 患者拿回的钱)
     fact_settlement_out_refund: |
-      SELECT id, organization_id, brand, patient_id, rq, billing_date, created_date,
+      SELECT id, organization_id, brand, patient_id, rq, billing_date, created_date, updated_date,
              settlement_type, doctor_id,
              settlement_project_name, settlement_money,
              registration_id, is_refund, settlement_status
@@ -144,7 +158,7 @@ sql_source:
         AND (patient_id, brand) IN (
           SELECT patient_id, brand FROM dw_group.fact_client_out
           WHERE last_visit_time IS NOT NULL
-          ORDER BY last_visit_time DESC LIMIT 100
+          ORDER BY last_visit_time DESC LIMIT 100 OFFSET 100
         )
 
     # ── 支付通道明细(17 列 pay_*,后续 transforms.pick_first_nonzero 推) ──
@@ -156,7 +170,7 @@ sql_source:
         AND (patient_id, brand) IN (
           SELECT patient_id, brand FROM dw_group.fact_client_out
           WHERE last_visit_time IS NOT NULL
-          ORDER BY last_visit_time DESC LIMIT 100
+          ORDER BY last_visit_time DESC LIMIT 100 OFFSET 100
         )
 
 # ─────────────────────────────────────────────────────────────
@@ -183,6 +197,8 @@ transforms:
       - examine
       - dispose
       - doc_order
+      - created_date  # W4 末:DW upsert,emr.yaml field_mapping 拿 updatedAt → source_event_id 幂等键
+      - updated_date
 
   # ── B. EMR.diag JSON 拆行 → 诊断 fact 候选 ──
   # W3 末改:不再丢 stdCode 缺失行(实测 98% 诊断没填 ICD 码,但 message 是标准中文术语)。
@@ -200,6 +216,8 @@ transforms:
       rq: rq
       user_id: user_id           # 诊断医生(继承 emr 父级,医患关系信号)
       doctor_name: doctor_name   # 诊断医生名(快照)
+      created_date: created_date  # W4 末:DW upsert,传父级 created/updated_date 给拆出子行
+      updated_date: updated_date
     element_fields:
       std_code: stdCode
       message: message
@@ -273,6 +291,8 @@ transforms:
       rq: rq
       user_id: user_id           # 治疗医生(继承 emr 父级)
       doctor_name: doctor_name   # 治疗医生名
+      created_date: created_date  # W4 末:DW upsert,传父级 created/updated_date 给拆出子行
+      updated_date: updated_date
     element_fields:
       treat_name: treatName
       tooth_position: toothPosition
@@ -294,6 +314,8 @@ transforms:
       rq: rq
       user_id: user_id           # 制定计划的医生
       doctor_name: doctor_name
+      created_date: created_date  # W4 末:DW upsert,传父级 created/updated_date
+      updated_date: updated_date
     element_fields:
       treat_name: treatName
       tooth_position: toothPosition
@@ -498,6 +520,8 @@ transforms:
       registration_id: registration_id
       user_id: user_id           # 接诊医生(影像通常在接诊时拍)
       doctor_name: doctor_name
+      created_date: created_date  # W4 末:DW upsert,传父级 created/updated_date
+      updated_date: updated_date
     element_fields:
       check_name: check_name
       file_path: file_url

apps/pac-service/package.json

@@ -17,6 +17,7 @@
     "prisma:studio": "prisma studio",
     "prisma:seed": "ts-node --transpile-only prisma/seed.ts",
     "cold-import": "ts-node --transpile-only src/cli/cold-import.cli.ts",
+    "sync-incremental": "ts-node --transpile-only src/cli/sync-incremental.cli.ts",
     "recompute-persona": "ts-node --transpile-only src/cli/recompute-persona.cli.ts",
     "recompute-plans": "ts-node --transpile-only src/cli/recompute-plans.cli.ts",
     "timeline": "ts-node --transpile-only src/cli/timeline.cli.ts",

apps/pac-service/prisma/schema.prisma

@@ -1192,6 +1192,14 @@ model AgentInvocation {
   /// judge 细项打分 {relevance:4, compliance:5, tone:4, actionability:3}
   judgeRubric Json?    @map("judge_rubric")
 
+  /// W4 末:客服 UI thumbs up/down 反馈("本段是否好用")— 'up' / 'down' / null
+  /// 跟 judgeScore 平行:judge 是 LLM 自动评,userFeedback 是真人客服评
+  /// 同一 invocation 只保留一次反馈(再点覆盖);用于话术 / 摘要 prompt 迭代依据
+  userFeedback   String?   @map("user_feedback")
+  userFeedbackAt DateTime? @map("user_feedback_at") @db.Timestamptz(3)
+  /// 反馈提交人(host 侧 userId,从 JWT.sub 来);便于审计 / 聚合分析
+  userFeedbackBy String?   @map("user_feedback_by")
+
   /// 输入快照(瘦身版,只存"agent 独占内容",不重复 fact / persona 主体数据):
   /// {
   ///   factIdsAtCall: ["fact-uuid", ...],   // 引用 — replay 时按 id 查 fact 表的 T0 版本还原

apps/pac-service/src/cli/sync-incremental.cli.ts

+/**
+ * Sync Incremental CLI(W4 末)
+ *
+ * 从上次 sync_logs.cursor_after 增量拉 DW 数据,跑完触发 persona + plan recompute。
+ *
+ * 链路:
+ *   1. ColdImportService.importDirectory({ incremental: true })
+ *      - 读 sync_logs[host=jvs-dw, resource=incremental_bundle].cursor_after 拿上次 cursor
+ *      - SQL 注入 WHERE updated_date > '${cursor}'(per-query)
+ *      - 跑完写新 sync_log + cursor_after JSON
+ *   2. 收集本批 affected patient_ids
+ *   3. 对每个 affected patient 跑 PersonaService.recompute(等价 BullMQ 触发,本地同步跑)
+ *   4. 跑 PlanEngineService.runHost(SQL 召回 + 6 因子打分,生成/更新 followup_plans)
+ *
+ * 用法:
+ *   pnpm sync-incremental -- --dir=./data/jvs-dw                 # 增量 + 联动 persona/plan
+ *   pnpm sync-incremental -- --dir=./data/jvs-dw --no-recompute  # 只拉数据不联动重算(debug)
+ *   pnpm sync-incremental -- --dir=./data/jvs-dw --dry-run       # 不写库(测试 cursor 注入是否正确)
+ *
+ * 部署:BullMQ cron 每天 02:00 触发(DW 那边每日刷新后)
+ */
+
+import { NestFactory } from '@nestjs/core';
+import { Logger } from '@nestjs/common';
+import { AppModule } from '../app.module';
+import { ColdImportService } from '../modules/sync/cold-import/cold-import.service';
+import { PersonaService } from '../modules/persona/persona.service';
+import { PlanEngineService } from '../modules/plan/engine/plan-engine.service';
+import { PrismaService } from '../prisma/prisma.service';
+
+interface CliArgs {
+  dir?: string;
+  dryRun: boolean;
+  noRecompute: boolean;
+  help: boolean;
+}
+
+function parseArgs(argv: string[]): CliArgs {
+  const out: CliArgs = { dryRun: false, noRecompute: false, help: false };
+  for (const a of argv) {
+    if (a === '--help' || a === '-h') out.help = true;
+    else if (a === '--dry-run') out.dryRun = true;
+    else if (a === '--no-recompute') out.noRecompute = true;
+    else if (a.startsWith('--dir=')) out.dir = a.slice('--dir='.length);
+  }
+  return out;
+}
+
+function printHelp() {
+  console.log(`
+Sync Incremental CLI
+
+DW 直连增量摄入 + 自动 persona/plan 联动重算
+
+Usage:
+  pnpm sync-incremental -- --dir=<manifest_dir> [--dry-run] [--no-recompute]
+
+Options:
+  --dir=<path>     必填,manifest.yaml 所在目录(增量 cursor 配置也在 manifest.sql_source.incremental)
+  --dry-run        只读 cursor 注入预览,不写库
+  --no-recompute   只拉数据,不触发 persona/plan 重算
+  --help, -h       显示本帮助
+
+首跑(无 cursor):等价全量(去 dev cohort LIMIT,按 yaml 完整拉)
+后续:WHERE updated_date > '\${cursor}',只拉新/改的行
+`);
+}
+
+async function bootstrap() {
+  const args = parseArgs(process.argv.slice(2));
+  if (args.help || !args.dir) {
+    printHelp();
+    process.exit(args.help ? 0 : 1);
+  }
+
+  const logger = new Logger('sync-incremental:cli');
+  logger.log(`Starting incremental sync(dir=${args.dir}, dryRun=${args.dryRun}, noRecompute=${args.noRecompute})`);
+
+  const app = await NestFactory.createApplicationContext(AppModule, {
+    logger: ['log', 'warn', 'error'],
+  });
+
+  try {
+    const importSvc = app.get(ColdImportService);
+    const result = await importSvc.importDirectory(args.dir!, {
+      dryRun: args.dryRun,
+      incremental: true,
+    });
+
+    logger.log('─────────────────────────────────────────');
+    logger.log(`Result:`);
+    logger.log(`  runId:                 ${result.runId}`);
+    logger.log(`  host:                  ${result.hostName} (${result.hostId})`);
+    logger.log(`  tenants:               [${result.tenantIds.join(',')}]`);
+    logger.log(`  status:                ${result.status}`);
+    logger.log(`  patients upserted:     ${result.totals.patientsUpserted}`);
+    logger.log(`  transactions written:  ${result.totals.transactionsWritten}`);
+    logger.log(`  duplicates (idem):     ${result.totals.duplicates}`);
+    logger.log(`  failed:                ${result.totals.failed}`);
+    logger.log(
+      `  facts:                 created=${result.totals.factsCreated} superseded=${result.totals.factsSuperseded} unchanged=${result.totals.factsUnchanged} failed=${result.totals.factsFailed}`,
+    );
+
+    if (args.dryRun || args.noRecompute) {
+      logger.log('Skipping persona/plan recompute (dry-run 或 --no-recompute)');
+      await app.close();
+      process.exit(0);
+    }
+
+    // ─────────────────────────────────────────
+    // 联动 persona 重算 — 仅受影响的 patient
+    // ─────────────────────────────────────────
+    const prisma = app.get(PrismaService);
+    const personaSvc = app.get(PersonaService);
+    const planEngine = app.get(PlanEngineService);
+
+    // 找本次 syncLog 之后 written 的 transactions 涉及的 patient
+    if (!result.syncLogId) {
+      logger.warn('No syncLog id — 跳过 persona/plan(可能 dry-run)');
+      await app.close();
+      process.exit(0);
+    }
+    const syncLog = await prisma.syncLog.findUnique({ where: { id: result.syncLogId } });
+    if (!syncLog) {
+      logger.warn('syncLog 找不到 — 跳过');
+      await app.close();
+      process.exit(0);
+    }
+    const affectedPatients = await prisma.patientTransaction.findMany({
+      where: {
+        hostId: result.hostId,
+        createdAt: { gte: syncLog.startedAt },
+      },
+      select: { patientId: true },
+      distinct: ['patientId'],
+    });
+    const patientIds = affectedPatients.map((r) => r.patientId).filter((id): id is string => !!id);
+    logger.log('─────────────────────────────────────────');
+    logger.log(`Persona recompute:${patientIds.length} patients affected`);
+    let pSuccess = 0;
+    let pNoop = 0;
+    let pFailed = 0;
+    for (const patientId of patientIds) {
+      try {
+        const r = await personaSvc.recompute({
+          patientId,
+          source: `incremental-sync:${result.runId}`,
+        });
+        if (r.status === 'success' || r.status === 'partial') pSuccess++;
+        else if (r.status === 'noop') pNoop++;
+        else pFailed++;
+      } catch (e) {
+        pFailed++;
+        logger.warn(`persona patient=${patientId} failed: ${(e as Error).message}`);
+      }
+    }
+    logger.log(`  success=${pSuccess} noop=${pNoop} failed=${pFailed}`);
+
+    // ─────────────────────────────────────────
+    // 联动 plan 重算 — 整 host(scenario SQL 跑一次刷新所有 patient 池)
+    // ─────────────────────────────────────────
+    logger.log('─────────────────────────────────────────');
+    logger.log(`Plan recompute:host=${result.hostName}`);
+    const tenants = await prisma.patient.findMany({
+      where: { hostId: result.hostId },
+      distinct: ['tenantId'],
+      select: { tenantId: true },
+    });
+    let totalPlansCreated = 0;
+    let totalHits = 0;
+    for (const t of tenants) {
+      const r = await planEngine.runAllForHost({
+        hostId: result.hostId,
+        tenantId: t.tenantId,
+        now: new Date(),
+      });
+      totalPlansCreated += r.plansCreated;
+      totalHits += r.patientsHit;
+      logger.log(`  tenant=${t.tenantId}: patientsHit=${r.patientsHit} plansCreated=${r.plansCreated} skipped=${r.plansSkippedAssigned}`);
+    }
+    logger.log(`  Total: patientsHit=${totalHits} plansCreated=${totalPlansCreated}`);
+    logger.log('─────────────────────────────────────────');
+  } catch (e) {
+    logger.error(`Incremental sync failed: ${(e as Error).message}`);
+    if ((e as Error).stack) logger.error((e as Error).stack);
+    await app.close();
+    process.exit(1);
+  }
+
+  await app.close();
+  process.exit(0);
+}
+
+bootstrap();

apps/pac-service/src/cli/verify-chain.cli.ts

+/**
+ * One-shot verify: 跑 chain-composer 对指定 patient, 打印各 chain 状态。
+ * 用法:pnpm tsx src/cli/verify-chain.cli.ts --id=<patientId>
+ */
+import { NestFactory } from '@nestjs/core';
+import { AppModule } from '../app.module';
+import { PrismaService } from '../prisma/prisma.service';
+import { ChainComposerService } from '../modules/plan/engine/chain-composer.service';
+
+async function main() {
+  const id = process.argv.find((a) => a.startsWith('--id='))?.slice('--id='.length);
+  if (!id) {
+    console.error('Usage: --id=<patientId>');
+    process.exit(1);
+  }
+  const app = await NestFactory.createApplicationContext(AppModule, { logger: ['error'] });
+  const prisma = app.get(PrismaService);
+  const composer = app.get(ChainComposerService);
+  const facts = await prisma.patientFact.findMany({
+    where: { patientId: id, status: { in: ['active', 'fulfilled'] } },
+    orderBy: { occurredAt: 'asc' },
+  });
+  const chains = composer.compose(facts as any);
+  console.log(`\n=== Patient ${id} — ${chains.length} chains ===\n`);
+  for (const c of chains) {
+    const target = c.target ? ' ★' : '';
+    console.log(
+      `[${c.status.padEnd(11)}] stage=${c.currentStage} ${(c.name ?? '?').padEnd(18)} tooth=${c.toothPosition ?? '-'} code=${c.code ?? '-'} cat=${c.category}${target}`,
+    );
+    const lc = (c as { lifecycleNoteZh?: string }).lifecycleNoteZh;
+    if (lc) console.log(`  lifecycle: ${lc}`);
+    const nodes = (c as unknown as { nodes?: Array<{ stage?: number; title?: string; detail?: string; hint?: string; done?: boolean }> }).nodes;
+    if (nodes && nodes.length) {
+      for (const n of nodes) console.log(`    S${n.stage ?? '?'} ${n.done ? '✓' : '○'} ${n.title ?? ''} ${n.detail ? '· ' + n.detail : ''}${n.hint ? ' [' + n.hint + ']' : ''}`);
+    }
+    const altClosedBy = (c as { alternativeClosedBy?: string }).alternativeClosedBy;
+    if (altClosedBy) console.log(`  alt-closed-by: ${altClosedBy}`);
+  }
+  await app.close();
+}
+main().catch((e) => { console.error(e); process.exit(1); });

apps/pac-service/src/modules/ai/calls/draft-plan-script/call.ts

@@ -14,9 +14,13 @@ import {
  * LLM 偶尔会越过 schema 约束塞禁词,这里再补一道(防御性)。
  * B 方案重写后,output 4 段都是 markdown 字符串,直接全文 join 扫禁词。
  */
+// ⚠️ 单字符禁词务必避免(会误伤合法词):
+//   '亲' → 误命中 亲切 / 亲自 / 亲人 / 母亲 / 父亲 等
+//   '宝' → 误命中 宝贝 / 宝藏 / 宝石 等
+// 只保留"销售化"的明确组合形式
 const FORBIDDEN_PHRASES = [
   '一定能', '保证', '绝对', '百分百', '100%',
-  '亲爱的', '亲', '宝',
+  '亲爱的',         // 淘宝式称呼,误伤面比单字符 '亲' 小很多
   '便宜', '促销', '折扣', '免费送',
 ];
 

apps/pac-service/src/modules/auth/auth.controller.ts

@@ -6,6 +6,8 @@ import { AuthService } from './auth.service';
 import {
   ExchangeCodeRequestDto,
   ExchangeCodeResponseDto,
+  MockLoginRequestDto,
+  MockLoginResponseDto,
   RefreshTokenRequestDto,
   RefreshTokenResponseDto,
   TokenExchangeRequestDto,
@@ -43,4 +45,18 @@ export class AuthController {
   refresh(@Body() dto: RefreshTokenRequestDto) {
     return this.auth.refresh(dto.refreshToken);
   }
+
+  @Public()
+  @Post('mock-login')
+  @ZodResponse({ status: 200, type: MockLoginResponseDto })
+  @ApiOperation({
+    summary:
+      'Mock login(开发 / 试部署用,env 门控)— 按 { tenant, role } 预制 user payload 直产 JWT',
+    description:
+      'env: PAC_ENABLE_MOCK_LOGIN=true 强开 / =false 强关;不设按 NODE_ENV(prod 默认关)。' +
+      '生产真 host SSO 接入后,把 env 设 false 或删该 endpoint。',
+  })
+  mockLogin(@Body() dto: MockLoginRequestDto) {
+    return this.auth.mockLogin(dto);
+  }
 }

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

@@ -6,6 +6,7 @@ import {
   ROLE_PERMISSIONS,
   type AccessTokenPayload,
   type ExchangeCodeResponse,
+  type MockLoginRequest,
   type Permission,
   type RefreshTokenResponse,
   type TokenDictionary,
@@ -207,4 +208,99 @@ export class AuthService {
   resolvePermissions(role: UserRole): Permission[] {
     return ROLE_PERMISSIONS[role];
   }
+
+  // ─────────────────────────────────────────────────────────────
+  // Mock Login(开发 / 试部署用 — env 门控,生产关闭)
+  // ─────────────────────────────────────────────────────────────
+  //
+  // 用途:试部署期间客服 / 演示用户没真 host SSO 也能登录工作台。
+  // 安全:env 门控(NODE_ENV != production 或 PAC_ENABLE_MOCK_LOGIN=true);
+  //      生产真 host 接入后,删 endpoint 或把 env 设 false。
+
+  /// jvs-dw 两个 brand 的预制 user payload(对齐 manifest.yaml tenant_map)
+  /// 来源:`apps/pac-service/data/jvs-dw/manifest.yaml` §"tenant 路由"
+  ///       `docs/deployment-data-ingest.md` §clinic UUID 列表
+  private readonly MOCK_PRESETS = {
+    ruier: {
+      tenantId: 'ba67e6cf30dc4f9c9c46adef188bbd04',
+      tenantNameZh: '瑞尔',
+      clinics: {
+        '7d49539c7573490387c03e6496ff1a6c': '杭州大厦诊所',
+        dad2f04a120947e2b82b41cbd108f3f4: '杭州高德诊所',
+        '66701845dd2342e19f9e9f576c4ffe9c': '北京朝阳公园诊所',
+      },
+    },
+    ruitai: {
+      tenantId: '77057aed269f4a14957ae0ad0eff359a',
+      tenantNameZh: '瑞泰',
+      clinics: {
+        c18cadf2d3cd4adda5527debd41356eb: '通善口腔学前街医院',
+        e83d432a38bb4f6284713b36db4e7497: '上海世纪公园',
+      },
+    },
+  } as const;
+
+  isMockLoginEnabled(): boolean {
+    if (process.env.PAC_ENABLE_MOCK_LOGIN === 'true') return true;
+    if (process.env.PAC_ENABLE_MOCK_LOGIN === 'false') return false;
+    return (this.config.get<string>('nodeEnv') ?? process.env.NODE_ENV) !== 'production';
+  }
+
+  async mockLogin(req: MockLoginRequest): Promise<ExchangeCodeResponse> {
+    if (!this.isMockLoginEnabled()) {
+      throw new BizError(ApiCode.AUTH_PERMISSION_DENIED, '模拟登录已在当前环境禁用');
+    }
+    const preset = this.MOCK_PRESETS[req.tenant];
+    if (!preset) {
+      throw new BizError(ApiCode.CLIENT_VALIDATION_FAILED, `unknown tenant: ${req.tenant}`);
+    }
+
+    // 找 jvs-dw host(seed 时已建)
+    const host = await this.prisma.host.findFirst({ where: { name: 'jvs-dw' } });
+    if (!host) {
+      throw new BizError(
+        ApiCode.HOST_NOT_FOUND,
+        '请先 seed jvs-dw host(pnpm --filter @pac/service exec prisma db seed)',
+      );
+    }
+
+    const clinicIds = Object.keys(preset.clinics);
+    const dictionary: TokenDictionary = {
+      clinics: preset.clinics as Record<string, string>,
+      users: {
+        // 给 sub 一个可读名,UI 头像右侧显示
+        [`mock-${req.tenant}-${req.role}`]: `${preset.tenantNameZh}·${roleNameZh(req.role)}(模拟)`,
+      },
+    };
+    const permissions = this.resolvePermissions(req.role);
+
+    const accessToken = await this.signAccessToken({
+      sub: `mock-${req.tenant}-${req.role}`,
+      hostId: host.id,
+      tenantId: preset.tenantId,
+      clinicIds,
+      role: req.role,
+      permissions,
+      dictionary,
+    });
+    const refreshToken = await this.signRefreshToken({
+      sub: `mock-${req.tenant}-${req.role}`,
+      hostId: host.id,
+      tenantId: preset.tenantId,
+      clinicIds,
+      role: req.role,
+      dictionary,
+    });
+    const expiresIn = parseDurationToSeconds(this.config.getOrThrow<string>('jwt.expiresIn'));
+
+    this.logger.log(
+      `mock-login: tenant=${req.tenant}(${preset.tenantNameZh}) role=${req.role} ` +
+        `clinics=${clinicIds.length} hostId=${host.id}`,
+    );
+    return { accessToken, refreshToken, expiresIn };
+  }
+}
+
+function roleNameZh(role: UserRole): string {
+  return ({ staff: '员工', leader: '主管', admin: '管理员' } as const)[role] ?? role;
 }

apps/pac-service/src/modules/auth/dto/auth.dto.ts

@@ -2,6 +2,8 @@ import { createZodDto } from 'nestjs-zod';
 import {
   ExchangeCodeRequestSchema,
   ExchangeCodeResponseSchema,
+  MockLoginRequestSchema,
+  MockLoginResponseSchema,
   RefreshTokenRequestSchema,
   RefreshTokenResponseSchema,
   TokenExchangeRequestSchema,
@@ -14,3 +16,5 @@ export class ExchangeCodeRequestDto extends createZodDto(ExchangeCodeRequestSche
 export class ExchangeCodeResponseDto extends createZodDto(ExchangeCodeResponseSchema) {}
 export class RefreshTokenRequestDto extends createZodDto(RefreshTokenRequestSchema) {}
 export class RefreshTokenResponseDto extends createZodDto(RefreshTokenResponseSchema) {}
+export class MockLoginRequestDto extends createZodDto(MockLoginRequestSchema) {}
+export class MockLoginResponseDto extends createZodDto(MockLoginResponseSchema) {}

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

@@ -4,6 +4,7 @@ import { maskName, maskPhone } from '@pac/utils';
 import { PrismaService } from '../../prisma/prisma.service';
 import { ChainComposerService } from '../plan/engine/chain-composer.service';
 import type { TenantScopeContext } from '../../common/decorators/tenant-scope.decorator';
+import { toothSet } from '../sync/pipeline/parsers/tooth-position.util';
 
 /**
  * PlanAggregateService — Plan 详情聚合服务。
@@ -77,11 +78,18 @@ export class PlanAggregateService {
         reasonKeys.add(`${t.code}|${tooth || '*'}`);
       }
     }
+    // W4 末:牙位精确匹配(Palmer 乳牙 + FDI 恒牙都支持)
+    //   旧版 strip 所有字母 → "1D OD" → "1" → Palmer 乳牙 1A/1B/1C/1D/1E 全部误匹配
+    //   新版用 toothSet:剥面后缀后保留牙位 base("1D OD" → "1D"; "11 M" → "11")
+    //   精确匹配避免 Palmer 5 颗乳牙在儿童 case 被误判
     const toothOverlap = (a: string, b: string): boolean => {
       if (!a || !b) return false;
-      const A = new Set(a.split(';').map((s) => s.replace(/[^0-9]/g, '').trim()).filter(Boolean));
-      const B = b.split(';').map((s) => s.replace(/[^0-9]/g, '').trim()).filter(Boolean);
-      return B.some((t) => A.has(t));
+      const A = toothSet(a);
+      if (A.size === 0) return false;
+      for (const t of toothSet(b)) {
+        if (A.has(t)) return true;
+      }
+      return false;
     };
     for (const c of chains) {
       if (!c.code) { c.target = false; continue; }
@@ -335,7 +343,7 @@ function serializeScript(s: {
   content: string | null;
   source: string | null;
   status: string;
-  generatedAt: Date | null;
+  generatedAt?: Date | null;
   updatedAt: Date;
 }) {
   const sections = parseScriptMarkdownToSections(s.content ?? '');

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

@@ -10,15 +10,25 @@ import {
 import type { Response } from 'express';
 import { ApiBearerAuth, ApiOperation, ApiTags } from '@nestjs/swagger';
 import { Permission } from '@pac/types';
+import { z } from 'zod';
 import { RequirePermission } from '../../common/decorators/permissions.decorator';
 import {
   TenantScope,
   TenantScopeContext,
 } from '../../common/decorators/tenant-scope.decorator';
+import {
+  CurrentUser,
+  AuthenticatedUser,
+} from '../../common/decorators/current-user.decorator';
+import { PrismaService } from '../../prisma/prisma.service';
 import { PlanScriptOrchestrator } from '../ai/orchestrators/plan-script.orchestrator';
 import { PlanSummaryOrchestrator } from '../ai/orchestrators/plan-summary.orchestrator';
 import { PlanAggregateService } from './plan-aggregate.service';
 
+const ScriptFeedbackSchema = z.object({
+  feedback: z.enum(['up', 'down']),
+});
+
 /**
  * PlansAggregateController — 生产路径的 plan 详情聚合 + AI 资产再生成端点。
  *
@@ -42,6 +52,7 @@ export class PlansAggregateController {
     private readonly demo: PlanAggregateService,
     private readonly planScript: PlanScriptOrchestrator,
     private readonly planSummary: PlanSummaryOrchestrator,
+    private readonly prisma: PrismaService,
   ) {}
 
   // ─────────────────────────────────────────────
@@ -114,6 +125,44 @@ export class PlansAggregateController {
   // Summary — 流式重生成(1 次产 3 段:onePage / medicalRecord / treatmentChain)
   // ─────────────────────────────────────────────
 
+  // ─────────────────────────────────────────────
+  // 话术 / 摘要 thumbs up/down 反馈("本段是否好用")
+  // ─────────────────────────────────────────────
+
+  /**
+   * 反馈某 plan 当前话术(对应 plan_scripts.agent_invocation_id)up/down。
+   * 同一 invocation 反复点会覆盖(再点 down 覆盖 up,以最新为准)。
+   * 没找到 planScript / agentInvocationId → 404(避免无 invocation 的 plan 接受反馈)。
+   *
+   * 后续可加:summary feedback(对称端点)/ 聚合 dashboard(up/down 比 + 命中 fallback 时禁止评)。
+   */
+  @Post(':id/script-feedback')
+  @RequirePermission(Permission.PLAN_VIEW_OWN)
+  @ApiOperation({ summary: '对当前话术 thumbs up/down 反馈("本段是否好用")' })
+  async submitScriptFeedback(
+    @TenantScope() scope: TenantScopeContext,
+    @CurrentUser() user: AuthenticatedUser,
+    @Param('id') planId: string,
+    @Body() body: unknown,
+  ) {
+    const { feedback } = ScriptFeedbackSchema.parse(body);
+    const script = await this.prisma.planScript.findFirst({
+      where: { planId, hostId: scope.hostId, tenantId: scope.tenantId },
+    });
+    if (!script?.agentInvocationId) {
+      return { ok: false as const, reason: 'no_invocation' };
+    }
+    await this.prisma.agentInvocation.update({
+      where: { id: script.agentInvocationId },
+      data: {
+        userFeedback: feedback,
+        userFeedbackAt: new Date(),
+        userFeedbackBy: user.sub,
+      },
+    });
+    return { ok: true as const, invocationId: script.agentInvocationId, feedback };
+  }
+
   @Get(':id/summary:stream')
   @RequirePermission(Permission.PLAN_VIEW_OWN)
   @ApiOperation({ summary: '流式重新生成 plan 摘要(SSE,1 次产 3 段)' })

apps/pac-service/src/modules/plan/engine/chain-composer.service.ts

@@ -79,7 +79,7 @@ export class ChainComposerService {
     // 替代闭环 pass:同 patient 同 tooth overlap 后续有"已治"链(closed/ongoing s>=3) →
     // 把当前 discovered/entered chain 标记为 closed(by alternative)
     // 例:罗国标 K04 14;15 根管诊断 → 后来 K08 14-17;47 + implant actual → K04 chain 视为替代闭环
-    markAlternativeClosed(deduped);
+    markAlternativeClosed(deduped, byType);
 
     // ⭐ chain ★ 标记不在这里做 patient 级对齐(撤回 filter)
     //   理由:chain-composer 只产 chain 客观状态(discovered/entered/ongoing/closed)
@@ -148,8 +148,19 @@ function filterDiscoveredByPatientLevel(chains: ComposedChain[]): ComposedChain[
   });
 }
 
-function markAlternativeClosed(chains: ComposedChain[]): void {
+function markAlternativeClosed(chains: ComposedChain[], byType: FactsByType): void {
   const ALT_CATS = new Set(['implant', 'surgical', 'prosthodontic']);
+  // ⭐ W4 末改造:扫 fact 而非 chain
+  //   原因:surgical(拔除)往往是"actual-only"链 — 无对应 dx sig,bucket.tooth='',
+  //   被原版 markAlternativeClosed(看 chain.toothPosition)跳过。
+  //   例:季根财 K04@23 + surgical actual @ 23(松动恒牙拔除术)→ 23 已拔不需 RCT,
+  //   但 surgical chain 是 actual-only(tooth='') → 老版 K04 chain 一直 ★ discovered。
+  //   改成扫 byType.treatment 的 actual,直接用 actual.content.tooth_position 跟 c.toothPosition 比。
+  const altActuals = byType.treatment.filter((tx) => {
+    if (tx.kind !== FactKind.ACTUAL) return false;
+    const cat = String((tx.content as Record<string, unknown>).category ?? '');
+    return ALT_CATS.has(cat);
+  });
   for (const c of chains) {
     if (c.status !== 'discovered' && c.status !== 'entered') continue;
     if (!c.toothPosition || !c.diagnosedAt) continue;
@@ -160,22 +171,39 @@ function markAlternativeClosed(chains: ComposedChain[]): void {
     // ⭐ W4 末新加豁免 #2:wholeMouth 链(全口治疗,牙位 ≥ 20 颗)不被 per-tooth 链替代
     //   全口洁治覆盖 26 颗牙 vs 种植 21;41 这 2 颗 — 临床上是"维护 + 局部治疗",不是替代
     if (isWholeMouthTooth(c.toothPosition)) continue;
-    for (const other of chains) {
-      if (other === c) continue;
-      if (!ALT_CATS.has(other.category)) continue;
-      if (!other.toothPosition || !other.diagnosedAt) continue;
-      // ⭐ 同 category 不交叉关闭(W3 末)— alt-close 语义是 K04 根管→K08 种植 这种"不同方案"替代,
-      //    同病种(都 implant / 都 surgical)多次诊断不是"替代"是"重复",该在桶分阶段合并而非这里互判
-      //    例:王辉 K08 多次诊断 tooth 顺序差异 → 旧版同 implant 互判 alt-closed → 误标
-      if (other.category === c.category) continue;
-      if (other.diagnosedAt < c.diagnosedAt) continue;
-      if (!toothOverlap(c.toothPosition, other.toothPosition)) continue;
-      // 命中 — 标记替代闭环
+    // ⭐ 全牙位覆盖才闭环 — 收集所有适用的 alt actuals 求并集
+    //   季根财 K08{16,17,25,26,27,44,45} 只被 surgical@44 覆盖 1 颗 → 不闭环(其他 6 颗仍缺口)
+    //   季根财 K04@23 被 surgical@23 完全覆盖 → 闭环 ✓
+    //   注:范萍莉 K08{41,47} 由同 cat implant actual 覆盖,走的是 s5Eligible 闸(同 cat 算正治不算替代)
+    const cToothSet = new Set(c.toothPosition.split(';').map((t) => t.trim()).filter(Boolean));
+    if (cToothSet.size === 0) continue;
+    const altCovered = new Set<string>();
+    const altSources: string[] = [];
+    const cDx = new Date(c.diagnosedAt);
+    if (isNaN(cDx.getTime())) continue;
+    for (const tx of altActuals) {
+      const txCat = String((tx.content as Record<string, unknown>).category ?? '');
+      if (txCat === c.category) continue;
+      if (!tx.occurredAt) continue;
+      if (tx.occurredAt.getTime() < cDx.getTime()) continue;
+      const txTooth = String((tx.content as Record<string, unknown>).tooth_position ?? '');
+      if (!txTooth) continue;
+      let hit = false;
+      for (const t of txTooth.split(';')) {
+        const trimmed = t.trim();
+        if (trimmed && cToothSet.has(trimmed)) {
+          altCovered.add(trimmed);
+          hit = true;
+        }
+      }
+      if (hit) altSources.push(`${CATEGORY_LABEL[txCat] ?? txCat}·${txTooth}`);
+    }
+    if (altCovered.size === cToothSet.size && altCovered.size > 0) {
+      // 全覆盖 → alt-closed
       c.status = 'closed';
       c.target = false;
-      c.alternativeClosedBy = other.name;
+      c.alternativeClosedBy = altSources.join(' / ');
       c.currentStage = 5;
-      break;
     }
   }
 }
@@ -234,12 +262,29 @@ function inferChainStage(
   // ─ 先算 S3 actual(后面 S2 需要 s3FirstActual 作 actual-only 桶 anchor)
   // **时间方向** — 只算 s1 之后的 actual(跟 scenario SQL `tx.occurred_at >= sig.occurred_at` 同口径)
   // s1Earliest null(actual-only 桶)→ 全 actual 都算(无 sig 锚点)
-  const allActuals = getActualTreatments(category, byType);
+  // ⭐ W4 末:**牙位过滤** — bucket.tooth 非空时只算同牙位 actual
+  //   蒋卓易 Joey K03@12 bug:原版无牙位过滤,把所有 restorative actuals(16/26/46/...)
+  //   都算到 K03@12 桶里 → 误判 s3Reached=true → stage=4 ongoing
+  //   实际上 12 一次治疗没做,SQL 召回是对的,chain 状态也该 stage=1 discovered
+  //   wholeMouth 桶('*whole')+ actual-only 桶('')不过滤(全口治疗按牙位无意义)
+  const allActualsByCategory = getActualTreatments(category, byType);
+  const allActuals = bucket.tooth && bucket.tooth !== '*whole'
+    ? allActualsByCategory.filter((tx) => {
+        const txTooth = String((tx.content as Record<string, unknown>).tooth_position ?? '');
+        return toothOverlap(bucket.tooth, txTooth);
+      })
+    : allActualsByCategory;
   const actuals = s1Earliest?.occurredAt
     ? allActuals.filter((tx) => tx.occurredAt && tx.occurredAt.getTime() >= s1Earliest.occurredAt!.getTime())
     : allActuals;
   const matchedSteps = matchMilestoneSteps(actuals, milestone);
-  const s3Reached = milestone ? matchedSteps.matched.length >= milestone.minSteps : actuals.length > 0;
+  // W4 末:s3Reached 双口径
+  //   ① terminalHit 命中(任一终末术式)→ 即使 minSteps 未满,治疗已收尾
+  //      例 endodontic:pulpotomy 单步 = 完整 VPT,跟完整 RCT(canal_filling)等价
+  //   ② matched.length >= minSteps(老逻辑,阶梯类)
+  const s3Reached = milestone
+    ? matchedSteps.terminalHit !== null || matchedSteps.matched.length >= milestone.minSteps
+    : actuals.length > 0;
   const s3FirstActual = earliest(actuals);
   const s3LastActual = latest(actuals);
 
@@ -266,13 +311,28 @@ function inferChainStage(
   // 6. ⭐ W4 末:lifecycle.requiresCrownProtection → 同牙位有 prosthodontic actual(冠/桩核)
   //    临床:根管后牙变脆 ~30% 折裂率,没戴冠不算真闭环
   //    杨光宗 27 K04 根管完成但没冠 → 应该 ongoing 提示客服回访做冠
+  // W4 末:requiresCrownProtection 局部 override —
+  //   命中 pulpotomy(VPT 终末)= 根髓活,牙不变脆,临床不需要冠保护
+  //   命中 canal_filling(完整 RCT)= 根管去髓,牙变脆,~30% 折裂,需冠保护
+  //   两者都未命中(仅开髓/根备等)= 治疗进行中,crownOk 判定不影响(s3Reached=false)
+  const pulpotomyTerminal = matchedSteps.terminalHit === 'pulpotomy';
   const crownOk = !lifecycle.requiresCrownProtection
+    || pulpotomyTerminal
     || hasCrownProtection(bucket.tooth, byType, s3AnchorTime);
+  // ⭐ W4 末:多牙位桶的"覆盖闸"——
+  //   union-find 把同 (code, category) 的多 sig 合并到一桶,bucket.tooth 是并集
+  //   (例:范萍莉 K08 sig {41,47} + implant actual {47} 合一桶,但 41 实际未处置)
+  //   如果实际 actual 没覆盖到桶里所有牙位,**不能算 closed**
+  //   ⚠️ 召回算法侧暂不动(治疗链内召回属 W5+,先只确保展示层正确)
+  //   wholeMouth(全口 K05 等)桶不参与本闸——全口治疗本来就不按颗牙判
+  const uncoveredTeeth = computeUncoveredTeeth(bucket.tooth, actuals);
+  const fullyCovered = uncoveredTeeth.length === 0;
   const s5Eligible =
     s3Reached &&
     s4Hits.length > 0 &&
     maxAllowedStage === 5 &&
     crownOk &&
+    fullyCovered &&
     !hasPostS3Refund(byType, s3AnchorTime) &&
     !hasPostS3Relapse(category, byType, s3AnchorTime);
 
@@ -309,9 +369,15 @@ function inferChainStage(
   //   显示并集让客服一眼看到"全部受影响牙位",不是只看到首诊那 1-3 颗
   //   例:张超 K08 合并 9 次诊断 → bucket.tooth="11;15;16;17;22;26;27;37" (8 颗) vs 旧版只显示 s1 的 "15;16;17"
   //   wholeMouth(K05/SRP_RECOMMENDED)桶 tooth='*whole' 统一显示"全口"
+  // W4 末:actual-only 桶(无 dx sig,bucket.tooth='')回退到 actuals 牙位并集
+  //   例 季根财 surgical 链:无 K01/K07 dx,actuals 各拔不同牙位(23;24/15;44/37/22)→
+  //   汇总并集"15;22;23;24;37;44" 显示给客服,不再"未标注牙位"
+  const actualToothUnion = actualsToothUnion(actuals);
   const tooth = dxRule?.wholeMouth
     ? '全口'
-    : (bucket.tooth && bucket.tooth !== '*whole' ? bucket.tooth : rawTooth);
+    : (bucket.tooth && bucket.tooth !== '*whole'
+        ? bucket.tooth
+        : (rawTooth || actualToothUnion));
   const chainName = `${chainLabel} · ${tooth || fallback}`;
   const diagnosedAt = s1Earliest?.occurredAt ? fmtYearMonthDay(s1Earliest.occurredAt) : '—';
   const gapDays = s1Earliest?.occurredAt
@@ -348,7 +414,10 @@ function inferChainStage(
     lifecycleNoteZh: lifecycle.noteZh,
     // 给 cross-chain alternative-closed pass 用;wholeMouth 桶 bucket.tooth='*whole'(内部 key),
     // 那种情况回填 s1Earliest 真实牙位串;其他用 bucket.tooth 并集(union-find 后)
-    toothPosition: bucket.tooth && bucket.tooth !== '*whole' ? bucket.tooth : rawTooth,
+    // W4 末:actual-only 桶用 actuals 牙位并集
+    toothPosition: bucket.tooth && bucket.tooth !== '*whole'
+      ? bucket.tooth
+      : (rawTooth || actualToothUnion),
     nodes: buildStageNodes({
       currentStage,
       status,
@@ -366,6 +435,7 @@ function inferChainStage(
       byType,
       doctorMap,
       crownOk,
+      uncoveredTeeth,
     }),
   };
 }
@@ -664,6 +734,50 @@ function normalizeTooth(s: string): string {
   return list.join(';');
 }
 
+/// actuals 牙位并集(去重 + 字典序)— actual-only 桶兜底显示用
+/// 例:季根财 surgical 4 次 actual 拔 {23;24, 15;44, 37, 22} → "15;22;23;24;37;44"
+function actualsToothUnion(actuals: ChainComposeInputFact[]): string {
+  const set = new Set<string>();
+  for (const tx of actuals) {
+    const tp = String((tx.content as Record<string, unknown>).tooth_position ?? '');
+    for (const t of tp.split(';')) {
+      const trimmed = t.trim();
+      if (trimmed) set.add(trimmed);
+    }
+  }
+  return Array.from(set).sort().join(';');
+}
+
+/// 桶 sig 牙位中 actual 没覆盖到的部分(差集)— W4 末加,给"覆盖闸"用
+///
+/// 例:范萍莉 K08·implant 桶 tooth='41;47',6 次 actual 全在 47 → 返回 ['41']
+/// 跳过条件:
+///   - 桶 tooth 空 / wholeMouth → 返回 []
+///   - sig 单颗牙时,只要任一 actual 牙位包含它就算覆盖
+///
+/// **注**:本判定 only for chain 展示层 closed 闸,不影响 scenario SQL 排除粒度。
+function computeUncoveredTeeth(
+  bucketTooth: string,
+  actuals: ChainComposeInputFact[],
+): string[] {
+  if (!bucketTooth || bucketTooth === '*whole') return [];
+  const bucketSet = new Set(bucketTooth.split(';').map((t) => t.trim()).filter(Boolean));
+  if (bucketSet.size === 0) return [];
+  const covered = new Set<string>();
+  for (const tx of actuals) {
+    const tp = String((tx.content as Record<string, unknown>).tooth_position ?? '');
+    for (const t of tp.split(';')) {
+      const trimmed = t.trim();
+      if (trimmed) covered.add(trimmed);
+    }
+  }
+  const uncovered: string[] = [];
+  for (const t of bucketSet) {
+    if (!covered.has(t)) uncovered.push(t);
+  }
+  return uncovered.sort();
+}
+
 /// 牙位是否有交集(用 ; 分隔,trim 后比较)
 function toothOverlap(a: string, b: string): boolean {
   const setA = new Set(
@@ -709,6 +823,10 @@ interface MilestoneMatch {
   allSatisfied: boolean;
   /// 每个 step → 命中的 actual treatment fact(用于 timeline label)
   stepToFact: Map<string, ChainComposeInputFact>;
+  /// W4 末:命中的"终末 step"(milestone.terminalSteps 列表中,任一命中即视为治疗收尾)
+  /// 例 endodontic:canal_filling(完整 RCT)或 pulpotomy(VPT 单步终末)
+  /// inferChainStage 用它判 s3Reached:命中 terminal 即满足,跳过 minSteps
+  terminalHit: PACTreatmentStepKey | null;
 }
 
 /// actual treatments 按 milestone.steps 匹配 — W4 末改进:
@@ -727,6 +845,7 @@ function matchMilestoneSteps(
       matched: actuals.length > 0 ? ['treatment'] : [],
       allSatisfied: actuals.length > 0,
       stepToFact,
+      terminalHit: null,
     };
   }
   const matched: string[] = [];
@@ -752,10 +871,15 @@ function matchMilestoneSteps(
       stepToFact.set(step, hit);
     }
   }
+  // W4 末:terminalHit — milestone.terminalSteps 中任一命中即视为治疗收尾
+  // 例 endodontic.terminalSteps=['canal_filling','pulpotomy'] — 任一命中 s3Reached=true
+  const terminal = milestone.terminalSteps ?? [];
+  const terminalHit = (terminal.find((s) => matched.includes(s)) as PACTreatmentStepKey | undefined) ?? null;
   return {
     matched,
     allSatisfied: matched.length === milestone.steps.length,
     stepToFact,
+    terminalHit,
   };
 }
 
@@ -864,6 +988,7 @@ function buildStageNodes(opts: {
   byType: FactsByType;
   doctorMap: Map<string, string>;
   crownOk: boolean;   // W4 末:lifecycle.requiresCrownProtection 满足与否(inferChainStage 算过)
+  uncoveredTeeth: string[];  // W4 末:多牙位桶里 actual 没覆盖到的牙位(用于 S5 hint)
 }): ChainNode[] {
   const {
     currentStage,
@@ -882,6 +1007,7 @@ function buildStageNodes(opts: {
     byType,
     doctorMap,
     crownOk,
+    uncoveredTeeth,
   } = opts;
   const reached = (s: number) => currentStage >= s;
   const cur = (s: number) => currentStage === s;
@@ -927,7 +1053,11 @@ function buildStageNodes(opts: {
   //   ④ S3 reached 无任何上面信号 → "直接执行 · 未经预约"(急诊场景)
   //   ⑤ status=discovered 无任何信号 → "尚未启动" + hint
   const plannedHint = findPlannedTreatmentHint(category, byType, s1Earliest?.occurredAt ?? null);
-  const s3Reached = matchedSteps.matched.length >= (milestone?.minSteps ?? 1) || actuals.length > 0;
+  // 跟 inferChainStage 同口径:terminalHit 命中即 s3Reached(无字典则 actual 即可)
+  const s3Reached =
+    matchedSteps.terminalHit !== null ||
+    matchedSteps.matched.length >= (milestone?.minSteps ?? 1) ||
+    (!milestone && actuals.length > 0);
   const s2Node: ChainNode = (() => {
     // S2 done:① 有 s2Earliest 强信号 OR ② S3 已到达(治疗都做了一定经过 S2)
     const s2Done = !!s2Earliest || s3Reached;
@@ -1085,11 +1215,26 @@ function buildStageNodes(opts: {
 
     // 未闭环:提示还差什么
     n.title = '未闭环';
-    // W4 末:requiresCrownProtection 但无冠 — 显式提示客服(根管后建议戴冠)
-    if (lifecycle.requiresCrownProtection && s3Reached && !crownOk) {
+    // W4 末:覆盖闸 — bucket 多牙位但 actual 没覆盖到全部 → 优先提示
+    //   例:K08·implant 桶 {41,47},6 次种植全在 47 → 提示"47 已闭环, 41 待处置"
+    //   说明患者已在治疗链内但仍有未处置牙位(可视为治疗链内召回的暗示)
+    if (uncoveredTeeth.length > 0) {
+      const covered = s3LastActual ? '已处置部分牙位' : '';
+      n.hint = covered
+        ? `${uncoveredTeeth.join(',')} 待处置(其余已处置)`
+        : `${uncoveredTeeth.join(',')} 待处置`;
+    } else if (lifecycle.requiresCrownProtection && s3Reached && !crownOk) {
       n.hint = '待冠保护(根管后建议戴冠,防牙冠折裂)';
+    } else if (matchedSteps.terminalHit) {
+      // W4 末:命中了 terminal step(如 pulpotomy / canal_filling)
+      // 治疗已收尾,缺的只是 S4 复查 / 时间观察 — 不算"待 missing step"
+      n.hint = '待复查 / 观察期(治疗已收尾)';
     } else if (milestone && matchedSteps.matched.length < milestone.steps.length) {
-      const missing = milestone.steps.filter((s) => !matchedSteps.matched.includes(s));
+      // 排除 terminalSteps:replacement 路径不算"缺步"(避免提示"待 pulpotomy"等)
+      const terminal = new Set<string>(milestone.terminalSteps ?? []);
+      const missing = milestone.steps.filter(
+        (s) => !matchedSteps.matched.includes(s) && !terminal.has(s),
+      );
       if (missing.length > 0) {
         const stepLabelFn = (step: string): string =>
           PACTreatmentStep[step as PACTreatmentStepKey] ?? step;
@@ -1245,7 +1390,7 @@ const STATUS_PRIORITY: Record<ChainStatus, number> = {
 };
 
 /// 没字典的 category 默认 lifecycle(one_shot 等价)
-const DEFAULT_LIFECYCLE = { maxStage: 5 as const, noteZh: '默认一次性' };
+const DEFAULT_LIFECYCLE = { maxStage: 5 as const, noteZh: '默认一次性', requiresCrownProtection: false };
 
 // ─────────────────────────────────────────────
 // Types(对外接口)

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

@@ -2,6 +2,7 @@ import { Injectable, Logger } from '@nestjs/common';
 import {
   PlanScenario,
   DiagnosisTreatmentMap,
+  APPT_COMPLAINT_TO_CATEGORY,
   lookupDxTreatment,
   diagnosisCodeNameZh,
   treatmentCategoryNameZh,
@@ -212,8 +213,14 @@ export class TreatmentInitiationRecallScenario implements PlanScenarioPlugin {
     const allCodes = [...dxCodes, ...recCodes];
     const excludeCats = rule.categories as readonly string[];
 
-    // (W3 末)SQL 预约排除已放宽 — 不再按 complaint_category 匹配,只看 sig 后有任何预约即排
-    //   理由:召回目的就是建预约,患者已经有未来预约 → 不需要再 push
+    // W4 末:按 excludeCats 算出对应的预约 complaint 文本(host appointment.complaint_category 字段值)
+    //   APPT_COMPLAINT_TO_CATEGORY 反查:filter complaint where category ∈ excludeCats
+    //   例 K07 excludeCats=['orthodontic'] → complaintTexts=['正畸','早矫']
+    //       K08 excludeCats=['implant','prosthodontic'] → ['种植','修复']
+    //   用于 ⑤d:sig 之后有 complaint 匹配的 appointment → 患者已 entered 治疗链,不召回
+    const complaintTexts = Object.entries(APPT_COMPLAINT_TO_CATEGORY)
+      .filter(([, cat]) => excludeCats.includes(cat))
+      .map(([text]) => text);
 
     // ╔═════════════════════════════════════════════════════════════════════╗
     // ║ 召回 SQL 完整解读(initiation = 潜在治疗新链召回)                  ║
@@ -352,17 +359,32 @@ export class TreatmentInitiationRecallScenario implements PlanScenarioPlugin {
                   ''
                 )
         )
-        AND NOT EXISTS (                                   -- ⑤b 排除:患者已有未来预约(W3 末放宽)
+        AND NOT EXISTS (                                   -- ⑤b 排除:患者已有未来预约
           -- 召回目的 = 让客服建预约。患者已经有未来预约 → 客服不需要再 push,医生到诊现场处理即可
-          -- 不按 complaint_category 匹配(陆伟根典型:K07 诊断 + 修复预约 → 不召也对,反正会来诊)
-          -- **只看 status='active'**(scheduled 未到诊)— fulfilled(已到诊)是历史,⑤a actual treatment 排除已覆盖
-          -- 时间锚点:future 预约(planned_for > now)— "已经有要来的事"
+          -- 不按 complaint_category 匹配(陆伟根:K07 诊断 + 修复预约 → 反正会来诊)
+          -- 只看 status='active' + future
           SELECT 1 FROM patient_facts appt
           WHERE appt.patient_id = p.id
             AND appt.type = 'appointment_record'
             AND appt.status = 'active'
             AND COALESCE(appt.planned_for, appt.occurred_at) > ${scope.now}::timestamptz
         )
+        AND NOT EXISTS (                                   -- ⑤d 排除:sig 之后 complaint 匹配的预约(W4 末加)
+          -- 跟 chain-composer.collectS2Facts 同口径:complaint_category 命中 expectedCategories → 患者已 entered
+          -- 例 林菲菲:K07@2026-04-14 诊断 + appointment(complaint=正畸)@2026-04-26 → 已进入正畸链 → 排除
+          -- "现在召回只做新链" 原则:entered/ongoing 患者不属于新链召回,等 W5+ 治疗链内召回 scenario
+          -- active 未到诊 + fulfilled 已到诊都算(只要有 complaint 匹配)
+          SELECT 1 FROM patient_facts appt
+          WHERE appt.patient_id = p.id
+            AND appt.type = 'appointment_record'
+            AND appt.status IN ('active', 'fulfilled')
+            AND COALESCE(appt.planned_for, appt.occurred_at) >= COALESCE(sig.occurred_at, sig.planned_for)
+            AND EXISTS (
+              SELECT 1
+              FROM unnest(string_to_array(COALESCE(appt.content->>'complaint_category', ''), ',')) AS c
+              WHERE trim(c) = ANY(${complaintTexts}::text[])
+            )
+        )
     `;
 
     // 同 patient 多个命中信号 → 取最早(daysSince 最大)作为主 hit

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

 import { Injectable, Logger, NotFoundException, BadRequestException } from '@nestjs/common';
-import { ExecutionOutcome } from '@pac/types';
+import { EXECUTION_OUTCOME_META, ExecutionOutcome } from '@pac/types';
 import { PrismaService } from '../../prisma/prisma.service';
 import type { TenantScopeContext } from '../../common/decorators/tenant-scope.decorator';
 
@@ -30,24 +30,16 @@ const MAX_CONTACT_ATTEMPTS_DEFAULT = 4; // 暂常量,后续接 host/scenario 配
  */
 type StatusTransition = 'completed' | 'abandoned' | 'keep';
 
-const OUTCOME_TO_STATUS: Record<string, StatusTransition> = {
-  // ── 4 起步 ──
-  abandoned: 'abandoned',
-  no_answer: 'keep',
-  scheduled_next: 'keep',
-  success_appointed: 'completed',
-  // ── 产品收集 ──
-  rescheduled: 'keep',
-  considering: 'keep',
-  declined_recent: 'keep',
-  needs_doctor: 'keep',
-  external_treatment: 'completed', // 已在外院 → 关闭召回(spec 说 "应关闭")
-  refused: 'completed',             // 明确拒绝不需治疗 → 关闭召回(不算放弃,是患者决策)
-  pending_info: 'keep',
-  sms_sent: 'keep',
-  proactive_sms: 'keep',
-  marked_invalid: 'completed',      // 无效记录 → 闭环(配 invalidReason 留底)
-};
+/**
+ * outcome → 状态机映射 — **派生自 @pac/types 单一真理源**
+ *
+ * 老版本(W4 早期)在这里 hardcode 一份 OUTCOME_TO_STATUS,前端 mock-data
+ * 也单独维护一份 `drives` 字段,3 处口径漂移已踩过坑。
+ * 现在统一从 EXECUTION_OUTCOME_META.drivesStatus 派生,改一处全生效。
+ */
+const OUTCOME_TO_STATUS: Record<string, StatusTransition> = Object.fromEntries(
+  Object.entries(EXECUTION_OUTCOME_META).map(([k, v]) => [k, v.drivesStatus]),
+);
 
 export interface SubmitExecutionInput {
   channel: string;

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

@@ -13,11 +13,39 @@ import type { ClickHouseSource } from './manifest.schema';
  *
  * 安全:密码从环境变量读取(password_env),plaintext 永不进 yaml。
  */
+/// W4 末:DW 增量配置(per table cursor)
+export interface IncrementalConfig {
+  /// per query 配置:cursor 列名(host 表那边的字段)+ 上次 cursor 值(从 sync_logs 读)
+  perQuery: Record<string, { cursorColumn: string; cursorValue: string | null }>;
+  /// 跑完后返回新的 cursor 值(每张表的 max)
+  cursorAdvances?: Record<string, string>;
+}
+
+/// W4 末:单患者刷新 scope(详情页"刷新"按钮)
+/// 把 manifest queries 的 cohort 子查询替换为 `WHERE patient_id='X' AND brand='Y'`
+/// 不跑 cursor、不写 cursor、不反向拉主档(本身就是单患者全量)
+export interface PatientScope {
+  /// host 侧 patient_id(字符串,DW patient_id 是 String 类型)
+  patientExternalId: string;
+  /// host 侧 brand(中文 "瑞尔" / "瑞泰" — DW 真实字段值)
+  brand: string;
+}
+
 @Injectable()
 export class ClickHouseSourceService {
   private readonly logger = new Logger(ClickHouseSourceService.name);
 
-  async loadAllTables(source: ClickHouseSource): Promise<Record<string, unknown[]>> {
+  /// W4 末:env 覆盖 manifest connection(便于多环境部署 不必改 yaml)
+  /// 优先级:env → manifest → 抛错
+  private resolveConnection(source: ClickHouseSource): {
+    url: string;
+    database: string;
+    username: string;
+    password: string;
+  } {
+    const url = process.env.DW_CLICKHOUSE_URL?.trim() || source.connection.url;
+    const database = process.env.DW_CLICKHOUSE_DATABASE?.trim() || source.connection.database;
+    const username = process.env.DW_CLICKHOUSE_USERNAME?.trim() || source.connection.username;
     const password = process.env[source.connection.password_env];
     if (!password) {
       throw new Error(
@@ -25,12 +53,20 @@ export class ClickHouseSourceService {
           `请检查 .env 或 dotenv 加载`,
       );
     }
+    return { url, database, username, password };
+  }
+
+  async loadAllTables(
+    source: ClickHouseSource,
+    incremental?: IncrementalConfig,
+  ): Promise<Record<string, unknown[]>> {
+    const conn = this.resolveConnection(source);
 
     const client: ClickHouseClient = createClient({
-      url: source.connection.url,
-      database: source.connection.database,
-      username: source.connection.username,
-      password,
+      url: conn.url,
+      database: conn.database,
+      username: conn.username,
+      password: conn.password,
       // Aliyun ADS 公网偶尔抽风,加大重试
       request_timeout: 60_000,
       compression: { response: true, request: false },
@@ -41,7 +77,12 @@ export class ClickHouseSourceService {
 
     try {
       for (const [tableName, sql] of Object.entries(source.queries)) {
-        const sqlWithLimit = this.applyDefaultLimit(sql, defaultLimit);
+        // W4 末:incremental 模式注入 cursor 条件 + cohort LIMIT 移除(增量不需要 dev cohort)
+        const incCfg = incremental?.perQuery[tableName];
+        const sqlWithIncremental = incCfg
+          ? this.injectIncrementalCursor(sql, incCfg.cursorColumn, incCfg.cursorValue)
+          : sql;
+        const sqlWithLimit = this.applyDefaultLimit(sqlWithIncremental, defaultLimit);
         this.logger.log(
           `[clickhouse] query "${tableName}" — ${sqlWithLimit.slice(0, 120).replace(/\s+/g, ' ')}...`,
         );
@@ -56,6 +97,42 @@ export class ClickHouseSourceService {
         this.logger.log(
           `[clickhouse]   "${tableName}" → ${rows.length} 行,${elapsed} ms`,
         );
+        // W4 末:incremental 跑完算新 cursor(= max(cursor_column))
+        if (incremental && incCfg && rows.length > 0) {
+          const maxVal = this.computeMax(rows as Record<string, unknown>[], incCfg.cursorColumn);
+          if (maxVal) {
+            incremental.cursorAdvances = incremental.cursorAdvances ?? {};
+            incremental.cursorAdvances[tableName] = maxVal;
+          }
+        }
+      }
+
+      // ⭐ W4 末 反向拉主档(方案 C):增量模式下,fact 表拉来的 patient_id 不一定在 fact_client_out 里
+      //   (例:患者 EMR 编辑了 last_visit_time 不变,主档 cursor 拉不到他)
+      //   → 收集所有 fact 表中出现的 patient_id,追加一次 fact_client_out WHERE patient_id IN (...)
+      //   合并入已有 fact_client_out tables(set 去重)→ 数据完整性 100%
+      //   stub 兜底(方案 A,parser 侧)+ 主档反向拉(方案 C,sync 侧)= 完整双保险
+      if (incremental && tables['fact_client_out']) {
+        const reverseRows = await this.reversePullPatientMaster(client, tables);
+        if (reverseRows.length > 0) {
+          const before = tables['fact_client_out'].length;
+          // 去重 by patient_id+brand:已有 cursor 拉到的不重复 push
+          const existing = new Set(
+            (tables['fact_client_out'] as Record<string, unknown>[]).map(
+              (r) => `${r.patient_id}|${r.brand}`,
+            ),
+          );
+          for (const r of reverseRows) {
+            const key = `${(r as Record<string, unknown>).patient_id}|${(r as Record<string, unknown>).brand}`;
+            if (!existing.has(key)) {
+              (tables['fact_client_out'] as Record<string, unknown>[]).push(r as Record<string, unknown>);
+              existing.add(key);
+            }
+          }
+          this.logger.log(
+            `[clickhouse]   反向拉主档:+${tables['fact_client_out'].length - before} 行(原 ${before} → 现 ${tables['fact_client_out'].length})`,
+          );
+        }
       }
     } finally {
       await client.close();
@@ -64,13 +141,212 @@ export class ClickHouseSourceService {
     return tables;
   }
 
+  /// W4 末:从已拉的 fact 表里收集 patient_id 集合,反向拉对应主档
+  /// 必要因为 fact_client_out 用 last_visit_time cursor — patient 主档 PII 没变但 fact 变了(EMR 编辑)
+  ///   →  fact 表带的 patient_id 不在 cursor 拉的主档里 → stub 派生,但 PII 缺失
+  /// 反向拉补齐:确保所有 fact 引用的 patient 都有真实主档(姓名/电话/性别等)
+  private async reversePullPatientMaster(
+    client: ClickHouseClient,
+    tables: Record<string, unknown[]>,
+  ): Promise<unknown[]> {
+    // 收集所有 fact 表的 patient_id + brand 集合(去重)
+    const factTables = ['fact_appointment_out', 'fact_emr_treatment_out', 'fact_settlement_out', 'fact_settlement_mode_out'];
+    const pairs = new Set<string>();
+    for (const t of factTables) {
+      for (const row of (tables[t] ?? []) as Record<string, unknown>[]) {
+        const pid = row.patient_id;
+        const brand = row.brand;
+        if (pid !== null && pid !== undefined && brand) {
+          pairs.add(`${pid}|||${brand}`);
+        }
+      }
+    }
+    if (pairs.size === 0) return [];
+    // 构造 IN ((pid1,brand1),(pid2,brand2),...) tuple list
+    // CH 支持 `(patient_id, brand) IN ((1,'瑞尔'),(2,'瑞泰'))` tuple in 语法
+    const tuples = [...pairs]
+      .map((p) => {
+        const [pid, brand] = p.split('|||');
+        return `('${(pid ?? '').replace(/'/g, "''")}', '${(brand ?? '').replace(/'/g, "''")}')`;
+      })
+      .join(',');
+    const sql = `SELECT * FROM dw_group.fact_client_out WHERE (patient_id, brand) IN (${tuples})`;
+    this.logger.log(`[clickhouse] 反向拉主档 query — ${pairs.size} pairs`);
+    const started = Date.now();
+    const result = await client.query({ query: sql, format: 'JSONEachRow' });
+    const rows = (await result.json()) as unknown[];
+    this.logger.log(`[clickhouse]   反向 fact_client_out → ${rows.length} 行,${Date.now() - started} ms`);
+    return rows;
+  }
+
+  /// W4 末:单患者刷新 — 把 manifest queries 全部改写为 `WHERE patient_id='X' AND brand='Y'` 范围拉
+  ///
+  /// 跟 loadAllTables 的差别:
+  ///   - 不读 / 不写 sync_logs cursor(daily incremental cron 完全不受影响)
+  ///   - 不跑反向拉主档(本身已 scope 到该 patient,主档 fact_client_out 同样 WHERE 拉到)
+  ///   - 不应用 default_limit(单患者数据量极小,几十~几百行)
+  ///
+  /// SQL 改写策略(等价 injectIncrementalCursor 套路):
+  ///   1. parse SELECT cols + FROM table
+  ///   2. extract 业务过滤(去掉 cohort 子查询、cursor、ORDER BY、LIMIT)
+  ///   3. rebuild: `SELECT cols FROM table WHERE patient_id='X' AND brand='Y' [AND <business>]`
+  ///   4. fact_client_out 没 patient_id?它**自己就是 patient 主档表**,patient_id 字段就是主键 →
+  ///      WHERE 同样过滤即可
+  async loadTablesForPatient(
+    source: ClickHouseSource,
+    scope: PatientScope,
+  ): Promise<Record<string, unknown[]>> {
+    const conn = this.resolveConnection(source);
+    const client: ClickHouseClient = createClient({
+      url: conn.url,
+      database: conn.database,
+      username: conn.username,
+      password: conn.password,
+      request_timeout: 60_000,
+      compression: { response: true, request: false },
+    });
+
+    const tables: Record<string, unknown[]> = {};
+    const pidEsc = scope.patientExternalId.replace(/'/g, "''");
+    const brandEsc = scope.brand.replace(/'/g, "''");
+
+    try {
+      for (const [tableName, sql] of Object.entries(source.queries)) {
+        const patientSql = this.injectPatientFilter(sql, pidEsc, brandEsc);
+        this.logger.log(
+          `[clickhouse·patient] query "${tableName}" — ${patientSql.slice(0, 140).replace(/\s+/g, ' ')}...`,
+        );
+        const started = Date.now();
+        const result = await client.query({
+          query: patientSql,
+          format: 'JSONEachRow',
+        });
+        const rows = (await result.json()) as unknown[];
+        tables[tableName] = rows;
+        this.logger.log(
+          `[clickhouse·patient]   "${tableName}" → ${rows.length} 行,${Date.now() - started} ms`,
+        );
+      }
+    } finally {
+      await client.close();
+    }
+    return tables;
+  }
+
+  /// 把原 SQL 的 cohort/cursor/ORDER/LIMIT 全部剥离,改写为 patient_id+brand 精确过滤
+  private injectPatientFilter(
+    originalSql: string,
+    patientIdEsc: string,
+    brandEsc: string,
+  ): string {
+    const m = originalSql.match(/^\s*SELECT\s+([\s\S]+?)\s+FROM\s+([\w.]+)/i);
+    if (!m) {
+      throw new Error(
+        `[patient-refresh] cannot parse SQL: ${originalSql.slice(0, 80)}...`,
+      );
+    }
+    const selectCols = m[1]!.trim();
+    const fromTable = m[2]!;
+    const clauses: string[] = [
+      `patient_id = '${patientIdEsc}'`,
+      `brand = '${brandEsc}'`,
+    ];
+    // 业务过滤(如 settlement_status=1 / is_refund=0 / appo_status IN ... )保留
+    clauses.push(...this.extractBusinessFilters(originalSql));
+    return `SELECT ${selectCols} FROM ${fromTable} WHERE ${clauses.join(' AND ')}`;
+  }
+
+  /// W4 末:重写 SQL,把 cursor 条件注入到原 SQL 的 cohort 子查询和外层 WHERE
+  /// 策略:增量模式去掉 dev cohort LIMIT,只按 cursor 过滤
+  ///   - 找最外层 FROM <table>,在它之后 inject WHERE cursor_column > 'cursor_value'
+  ///   - 同时去掉 cohort 子查询(WHERE (patient_id, brand) IN (...))跟 ORDER BY/LIMIT
+  /// 简化版:直接重写为 `SELECT <orig_columns> FROM dw_group.<table> WHERE cursor_column > '...'`
+  /// 假设:cold-import 的 query 已 SELECT 出 cursor_column(本任务 manifest 已加)
+  private injectIncrementalCursor(
+    originalSql: string,
+    cursorColumn: string,
+    cursorValue: string | null,
+  ): string {
+    // 提取 SELECT 子句 (FROM 之前) 跟 FROM <table>
+    const m = originalSql.match(/^\s*SELECT\s+([\s\S]+?)\s+FROM\s+([\w.]+)/i);
+    if (!m) {
+      throw new Error(
+        `[incremental] cannot parse SQL for cursor injection: ${originalSql.slice(0, 80)}...`,
+      );
+    }
+    const selectCols = m[1]!.trim();
+    const fromTable = m[2]!;
+    // 收集所有 WHERE 子句(cursor + 业务过滤),最后统一 'WHERE ... AND ...' 拼装
+    const clauses: string[] = [];
+    if (cursorValue) {
+      clauses.push(`${cursorColumn} > '${cursorValue.replace(/'/g, "''")}'`);
+    }
+    // 业务过滤(如 settlement_status=1)— 去掉 cohort 子查询(patient_id,brand IN ...)
+    clauses.push(...this.extractBusinessFilters(originalSql));
+    const whereSql = clauses.length > 0 ? ` WHERE ${clauses.join(' AND ')}` : '';
+    return `SELECT ${selectCols} FROM ${fromTable}${whereSql} ORDER BY ${cursorColumn}`;
+  }
+
+  /// 从原 SQL 抽出 WHERE 子句里**非 cohort** 的业务过滤条件
+  /// 返回 clause 数组(每个 clause 不带 WHERE/AND 前缀,纯条件)
+  private extractBusinessFilters(sql: string): string[] {
+    // 抓 WHERE ... 到 ORDER BY/LIMIT/end 之间
+    const m = sql.match(/\bWHERE\s+([\s\S]+?)(?:\bORDER\s+BY\b|\bLIMIT\b|$)/i);
+    if (!m) return [];
+    const whereBody = m[1]!.trim();
+    // 拆 AND,去掉:① cohort 子查询 ② 老的 last_visit_time IS NOT NULL(增量不需要)
+    return this.splitAndClauses(whereBody)
+      .map((c) => c.trim())
+      .filter(
+        (c) =>
+          c &&
+          !/\(patient_id\s*,\s*brand\)\s+IN/i.test(c) &&
+          !/^last_visit_time\s+IS\s+NOT\s+NULL$/i.test(c),
+      );
+  }
+
+  private splitAndClauses(whereBody: string): string[] {
+    // 按 ` AND `(大小写)拆分,但跳过括号内的 AND
+    const out: string[] = [];
+    let depth = 0;
+    let buf = '';
+    const tokens = whereBody.split(/(\bAND\b)/i);
+    for (const tok of tokens) {
+      for (const ch of tok) {
+        if (ch === '(') depth++;
+        else if (ch === ')') depth--;
+      }
+      if (/^\s*AND\s*$/i.test(tok) && depth === 0) {
+        out.push(buf);
+        buf = '';
+      } else {
+        buf += tok;
+      }
+    }
+    if (buf.trim()) out.push(buf);
+    return out;
+  }
+
+  /// 算行集合中 cursor_column 的字符串 max(host updated_date 是 String 类型)
+  private computeMax(rows: Record<string, unknown>[], column: string): string | null {
+    let max: string | null = null;
+    for (const r of rows) {
+      const v = r[column];
+      if (v === null || v === undefined) continue;
+      const s = String(v);
+      if (!max || s > max) max = s;
+    }
+    return max;
+  }
+
   /**
    * 给没显式带 LIMIT 的 SQL 自动追加 LIMIT,防内存炸。
    * 简单字符串嗅探,匹配 LIMIT N(忽略大小写,允许末尾分号)。
    */
   private applyDefaultLimit(sql: string, defaultLimit: number): string {
     const trimmed = sql.trim().replace(/;\s*$/, '');
-    if (/\bLIMIT\s+\d+(\s*,\s*\d+)?\s*$/i.test(trimmed)) return trimmed;
+    // 已有 LIMIT N / LIMIT N, M / LIMIT N OFFSET M 在末尾 → 不再追加
+    if (/\bLIMIT\s+\d+(\s*,\s*\d+|\s+OFFSET\s+\d+)?\s*$/i.test(trimmed)) return trimmed;
     return `${trimmed} LIMIT ${defaultLimit}`;
   }
 }

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

@@ -20,7 +20,11 @@ import {
   ColdImportManifestSchema,
   inferFileFormat,
 } from './manifest.schema';
-import { ClickHouseSourceService } from './clickhouse-source.service';
+import {
+  ClickHouseSourceService,
+  type IncrementalConfig,
+  type PatientScope,
+} from './clickhouse-source.service';
 import { TransformEngine } from '../transforms/transform-engine';
 import { buildTenantResolver, type TenantResolver } from './tenant-resolver';
 
@@ -54,7 +58,7 @@ export class ColdImportService {
 
   async importDirectory(
     dir: string,
-    options: { dryRun?: boolean } = {},
+    options: { dryRun?: boolean; incremental?: boolean } = {},
   ): Promise<ImportRunResult> {
     const absDir = path.resolve(dir);
     const runId = randomUUID();
@@ -86,7 +90,29 @@ export class ColdImportService {
     );
 
     // 3. 一次性加载所有 raw tables(文件 / ClickHouse 二选一)
-    let tables = await this.loadAllTables(absDir, manifest);
+    // W4 末:incremental 模式构建 cursor map(从最近一次成功 sync_log 的 cursor_after JSON 读)
+    let incrementalConfig: IncrementalConfig | undefined;
+    if (options.incremental) {
+      const perQueryCfg = manifest.sql_source?.incremental?.per_query;
+      if (!perQueryCfg) {
+        throw new Error(
+          `--incremental 模式但 manifest.sql_source.incremental.per_query 未配置;请在 manifest.yaml 补 cursor 配置`,
+        );
+      }
+      const lastCursor = await this.readLastIncrementalCursor(host.id);
+      this.logger.log(
+        `Incremental cursor 读:${Object.keys(lastCursor).length === 0 ? '(首跑,全量)' : JSON.stringify(lastCursor)}`,
+      );
+      incrementalConfig = {
+        perQuery: Object.fromEntries(
+          Object.entries(perQueryCfg).map(([table, cfg]) => [
+            table,
+            { cursorColumn: cfg.cursor_column, cursorValue: lastCursor[table] ?? null },
+          ]),
+        ),
+      };
+    }
+    let tables = await this.loadAllTables(absDir, manifest, incrementalConfig);
 
     // 3.5 Layer A.5 transforms — yaml 声明式形态改造(JSON 拆行 / 派生 / 路由等)
     if (manifest.transforms && manifest.transforms.length > 0) {
@@ -113,6 +139,15 @@ export class ColdImportService {
     // 5. SyncLog start
     // SyncLog 自身的 tenantId 列只能填一个;多 tenant 跑用 '_multi' sentinel
     const syncLogTenant = knownTenants.length === 1 ? knownTenants[0]! : '_multi';
+    // W4 末:incremental 模式 → resource='incremental_bundle' + cursor_before 写入老 cursor
+    const syncResource = options.incremental ? 'incremental_bundle' : 'cold_import_bundle';
+    const cursorBeforeJson = options.incremental && incrementalConfig
+      ? JSON.stringify(
+          Object.fromEntries(
+            Object.entries(incrementalConfig.perQuery).map(([k, v]) => [k, v.cursorValue ?? '']),
+          ),
+        )
+      : null;
     const syncLog = options.dryRun
       ? null
       : await this.prisma.syncLog.create({
@@ -120,9 +155,10 @@ export class ColdImportService {
             hostId: host.id,
             tenantId: syncLogTenant,
             direction: SyncDirection.PULL, // 冷启复用 pull 语义(同套 pipeline)
-            resource: 'cold_import_bundle',
-            triggeredBy: `cold_import:${path.basename(absDir)}:${runId}`,
+            resource: syncResource,
+            triggeredBy: `${options.incremental ? 'incremental' : 'cold_import'}:${path.basename(absDir)}:${runId}`,
             status: SyncStatus.RUNNING,
+            cursorBefore: cursorBeforeJson,
           },
         });
 
@@ -197,6 +233,21 @@ export class ColdImportService {
           ? SyncStatus.PARTIAL
           : SyncStatus.FAILED;
 
+    // W4 末:incremental cursor_after — 合并老 cursor + 本批新增 max
+    //   本批某表 0 行(无新数据)→ 保留老 cursor 不变(下次同样 WHERE > old_cursor)
+    //   本批某表有行 → cursor 推进到本批 max(updated_date)
+    let cursorAfterJson: string | null = null;
+    if (options.incremental && incrementalConfig) {
+      const oldCursors: Record<string, string> = JSON.parse(cursorBeforeJson ?? '{}');
+      const advances = incrementalConfig.cursorAdvances ?? {};
+      const merged = { ...oldCursors };
+      for (const [tbl, newVal] of Object.entries(advances)) {
+        const old = merged[tbl];
+        if (!old || newVal > old) merged[tbl] = newVal;
+      }
+      cursorAfterJson = JSON.stringify(merged);
+      this.logger.log(`Incremental cursor 写:${cursorAfterJson}`);
+    }
     if (syncLog) {
       await this.prisma.syncLog.update({
         where: { id: syncLog.id },
@@ -209,6 +260,7 @@ export class ColdImportService {
           failed: totals.failed,
           errorMessage: firstError,
           endedAt: new Date(),
+          cursorAfter: cursorAfterJson,
         },
       });
     }
@@ -234,6 +286,164 @@ export class ColdImportService {
   }
 
   // ─────────────────────────────────────────────────────────
+  // W4 末:单患者按需刷新(详情页"刷新"按钮 / SyncService.runPullForPatient)
+  //
+  // 关键纪律(cursor 隔离):
+  //   - resource='patient_refresh',跟 incremental_bundle / cold_import_bundle **分开 sync_logs**
+  //   - 不读 sync_logs cursor(不被增量 cron 影响),**不写** cursor_after(不污染增量 cron)
+  //   - daily cron 完全不受单患者刷新影响 ✓
+  //
+  // 等价 importDirectory({incremental:false}) 但 SQL 注入 patient_id+brand 精确范围:
+  //   - chSource.loadTablesForPatient(scope) 改写 manifest queries 拉单患者全表
+  //   - 同 transforms / assemblers / parser 链路(下游无感知)
+  //   - source_event_id partial UNIQUE 自动幂等(多次刷新不重复)
+  // ─────────────────────────────────────────────────────────
+  async importPatient(
+    dir: string,
+    scope: PatientScope & { triggeredBy?: string },
+  ): Promise<ImportRunResult> {
+    const absDir = path.resolve(dir);
+    const runId = randomUUID();
+    this.logger.log(
+      `Patient refresh starting: ${absDir} patient=${scope.patientExternalId} brand=${scope.brand} runId=${runId}`,
+    );
+
+    // 1. Manifest
+    const manifest = this.readManifest(absDir);
+    if (!manifest.sql_source) {
+      throw new Error(
+        `Patient refresh 需要 sql_source(ClickHouse 直连);manifest 当前是 tables[] 文件源,不支持`,
+      );
+    }
+
+    // 2. Host
+    const host = await this.prisma.host.findUnique({
+      where: { name: manifest.host_name },
+    });
+    if (!host) {
+      throw new Error(`Host not found by name=${manifest.host_name}`);
+    }
+
+    const tenantResolver = buildTenantResolver(manifest);
+    const seenTenants = new Set<string>();
+
+    // 3. 单患者 SQL — 改写所有 queries 加 WHERE patient_id+brand
+    let tables = await this.chSource.loadTablesForPatient(manifest.sql_source, {
+      patientExternalId: scope.patientExternalId,
+      brand: scope.brand,
+    });
+
+    // 3.5 Layer A.5 transforms — 同 importDirectory(单患者数据量小,几十~几百行,毫秒级)
+    if (manifest.transforms && manifest.transforms.length > 0) {
+      const transformInputs = tables as Record<string, Record<string, unknown>[]>;
+      tables = this.transformEngine.run({
+        tables: transformInputs,
+        transforms: manifest.transforms,
+      });
+    }
+
+    // 4. Assemblers
+    const assemblerConfigs = this.loadAllAssemblers(absDir, manifest);
+    const patientCfg = assemblerConfigs.find((c) => c.canonical === 'patient');
+    const subjectCfgs = assemblerConfigs.filter((c) => c.canonical !== 'patient');
+
+    // 5. SyncLog — resource='patient_refresh' ⭐ 跟增量隔离 ⭐
+    //    tenantId 用 resolver 已知的(单 brand → 唯一 tenant);若动态 pass-through 用 sentinel
+    const knownTenants = tenantResolver.knownTenants();
+    const syncLogTenant = knownTenants.length === 1 ? knownTenants[0]! : '_multi';
+    const syncLog = await this.prisma.syncLog.create({
+      data: {
+        hostId: host.id,
+        tenantId: syncLogTenant,
+        direction: SyncDirection.PULL,
+        resource: 'patient_refresh', // ⭐ 跟 incremental_bundle / cold_import_bundle 区分
+        triggeredBy: scope.triggeredBy ?? `patient_refresh:${scope.patientExternalId}:${runId}`,
+        status: SyncStatus.RUNNING,
+        // cursorBefore / cursorAfter 都不写(本身不参与增量)
+      },
+    });
+
+    // 6. 跑 patient 主档 + subjects(同 importDirectory 路径)
+    const perResource: PerResourceStats[] = [];
+    const totals = this.zeroTotals();
+    let firstError: string | null = null;
+    const normalize = { amountUnit: manifest.amount_unit, timezone: manifest.timezone };
+
+    if (patientCfg) {
+      const stats = await this.processPatients(
+        tables, patientCfg, host.id, tenantResolver, seenTenants, normalize, false,
+      );
+      perResource.push(stats);
+      totals.patientsUpserted += stats.patientsUpserted;
+      totals.failed += stats.failed;
+      if (!firstError && stats.failed > 0) firstError ||= `patient: ${stats.failed} rows failed`;
+    }
+
+    for (const cfg of subjectCfgs) {
+      try {
+        const stats = await this.processSubject(
+          tables, cfg, host.id, tenantResolver, seenTenants, normalize, syncLog.id, false,
+        );
+        perResource.push(stats);
+        totals.transactionsWritten += stats.transactionsWritten;
+        totals.duplicates += stats.duplicates;
+        totals.failed += stats.failed;
+        totals.factsCreated += stats.factsCreated;
+        totals.factsSuperseded += stats.factsSuperseded;
+        totals.factsUnchanged += stats.factsUnchanged;
+        totals.factsEvidenceAppended += stats.factsEvidenceAppended;
+        totals.factsFailed += stats.factsFailed;
+      } catch (err) {
+        const msg = err instanceof Error ? err.message : String(err);
+        firstError ||= `${cfg.canonical}: ${msg}`;
+        this.logger.error(`Patient refresh resource ${cfg.canonical} failed: ${msg}`);
+      }
+    }
+
+    // 7. SyncLog finalize
+    const fetched =
+      totals.patientsUpserted + totals.transactionsWritten + totals.duplicates + totals.failed;
+    const status =
+      totals.failed === 0
+        ? SyncStatus.SUCCESS
+        : totals.patientsUpserted + totals.transactionsWritten > 0
+          ? SyncStatus.PARTIAL
+          : SyncStatus.FAILED;
+
+    await this.prisma.syncLog.update({
+      where: { id: syncLog.id },
+      data: {
+        status,
+        fetched,
+        transactionsWritten: totals.transactionsWritten,
+        factsEmitted: totals.factsCreated + totals.factsSuperseded,
+        duplicates: totals.duplicates,
+        failed: totals.failed,
+        errorMessage: firstError,
+        endedAt: new Date(),
+      },
+    });
+
+    this.logger.log(
+      `Patient refresh done: patient=${scope.patientExternalId} status=${status} ` +
+        `patients=${totals.patientsUpserted} txns=${totals.transactionsWritten} ` +
+        `dups=${totals.duplicates} facts(created=${totals.factsCreated} superseded=${totals.factsSuperseded})`,
+    );
+
+    return {
+      runId,
+      hostId: host.id,
+      hostName: host.name,
+      tenantIds: [...seenTenants].sort(),
+      dryRun: false,
+      syncLogId: syncLog.id,
+      status,
+      totals,
+      perResource,
+    };
+  }
+
+  // ─────────────────────────────────────────────────────────
   // Patients 主档(用同一份 yaml 形态,但走 upsert 路径)
   // ─────────────────────────────────────────────────────────
 
@@ -379,6 +589,14 @@ export class ColdImportService {
         patientIndex = await this.buildPatientIndex(hostId, tenantId);
         patientIndexByTenant.set(tenantId, patientIndex);
       }
+      // ⭐ W4 末 stub auto-create:本批 fact 引用的 patient 主档没拉到 → 即时建空 stub
+      //   后续 fact_client_out(同 run 反向拉 OR 下次 sync 主档更新)会 upsert 补 PII
+      //   保证 fact 立即派生不丢,不依赖等主档(详见 docs/dw-data-source-issues.md "patient stub")
+      const patientExternalId = canonicalRow.patientExternalId as string | undefined;
+      if (patientExternalId && !patientIndex.has(patientExternalId)) {
+        const stubId = await this.ensurePatientStub(hostId, tenantId, patientExternalId);
+        patientIndex.set(patientExternalId, stubId);
+      }
       const txn = this.synthesizer.synthesize({
         rawRow: rawSource,
         canonicalRow,
@@ -475,6 +693,28 @@ export class ColdImportService {
     return new Map(rows.map((p) => [p.externalId, p.id]));
   }
 
+  /// W4 末:本批 fact 引用的 patient 主档没拉到 → 即时建空 stub
+  /// 只填三段隔离键(hostId/tenantId/externalId)+ active=true,姓名/电话留空待后续 upsert
+  /// patientProfile 也建空行(scenario SQL JOIN 必须的 doNotContact=false / deceased=false)
+  /// 调一次约 5-10 ms(单行 upsert + 1:1 profile upsert),N 次循环可接受;后续可批量优化
+  private async ensurePatientStub(
+    hostId: string,
+    tenantId: string,
+    externalId: string,
+  ): Promise<string> {
+    const patient = await this.prisma.patient.upsert({
+      where: { hostId_tenantId_externalId: { hostId, tenantId, externalId } },
+      create: { hostId, tenantId, externalId, active: true },
+      update: {}, // 有则 noop(姓名等真实主档 upsert 走 processPatients 路径)
+    });
+    await this.prisma.patientProfile.upsert({
+      where: { patientId: patient.id },
+      create: { patientId: patient.id, doNotContact: false, deceased: false, tags: [] },
+      update: {},
+    });
+    return patient.id;
+  }
+
   // ─────────────────────────────────────────────────────────
   // Manifest + assembler + raw tables 读盘
   // ─────────────────────────────────────────────────────────
@@ -492,18 +732,42 @@ export class ColdImportService {
     return result.data;
   }
 
+  /// W4 末:读最近一次成功的 incremental sync_log 的 cursor_after JSON
+  /// 返回 { tableName: cursorValue } map(无记录返回空对象 → 首跑等价全量)
+  private async readLastIncrementalCursor(hostId: string): Promise<Record<string, string>> {
+    const last = await this.prisma.syncLog.findFirst({
+      where: {
+        hostId,
+        resource: 'incremental_bundle',
+        status: SyncStatus.SUCCESS,
+        cursorAfter: { not: null },
+      },
+      orderBy: { startedAt: 'desc' },
+    });
+    if (!last?.cursorAfter) return {};
+    try {
+      const parsed = JSON.parse(last.cursorAfter) as Record<string, string>;
+      return parsed;
+    } catch (e) {
+      this.logger.warn(`Cursor JSON parse failed: ${(e as Error).message};当全量处理`);
+      return {};
+    }
+  }
+
   private async loadAllTables(
     dir: string,
     manifest: ColdImportManifest,
+    incremental?: IncrementalConfig,
   ): Promise<Record<string, unknown[]>> {
     // ── ClickHouse 直连模式 ──
     if (manifest.sql_source) {
       this.logger.log(
         `数据源:ClickHouse SQL 直连 — ${manifest.sql_source.connection.url} ` +
           `database=${manifest.sql_source.connection.database} ` +
-          `queries=${Object.keys(manifest.sql_source.queries).length}`,
+          `queries=${Object.keys(manifest.sql_source.queries).length}` +
+          (incremental ? ' [incremental mode]' : ''),
       );
-      return this.chSource.loadAllTables(manifest.sql_source);
+      return this.chSource.loadAllTables(manifest.sql_source, incremental);
     }
 
     // ── 文件源模式 ──

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

@@ -63,6 +63,22 @@ export const ClickHouseSourceSchema = z.object({
   queries: z.record(z.string(), z.string().min(1)),
   /// 每个 query 上限(防内存炸);默认 100k 行
   default_limit: z.number().int().positive().default(100000).optional(),
+  /// W4 末:DW 增量配置(per table cursor column)
+  /// 跑增量模式时 PAC 会读 sync_logs 上次 cursor_after,注入 WHERE cursor_column > '...'
+  /// 跑完写新 cursor = max(cursor_column) 到 sync_logs
+  /// 首次跑(无 cursor)= 全量,后续 = 增量
+  incremental: z
+    .object({
+      /// per query 配置;表名(query key)→ cursor_column
+      /// 例:fact_emr_treatment_out: updated_date / fact_client_out: last_visit_time
+      per_query: z.record(
+        z.string(),
+        z.object({
+          cursor_column: z.string().min(1),
+        }),
+      ),
+    })
+    .optional(),
 });
 export type ClickHouseSource = z.infer<typeof ClickHouseSourceSchema>;
 

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

@@ -7,6 +7,7 @@ import {
   PACDiagnosisCodeSchema,
 } from '@pac/types';
 import type { Parser, ParserContext, FactDraft } from './parser.interface';
+import { normalizeToothPosition } from './tooth-position.util';
 
 /**
  * DiagnosisParser — `diagnosis_recorded` 解析器(v2.1 新)
@@ -51,7 +52,7 @@ export class DiagnosisParser implements Parser {
         : 'name_map'
       : null;
 
-    const toothPosition = (c.toothPosition as string | undefined) ?? null;
+    const toothPosition = normalizeToothPosition(c.toothPosition as string | undefined);
     const sourceEncounter = (c.sourceEncounterExternalId as string | undefined) ?? null;
     // host 录入习惯尾部带标点("慢性牙龈炎;" / "牙周炎。" / "牙龈炎,"  / "龋齿？" / "缺失？"...)
     // 在 parser 层一次性清洗:首尾空白 + 尾部中英文标点 → 下游 chain-composer / WhyCard / persona 全部受益

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

 import { Injectable, Logger } from '@nestjs/common';
 import { Action, FactKind, FactStatus, FactType } from '@pac/types';
 import type { FactDraft, Parser, ParserContext } from './parser.interface';
+import { normalizeToothPosition } from './tooth-position.util';
 
 /**
  * ImageParser — `image_uploaded` 解析器
@@ -26,7 +27,7 @@ export class ImageParser implements Parser {
     const uploadedAt = c.uploadedAt ? new Date(c.uploadedAt as string) : null;
     const modality = (c.modality as string | undefined) ?? null;
     const finding = (c.finding as string | undefined) ?? null;
-    const toothPositions = (c.toothPositions as string | undefined) ?? null;
+    const toothPositions = normalizeToothPosition(c.toothPositions as string | undefined);
     const encounterExternalId = (c.encounterExternalId as string | undefined) ?? null;
 
     return [

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

@@ -7,6 +7,7 @@ import {
   PACDiagnosisCodeSchema,
 } from '@pac/types';
 import type { Parser, ParserContext, FactDraft } from './parser.interface';
+import { normalizeToothPosition } from './tooth-position.util';
 
 /**
  * RecommendationParser — `recommendation_extracted` 解析器(v2.1 新)
@@ -66,7 +67,7 @@ export class RecommendationParser implements Parser {
         summary: null,
         content: {
           code: codeParsed.data,
-          tooth_position: (c.toothPosition as string | undefined) ?? null,
+          tooth_position: normalizeToothPosition(c.toothPosition as string | undefined),
           doctor_id: c.doctorId ? String(c.doctorId) : null,
           doctor_name: (c.doctorName as string | undefined) ?? null,
           extracted_by: extractedBy,

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

+/**
+ * 牙位字符串规范化(W4 末)
+ *
+ * Host(瑞泰/瑞尔 DW)的 toothPosition 字段经常带牙面后缀:
+ *   FDI 恒牙形态(数字 2 位):
+ *     "17 D"       → 17 号牙远中面(distal)
+ *     "37 O"       → 37 号牙咬合面(occlusal)
+ *     "46 B;36 B"  → 多牙位带颊侧面(buccal)
+ *     "11 M;21 M"  → 多牙位带近中面(mesial)
+ *   Palmer 乳牙形态(象限数字 + 字母 A-E,儿童 host 大量使用):
+ *     "1D OD"      → 上颌右乳第一磨牙 远中-咬合面
+ *     "1D M"       → 上颌右乳第一磨牙 近中面
+ *     "2E MO"      → 上颌左乳第二磨牙 近中-咬合面
+ *
+ * 牙面修饰:
+ *   D = Distal(远中)  M = Mesial(近中)
+ *   O = Occlusal(咬合) B = Buccal(颊侧)
+ *   L = Lingual(舌侧) P = Palatal(腭侧)
+ *   I = Incisal(切端)
+ *
+ * 问题:同一颗牙(17 / 1D 等)在不同接诊带不同牙面后缀 → chain-composer 拆链
+ *
+ * 处置(本工具职责):**只剥牙面后缀,保留牙位编号(FDI 或 Palmer)本身**。
+ *   FDI:
+ *     "17 D"       → "17"
+ *     "46 B;36 B"  → "46;36"
+ *     "11 M;21 M"  → "11;21"
+ *     "32"         → "32"        (无变化)
+ *   Palmer 乳牙(W4 末加):
+ *     "1D OD"      → "1D"        (剥 OD 面后缀,保留 1D 牙位)
+ *     "1D M"       → "1D"
+ *     "2E MO"      → "2E"
+ *     "1A;1B;1C"   → "1A;1B;1C"  (无空格 = 无面后缀,不动)
+ *
+ * 边界:
+ *   - 只匹配 "牙位 + **空格** + 牙面字母" 形态(空格是关键分隔)
+ *   - 不带空格的 Palmer 单字母(1A/1B/1C/1D/1E)= 完整牙位,保留
+ *   - 输入 null/empty 原样返回
+ */
+
+// 牙位 base = FDI 1-2 位数字(11/22/47 等) 或 Palmer 数字+字母(1A/1D/3E 等)
+// 后跟空格 + 一组牙面字母(DMOBLPI 大小写) → 把面字母剥掉,保留 base
+const SURFACE_SUFFIX_RE = /(\d+[A-Ea-e]?)\s+[DMOBLPIdmoblpi]+/g;
+
+export function normalizeToothPosition(input: string | null | undefined): string | null {
+  if (input === null || input === undefined) return null;
+  const trimmed = String(input).trim();
+  if (!trimmed) return null;
+  // 替换:把 "牙位 base + 空格 + 牙面字母+" 中的面字母部分去掉,保留 base
+  const out = trimmed.replace(SURFACE_SUFFIX_RE, '$1');
+  return out || null;
+}
+
+/**
+ * 牙位串拆分 + 规整化后返回单牙位 set
+ * 用于 chain target match / scenario tooth-level 排除等场景
+ *
+ * 例:
+ *   "1D OD;3E O;4E O" → Set { "1D", "3E", "4E" }
+ *   "11 M;21 M"       → Set { "11", "21" }
+ *   "1A;1B;1C"        → Set { "1A", "1B", "1C" }
+ */
+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));
+}

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

 import { Injectable, Logger } from '@nestjs/common';
 import { Action, FactKind, FactStatus, FactType } from '@pac/types';
 import type { Parser, ParserContext, FactDraft } from './parser.interface';
+import { normalizeToothPosition } from './tooth-position.util';
 
 /**
  * TreatmentParser — 治疗类 action 共用解析器(v2.1 新)
@@ -51,7 +52,7 @@ export class TreatmentParser implements Parser {
       String(c.status ?? '').toLowerCase(),
     );
 
-    const toothPosition = (c.toothPosition as string | undefined) ?? null;
+    const toothPosition = normalizeToothPosition(c.toothPosition as string | undefined);
     const subtype = (c.subtype as string | undefined) ?? null;
     // W4 末:treat_stages — host stage 词已在 assembler enum_mapping 翻译到 PAC 标准 enum
     // applyEnum array 支持已加;这里只需做 array filter(去除空字符串/非字符串元素)

apps/pac-service/src/modules/sync/sync.controller.ts

@@ -60,6 +60,13 @@ export class SyncController {
     @TenantScope() scope: TenantScopeContext,
     @Param('patientId') patientId: string,
   ) {
-    return this.sync.runPullForPatient(scope, patientId);
+    const r = await this.sync.runPullForPatient(scope, patientId);
+    return {
+      syncLogId: r.syncLogId,
+      status: r.status,
+      transactionsWritten: r.transactionsWritten,
+      factsEmitted: r.factsEmitted,
+      plansCreated: r.plansCreated,
+    };
   }
 }

apps/pac-service/src/modules/sync/sync.module.ts

 import { Module } from '@nestjs/common';
 import { FactsModule } from '../facts/facts.module';
+import { PersonaModule } from '../persona/persona.module';
+import { PlanModule } from '../plan/plan.module';
 import { SyncController } from './sync.controller';
 import { SyncService } from './sync.service';
 import { PullStrategyRegistry } from './adapters/adapter.registry';
@@ -31,7 +33,14 @@ import { HmacVerifier } from './push/hmac-verifier.service';
  *     - PipelineModule(synthesizer + parser pipeline)
  */
 @Module({
-  imports: [FactsModule, AssemblerModule, TransformsModule, PipelineModule],
+  imports: [
+    FactsModule,
+    AssemblerModule,
+    TransformsModule,
+    PipelineModule,
+    PersonaModule, // W4 末:单患者刷新触发 persona.recompute
+    PlanModule, // W4 末:单患者刷新触发 planEngine.recomputeForPatient
+  ],
   controllers: [SyncController, PushController],
   providers: [
     SyncService,

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

-import { Injectable, Logger, NotImplementedException } from '@nestjs/common';
-import { Cron, CronExpression } from '@nestjs/schedule';
+import {
+  Injectable,
+  Logger,
+  NotImplementedException,
+  NotFoundException,
+} from '@nestjs/common';
+import { Cron } from '@nestjs/schedule';
+import * as fs from 'node:fs';
+import * as path from 'node:path';
+import * as yaml from 'js-yaml';
 import { PrismaService } from '../../prisma/prisma.service';
 import { FactsService } from '../facts/facts.service';
 import { AlertService } from '../../common/alerting/alert.service';
 import { PullStrategyRegistry } from './adapters/adapter.registry';
+import { ColdImportService } from './cold-import/cold-import.service';
+import { PersonaService } from '../persona/persona.service';
+import { PlanEngineService } from '../plan/engine/plan-engine.service';
+import type { TenantScopeContext } from '../../common/decorators/tenant-scope.decorator';
 
 /**
- * SyncService — 增量拉取 + 漂移检测 orchestration
+ * SyncService — 增量拉取 + 漂移检测 orchestration + 单患者刷新
  *
- * 暂未实施。当前数据接入只走 cold-import(`pnpm cold-import`,见 ColdImportService);
- * pull / push 路径待 host 真实 API 就绪后再启用,届时复用 AssemblerEngine + TransactionSynthesizer
- * + ParserPipeline 三件套(已实现)。
+ * 暂未实施部分:周期性 pull / push 路径(host 真实 API 就绪后再启用)
+ *
+ * 已实施:
+ *   - W4 末 单患者刷新(runPullForPatient)— 详情页"刷新"按钮调用
+ *     · ClickHouse 直连 DW,SQL 注入 WHERE patient_id+brand 精确范围
+ *     · resource='patient_refresh' 跟 daily incremental cursor 完全隔离
+ *     · 跑完顺手 persona.recompute + planEngine.recomputeForPatient
  */
 @Injectable()
 export class SyncService {
@@ -21,13 +37,22 @@ export class SyncService {
     private readonly facts: FactsService,
     private readonly registry: PullStrategyRegistry,
     private readonly alerter: AlertService,
+    private readonly coldImport: ColdImportService,
+    private readonly persona: PersonaService,
+    private readonly planEngine: PlanEngineService,
   ) {}
 
   /**
-   * Sync 拉数据 cron — 每小时跑一次(W2 决策:对召回业务小时级足够 + 不压宿主)。
+   * Sync 拉数据 cron — env 驱动(env 未设默认不跑)
+   * PAC_SYNC_HOURLY_CRON:
+   *   不设         → 不跑(local + 当前所有环境默认 — pull 通道未启用)
+   *   '0 * * * *'  → host pull 通道接通后启用,小时级拉
+   *
    * 事件驱动主路径(秒级响应)由 pipeline-dispatcher 入队 persona-recompute,本 cron 只是兜底拉数据。
    */
-  @Cron(CronExpression.EVERY_HOUR, { name: 'sync-scheduled-tick' })
+  @Cron(process.env.PAC_SYNC_HOURLY_CRON ?? '0 0 31 12 *' /* never — pull 通道未启用 */, {
+    name: 'sync-scheduled-tick',
+  })
   async runScheduledForAll(): Promise<void> {
     // 暂未启用 — pull 通道接通后挂回本 cron
   }
@@ -38,16 +63,138 @@ export class SyncService {
     );
   }
 
+  /**
+   * 单患者按需刷新(详情页"刷新"按钮)
+   *
+   * 流程:
+   *   1. 查 patient(scope 限定 host+tenant 隔离)
+   *   2. 反查 manifest tenant_map → brand 中文名(SQL WHERE 用)
+   *   3. ColdImportService.importPatient → 单患者全量从 DW 拉(SQL 注入 patient_id+brand)
+   *   4. Persona.recompute(该 patient)
+   *   5. PlanEngine.recomputeForPatient(该 patient)
+   *
+   * 不动 cursor / 不阻塞 daily incremental cron(resource='patient_refresh' 隔离)
+   */
   async runPullForPatient(
-    _scope: unknown,
-    _patientId: string,
-  ): Promise<{ syncLogId: string; status: string; dedupedFromExisting?: boolean }> {
-    throw new NotImplementedException(
-      '单患者 pull 暂未实施,数据请通过 cold-import 入站',
+    scope: TenantScopeContext,
+    patientId: string,
+  ): Promise<{
+    syncLogId: string;
+    status: string;
+    transactionsWritten: number;
+    factsEmitted: number;
+    plansCreated: number;
+  }> {
+    // 1. patient lookup(隔离基线)
+    const patient = await this.prisma.patient.findFirst({
+      where: { id: patientId, hostId: scope.hostId, tenantId: scope.tenantId },
+    });
+    if (!patient) {
+      throw new NotFoundException(`Patient ${patientId} not found in tenant`);
+    }
+
+    // 2. host + manifest 反查 brand
+    const host = await this.prisma.host.findUnique({ where: { id: scope.hostId } });
+    if (!host) {
+      throw new NotFoundException(`Host ${scope.hostId} not found`);
+    }
+    const dataDir = this.resolveDataDir(host.name);
+    const brand = this.resolveBrandFromTenant(dataDir, patient.tenantId);
+
+    this.logger.log(
+      `patient-refresh: host=${host.name} patient=${patient.externalId}(${patient.id}) brand=${brand} dir=${dataDir}`,
     );
+
+    // 3. 跑单患者 cold-import(SQL 注入 WHERE patient_id+brand)
+    const r = await this.coldImport.importPatient(dataDir, {
+      patientExternalId: patient.externalId,
+      brand,
+      triggeredBy: `patient_refresh:${patient.externalId}`,
+    });
+
+    // 4. Persona 重算(失败不阻断,log warn)
+    try {
+      await this.persona.recompute({
+        patientId: patient.id,
+        source: `patient_refresh:${r.runId}`,
+      });
+    } catch (err) {
+      this.logger.warn(
+        `patient-refresh persona patient=${patient.id}: ${(err as Error).message}`,
+      );
+    }
+
+    // 5. Plan 重算(per patient — runForPatient 会跑该 tenant 全量但 selector 只命中该 patient)
+    let plansCreated = 0;
+    try {
+      const r2 = await this.planEngine.recomputeForPatient({
+        hostId: scope.hostId,
+        tenantId: scope.tenantId,
+        patientId: patient.id,
+      });
+      plansCreated = r2.plansCreated;
+    } catch (err) {
+      this.logger.warn(
+        `patient-refresh plan patient=${patient.id}: ${(err as Error).message}`,
+      );
+    }
+
+    this.logger.log(
+      `patient-refresh DONE: patient=${patient.externalId} status=${r.status} ` +
+        `txns=${r.totals.transactionsWritten} facts=${r.totals.factsCreated + r.totals.factsSuperseded} ` +
+        `plansCreated=${plansCreated}`,
+    );
+
+    return {
+      syncLogId: r.syncLogId!,
+      status: r.status,
+      transactionsWritten: r.totals.transactionsWritten,
+      factsEmitted: r.totals.factsCreated + r.totals.factsSuperseded,
+      plansCreated,
+    };
   }
 
   async checkPullDrift(): Promise<void> {
     // 暂未启用 — pull 通道接通后启用漂移监控
   }
+
+  // ─── helpers ───
+
+  /// 数据目录:env PAC_INCREMENTAL_DATA_DIR 优先,否则默认 ../../data/<host>
+  /// (跟 SyncIncrementalSchedulerService 共用 env,运维只需配一处)
+  private resolveDataDir(hostName: string): string {
+    const base =
+      process.env.PAC_INCREMENTAL_DATA_DIR ??
+      path.resolve(__dirname, '../../../data');
+    return path.join(base, hostName);
+  }
+
+  /// 从 manifest.yaml tenant_map 反查 tenantId(UUID) → brand 中文名(SQL WHERE 用)
+  /// 找不到回退用 tenantId 本身(动态 pass-through host)
+  private resolveBrandFromTenant(dir: string, tenantId: string): string {
+    const manifestPath = path.join(dir, 'manifest.yaml');
+    if (!fs.existsSync(manifestPath)) {
+      this.logger.warn(`manifest.yaml not found at ${manifestPath}, fallback brand=${tenantId}`);
+      return tenantId;
+    }
+    try {
+      const parsed = yaml.load(fs.readFileSync(manifestPath, 'utf-8')) as {
+        tenant_map?: Record<string, string>;
+        brand_to_tenant?: Record<string, string>;
+      };
+      const map = parsed.tenant_map ?? parsed.brand_to_tenant ?? {};
+      // 反向找:map { 瑞尔: <UUID> } → 给 UUID 找回 "瑞尔"
+      for (const [brand, uuid] of Object.entries(map)) {
+        if (uuid === tenantId) return brand;
+      }
+      // 未匹配 → pass-through(field 模式 host 直接用 brand 当 tenantId)
+      this.logger.warn(
+        `tenant_map 反查未命中 tenantId=${tenantId},pass-through 用原值当 brand`,
+      );
+      return tenantId;
+    } catch (err) {
+      this.logger.warn(`manifest 解析失败:${(err as Error).message},fallback`);
+      return tenantId;
+    }
+  }
 }

apps/pac-service/src/queues/dw-lag-monitor.service.ts

+import { Injectable, Logger } from '@nestjs/common';
+import { Cron } from '@nestjs/schedule';
+import { PrismaService } from '../prisma/prisma.service';
+
+/**
+ * DwLagMonitorService — 每小时检查 DW 增量数据滞后(W4 末)
+ *
+ * 输入:sync_logs 中最近一条成功的 incremental_bundle 的 cursor_after JSON
+ *       例:{"fact_emr_treatment_out":"2026-05-26 15:30:00",...}
+ *
+ * 计算:max(cursor_after.*) vs now() → diff hours
+ *   - diff <= 24h:🟢 健康
+ *   - 24h < diff <= 48h:🟡 注意(DW 可能没刷新,提醒值班)
+ *   - diff > 48h:🔴 异常(数据严重滞后,事件可能漏召)
+ *
+ * 当前实现:log + (TODO) 接 webhook/email/钉钉。
+ *
+ * 调整阈值:PAC_LAG_WARN_HOURS=24 / PAC_LAG_ERROR_HOURS=48 env
+ */
+@Injectable()
+export class DwLagMonitorService {
+  private readonly logger = new Logger(DwLagMonitorService.name);
+
+  constructor(private readonly prisma: PrismaService) {}
+
+  /// DW 数据滞后告警 cron — env 驱动
+  /// PAC_LAG_MONITOR_CRON:
+  ///   不设         → 不跑(local 默认)
+  ///   '0 * * * *'  → 生产 / staging 推荐(每小时检查)
+  @Cron(process.env.PAC_LAG_MONITOR_CRON ?? '0 0 31 12 *' /* never — env not set */, {
+    name: 'dw-lag-monitor',
+  })
+  async checkLag(): Promise<void> {
+    const warnH = Number(process.env.PAC_LAG_WARN_HOURS ?? '24');
+    const errorH = Number(process.env.PAC_LAG_ERROR_HOURS ?? '48');
+    const now = Date.now();
+
+    const hosts = await this.prisma.host.findMany({ select: { id: true, name: true } });
+    for (const host of hosts) {
+      const last = await this.prisma.syncLog.findFirst({
+        where: {
+          hostId: host.id,
+          resource: 'incremental_bundle',
+          status: 'success',
+          cursorAfter: { not: null },
+        },
+        orderBy: { startedAt: 'desc' },
+      });
+      if (!last?.cursorAfter) {
+        this.logger.warn(`dw-lag: host=${host.name} 还没跑过增量(无 cursor)— 检查 sync-incremental cron`);
+        continue;
+      }
+      let cursors: Record<string, string>;
+      try {
+        cursors = JSON.parse(last.cursorAfter) as Record<string, string>;
+      } catch {
+        this.logger.warn(`dw-lag: host=${host.name} cursor JSON 解析失败 — ${last.cursorAfter}`);
+        continue;
+      }
+      const maxCursorTs = Math.max(
+        ...Object.values(cursors)
+          .map((v) => new Date(v).getTime())
+          .filter((t) => !isNaN(t)),
+      );
+      const diffHours = (now - maxCursorTs) / 3_600_000;
+      const tag =
+        diffHours > errorH ? '🔴' :
+        diffHours > warnH ? '🟡' :
+        '🟢';
+      const msg = `dw-lag: ${tag} host=${host.name} max_cursor=${new Date(maxCursorTs).toISOString()} lag=${diffHours.toFixed(1)}h (warn=${warnH} error=${errorH})`;
+      if (diffHours > errorH) {
+        this.logger.error(msg);
+        // TODO W5+: 接 alerting service(webhook/email/钉钉) — 现在 log ERROR 让 ops 看
+      } else if (diffHours > warnH) {
+        this.logger.warn(msg);
+      } else {
+        this.logger.log(msg);
+      }
+    }
+  }
+}

apps/pac-service/src/queues/queues.module.ts

@@ -4,9 +4,12 @@ import { ConfigModule, ConfigService } from '@nestjs/config';
 import type { AppConfig } from '../config/configuration';
 import { PersonaModule } from '../modules/persona/persona.module';
 import { PlanModule } from '../modules/plan/plan.module';
+import { SyncModule } from '../modules/sync/sync.module';
 import { QueueName } from './queue-names';
 import { QueueProducer } from './queue-producer.service';
 import { StaleScanService } from './stale-scan.service';
+import { SyncIncrementalSchedulerService } from './sync-incremental.scheduler';
+import { DwLagMonitorService } from './dw-lag-monitor.service';
 import { PersonaRecomputeProcessor } from './processors/persona-recompute.processor';
 import { PlanRecomputeProcessor } from './processors/plan-recompute.processor';
 import { PlanAssetGenerateProcessor } from './processors/plan-asset-generate.processor';
@@ -51,14 +54,17 @@ import { PlanAssetGenerateProcessor } from './processors/plan-asset-generate.pro
     ),
     PersonaModule,
     PlanModule,
+    SyncModule, // 给 SyncIncrementalSchedulerService 注入 ColdImportService
   ],
   providers: [
     QueueProducer,
     StaleScanService,
+    SyncIncrementalSchedulerService,
+    DwLagMonitorService,
     PersonaRecomputeProcessor,
     PlanRecomputeProcessor,
     PlanAssetGenerateProcessor,
   ],
-  exports: [BullModule, QueueProducer, StaleScanService],
+  exports: [BullModule, QueueProducer, StaleScanService, SyncIncrementalSchedulerService],
 })
 export class QueuesModule {}

apps/pac-service/src/queues/stale-scan.service.ts

 import { Injectable, Logger } from '@nestjs/common';
-import { Cron, CronExpression } from '@nestjs/schedule';
+import { Cron } from '@nestjs/schedule';
 import { PrismaService } from '../prisma/prisma.service';
 import { QueueProducer } from './queue-producer.service';
 
@@ -27,10 +27,17 @@ export class StaleScanService {
   ) {}
 
   /**
-   * 凌晨 02:00 跑,扫所有 host 的 stale patient 补算。
+   * Stale persona 扫描 cron — env 驱动
+   *
+   * PAC_STALE_SCAN_CRON:
+   *   不设         → 不跑(local 默认)
+   *   '0 2 * * *'  → 生产 / staging 推荐(凌晨 02:00,DW 增量同步前一会儿)
+   *
    * 量级估算:5 家试点 30 万患者,扫一次约 1-5 秒,enqueue 部分(预期 < 1% stale)。
    */
-  @Cron(CronExpression.EVERY_DAY_AT_2AM, { name: 'persona-stale-scan' })
+  @Cron(process.env.PAC_STALE_SCAN_CRON ?? '0 0 31 12 *' /* never — env not set */, {
+    name: 'persona-stale-scan',
+  })
   async scanAndEnqueueStale(): Promise<void> {
     const startedAt = Date.now();
     this.logger.log('stale-scan: START');

apps/pac-service/src/queues/sync-incremental.scheduler.ts

+import { Injectable, Logger } from '@nestjs/common';
+import { Cron, CronExpression } from '@nestjs/schedule';
+import * as path from 'path';
+import { PrismaService } from '../prisma/prisma.service';
+import { ColdImportService } from '../modules/sync/cold-import/cold-import.service';
+import { PersonaService } from '../modules/persona/persona.service';
+import { PlanEngineService } from '../modules/plan/engine/plan-engine.service';
+
+/**
+ * SyncIncrementalSchedulerService — W4 末:DW 直连增量自动跑(每天 02:30)
+ *
+ * 上游:DW 团队每日凌晨 ~02:00 完成全量刷新
+ * 我们 02:30 触发:
+ *   1. ColdImportService.importDirectory({ incremental: true })
+ *      - 读 sync_logs 上次 cursor_after → SQL 注入 WHERE updated_date > '...'
+ *      - 反向拉主档(C 方案)+ stub auto-create(A 方案)→ 无数据丢失
+ *      - 写新 cursor 到 sync_logs
+ *   2. Persona 重算(affected patient — 本次 sync 写入的 distinct patient_id)
+ *   3. Plan 重算(per tenant,scenario SQL + 6 因子打分)
+ *
+ * 多 host:循环 PAC_INCREMENTAL_HOSTS env(逗号分隔,默认 'jvs-dw')
+ * 每个 host 期望 data/<host>/manifest.yaml 存在
+ *
+ * 跑失败:
+ *   - cursor 不前进(ColdImportService 内 transaction)→ 下次自动 catchup
+ *   - log ERROR + 不抛(让 cron 下次继续)
+ */
+@Injectable()
+export class SyncIncrementalSchedulerService {
+  private readonly logger = new Logger(SyncIncrementalSchedulerService.name);
+
+  constructor(
+    private readonly prisma: PrismaService,
+    private readonly coldImport: ColdImportService,
+    private readonly persona: PersonaService,
+    private readonly planEngine: PlanEngineService,
+  ) {}
+
+  /// DW 增量同步 cron — env 驱动
+  /// PAC_INCREMENTAL_CRON:
+  ///   不设       → 不跑(local 默认,避免开发期自动消耗 DW 流量)
+  ///   '30 2 * * *' → 生产推荐(DW 02:00 全量刷新后)
+  ///   '30 3 * * *' → staging 错峰
+  /// 详见 .env.example
+  @Cron(process.env.PAC_INCREMENTAL_CRON ?? '0 0 31 12 *' /* never — env not set */, {
+    name: 'sync-incremental-daily',
+  })
+  async runDaily(): Promise<void> {
+    const hosts = (process.env.PAC_INCREMENTAL_HOSTS ?? 'jvs-dw')
+      .split(',')
+      .map((h) => h.trim())
+      .filter(Boolean);
+    const dataDir = process.env.PAC_INCREMENTAL_DATA_DIR ?? path.resolve(__dirname, '../../data');
+    this.logger.log(`sync-incremental: START hosts=[${hosts.join(',')}] dataDir=${dataDir}`);
+    for (const host of hosts) {
+      try {
+        await this.runOne(path.join(dataDir, host));
+      } catch (err) {
+        this.logger.error(
+          `sync-incremental: host=${host} failed: ${(err as Error).message}`,
+        );
+        // 不抛 — 下个 host 继续;cursor 没前进自然下次 catchup
+      }
+    }
+    this.logger.log('sync-incremental: ALL DONE');
+  }
+
+  /// 跑单个 host 的完整链路(可手动调,debug 用)
+  async runOne(dir: string): Promise<void> {
+    const started = Date.now();
+    const r = await this.coldImport.importDirectory(dir, { incremental: true });
+    this.logger.log(
+      `sync-incremental: cold-import done host=${r.hostName} ` +
+        `patients=${r.totals.patientsUpserted} txns=${r.totals.transactionsWritten} ` +
+        `facts(created=${r.totals.factsCreated} superseded=${r.totals.factsSuperseded})`,
+    );
+
+    // ─── Persona recompute(affected patient only)──────
+    if (r.syncLogId) {
+      const syncLog = await this.prisma.syncLog.findUnique({ where: { id: r.syncLogId } });
+      if (syncLog) {
+        const affected = await this.prisma.patientTransaction.findMany({
+          where: { hostId: r.hostId, createdAt: { gte: syncLog.startedAt } },
+          select: { patientId: true },
+          distinct: ['patientId'],
+        });
+        const pids = affected.map((p) => p.patientId).filter((p): p is string => !!p);
+        let ok = 0;
+        let failed = 0;
+        for (const pid of pids) {
+          try {
+            await this.persona.recompute({
+              patientId: pid,
+              source: `incremental-sync:${r.runId}`,
+            });
+            ok++;
+          } catch (err) {
+            failed++;
+            this.logger.warn(`persona patient=${pid}: ${(err as Error).message}`);
+          }
+        }
+        this.logger.log(`persona recompute: success=${ok} failed=${failed} (${pids.length} affected)`);
+      }
+    }
+
+    // ─── Plan recompute(per tenant)──────
+    const tenants = await this.prisma.patient.findMany({
+      where: { hostId: r.hostId },
+      distinct: ['tenantId'],
+      select: { tenantId: true },
+    });
+    let plansCreated = 0;
+    for (const t of tenants) {
+      const r2 = await this.planEngine.runAllForHost({
+        hostId: r.hostId,
+        tenantId: t.tenantId,
+        now: new Date(),
+      });
+      plansCreated += r2.plansCreated;
+    }
+    this.logger.log(
+      `plan recompute: ${tenants.length} tenants, plansCreated=${plansCreated} ` +
+        `(total elapsed=${Date.now() - started}ms)`,
+    );
+  }
+}

apps/pac-web/Dockerfile

 # syntax=docker/dockerfile:1.7
+# PAC Web Dockerfile — Next.js standalone build
 ARG NODE_VERSION=22-alpine
 
 FROM node:${NODE_VERSION} AS base
@@ -7,30 +8,31 @@ RUN corepack enable && corepack prepare pnpm@10.13.1 --activate
 WORKDIR /app
 
 FROM base AS deps
-COPY pnpm-workspace.yaml pnpm-lock.yaml* package.json .npmrc ./
+COPY pnpm-workspace.yaml pnpm-lock.yaml package.json .npmrc* ./
 COPY turbo.json tsconfig.base.json ./
-COPY apps/recall-web/package.json apps/recall-web/
-COPY packages/shared-types/package.json packages/shared-types/
-COPY packages/shared-utils/package.json packages/shared-utils/
-RUN pnpm install --frozen-lockfile=false
+COPY apps/pac-web/package.json apps/pac-web/
+COPY packages/types/package.json packages/types/
+COPY packages/utils/package.json packages/utils/
+RUN pnpm install --frozen-lockfile
 
 FROM deps AS dev
 COPY . .
-WORKDIR /app/apps/recall-web
+WORKDIR /app/apps/pac-web
 EXPOSE 3000
 CMD ["pnpm", "dev"]
 
 FROM deps AS build
 COPY . .
-WORKDIR /app/apps/recall-web
+RUN pnpm --filter @pac/types build
+WORKDIR /app/apps/pac-web
 RUN pnpm build
 
 FROM node:${NODE_VERSION} AS prod
 RUN apk add --no-cache libc6-compat
 WORKDIR /app
 ENV NODE_ENV=production
-COPY --from=build /app/apps/recall-web/.next/standalone ./
-COPY --from=build /app/apps/recall-web/.next/static ./apps/recall-web/.next/static
-COPY --from=build /app/apps/recall-web/public ./apps/recall-web/public
+COPY --from=build /app/apps/pac-web/.next/standalone ./
+COPY --from=build /app/apps/pac-web/.next/static ./apps/pac-web/.next/static
+COPY --from=build /app/apps/pac-web/public ./apps/pac-web/public
 EXPOSE 3000
-CMD ["node", "apps/recall-web/server.js"]
+CMD ["node", "apps/pac-web/server.js"]

apps/pac-web/src/app/(app)/plans/[planId]/page.tsx

 'use client';
 
 import Link from 'next/link';
-import { use } from 'react';
+import { use, useEffect } from 'react';
+import { useRouter } from 'next/navigation';
+import { toast } from 'sonner';
 import { ChevronLeft } from 'lucide-react';
-import { Permission } from '@pac/types';
+import { ApiCode, Permission } from '@pac/types';
 import { Can } from '@/components/can';
 import { Card, CardContent } from '@/components/ui/card';
 import { Button } from '@/components/ui/button';
@@ -44,6 +46,16 @@ export default function PlanDetailRoutePage({ params }: { params: Promise<{ plan
 function PlanDetailLoader({ planId }: { planId: string }) {
   const { state, refresh } = usePlanAggregate(planId);
   const dictionary = useAuthStore((s) => s.user?.dictionary);
+  const router = useRouter();
+
+  // W4 末:单患者刷新后 plan 可能已被 supersede / abandoned(scenario 不再命中)
+  // → /full 接口返回 PLAN_NOT_FOUND → 这里捕获后 toast + 跳列表(避免用户卡在 error 页)
+  useEffect(() => {
+    if (state.status === 'error' && state.code === ApiCode.PLAN_NOT_FOUND) {
+      toast.info('该召回任务已不存在', { description: '可能已完成或被覆盖,返回召回池' });
+      router.push('/plans');
+    }
+  }, [state, router]);
 
   if (state.status === 'loading' || state.status === 'idle') {
     return (
@@ -54,6 +66,14 @@ function PlanDetailLoader({ planId }: { planId: string }) {
   }
 
   if (state.status === 'error') {
+    // PLAN_NOT_FOUND 已 useEffect 跳走,这里只渲染过场骨架(避免一闪而过的 error UI 闪烁)
+    if (state.code === ApiCode.PLAN_NOT_FOUND) {
+      return (
+        <div className="flex h-screen items-center justify-center text-sm text-muted-foreground">
+          召回任务已不存在,返回召回池…
+        </div>
+      );
+    }
     return (
       <main className="container mx-auto max-w-3xl p-8 space-y-3">
         <Button asChild variant="ghost" size="sm">
@@ -81,7 +101,7 @@ function PlanDetailLoader({ planId }: { planId: string }) {
   return (
     <div className="bg-slate-50">
       <TaskDrawer currentPlanId={planId} />
-      <PlanDetailApp data={adaptData(state.data, dictionary)} />
+      <PlanDetailApp data={adaptData(state.data, dictionary)} onRefreshAggregate={refresh} />
     </div>
   );
 }

apps/pac-web/src/components/auth-gate.tsx

@@ -3,6 +3,7 @@
 import { useEffect, useState } from 'react';
 import { useAuthBootstrap } from '@/hooks/use-auth-bootstrap';
 import { useAuthStore } from '@/stores/auth-store';
+import { MockLoginDialog } from '@/components/mock-login-dialog';
 
 const Placeholder = () => (
   <div className="flex h-screen items-center justify-center text-sm text-muted-foreground">
@@ -24,16 +25,22 @@ export function AuthGate({ children }: { children: React.ReactNode }) {
   // mount 后真正分流:
   // - store 已 authenticated → 放行(覆盖 bootstrap 边界 case,如 back 重挂)
   // - 还在 bootstrap → 占位
-  // - 都不是 → 引导回宿主
+  // - 都不是 → 弹"快速登录"对话框(开发 / 试部署用,后端 env 门控)
   if (isAuthenticated) return <>{children}</>;
   if (status === 'authenticating' || status === 'idle') return <Placeholder />;
 
+  // 未鉴权 fallback —— 透明占位 + 强制 MockLoginDialog
+  // 真生产把后端 PAC_ENABLE_MOCK_LOGIN=false,mockLogin 返 10107,dialog 会 toast 错误
+  // 后用户能看到底层占位文案了解需要走宿主 SSO
   return (
-    <div className="flex h-screen flex-col items-center justify-center gap-2 p-8 text-center">
-      <p className="text-lg font-medium">无法加载工作台</p>
-      <p className="max-w-md text-sm text-muted-foreground">
-        缺少有效的访问凭证。请回到宿主系统重新打开召回模块（确保 URL 携带一次性 code 参数）。
-      </p>
-    </div>
+    <>
+      <div className="flex h-screen flex-col items-center justify-center gap-2 p-8 text-center">
+        <p className="text-lg font-medium text-slate-700">召回工作台</p>
+        <p className="max-w-md text-sm text-muted-foreground">
+          请在弹窗中选择身份进入。生产环境会自动通过宿主 SSO 登录,无需手动选择。
+        </p>
+      </div>
+      <MockLoginDialog open />
+    </>
   );
 }

apps/pac-web/src/components/mock-login-dialog.tsx

+'use client';
+
+import { useState } from 'react';
+import { toast } from 'sonner';
+import type { UserRole } from '@pac/types';
+import {
+  Dialog,
+  DialogContent,
+  DialogDescription,
+  DialogHeader,
+  DialogTitle,
+} from '@/components/ui/dialog';
+import { useAuthStore } from '@/stores/auth-store';
+import { mockLogin } from '@/lib/auth-api';
+import { cn } from '@/lib/utils';
+
+/**
+ * MockLoginDialog — 试部署 / 演示用快速登录(只在 dev 启用)
+ *
+ * 用途:还没接 host SSO 时,客服 / 演示者可一键以 瑞尔/瑞泰 × staff/leader/admin
+ *      身份登录工作台。后端 env `PAC_ENABLE_MOCK_LOGIN=false` 一关即生产模式。
+ *
+ * 不可关闭(open=true 强制保持):未鉴权用户**必须选一个身份**才能进列表页。
+ * 已鉴权后由 AuthGate 接管,放行 children。
+ *
+ * 设计:6 个按钮,2 brand × 3 role 网格;点击 → mockLogin API → setTokens → reload。
+ */
+
+type TenantSlug = 'ruier' | 'ruitai';
+
+const TENANTS: { slug: TenantSlug; nameZh: string; tone: string }[] = [
+  { slug: 'ruier', nameZh: '瑞尔', tone: 'border-teal-200 bg-teal-50/40' },
+  { slug: 'ruitai', nameZh: '瑞泰', tone: 'border-sky-200 bg-sky-50/40' },
+];
+
+const ROLES: { key: UserRole; nameZh: string; desc: string }[] = [
+  { key: 'staff', nameZh: '员工', desc: '执行客服 · 看自己的召回任务' },
+  { key: 'leader', nameZh: '主管', desc: '看本团队所有任务 · 可指派 / 回收' },
+  { key: 'admin', nameZh: '管理员', desc: '全部权限 · 含后台管理' },
+];
+
+export function MockLoginDialog({ open }: { open: boolean }) {
+  const setTokens = useAuthStore((s) => s.setTokens);
+  const [busy, setBusy] = useState<string | null>(null); // 'ruier:staff' 等
+
+  const pick = async (tenant: TenantSlug, role: UserRole) => {
+    const key = `${tenant}:${role}`;
+    if (busy) return;
+    setBusy(key);
+    try {
+      const r = await mockLogin({ tenant, role });
+      setTokens({
+        accessToken: r.accessToken,
+        refreshToken: r.refreshToken,
+        expiresIn: r.expiresIn,
+      });
+      const tNameZh = TENANTS.find((t) => t.slug === tenant)?.nameZh ?? tenant;
+      const rNameZh = ROLES.find((r) => r.key === role)?.nameZh ?? role;
+      toast.success(`已登录:${tNameZh} · ${rNameZh}`, {
+        description: '(模拟身份,真生产环境会接宿主 SSO)',
+      });
+      // AuthGate 监听 isAuthenticated,setTokens 后自动放行
+    } catch (err) {
+      const msg = err instanceof Error ? err.message : String(err);
+      toast.error('登录失败', { description: msg.slice(0, 120) });
+      setBusy(null);
+    }
+  };
+
+  return (
+    <Dialog open={open}>
+      <DialogContent
+        // 禁掉 ESC / 点遮罩关闭 — 未鉴权必须选身份才能进
+        onEscapeKeyDown={(e) => e.preventDefault()}
+        onPointerDownOutside={(e) => e.preventDefault()}
+        // 隐藏右上 X 关闭按钮(子树里的 DialogPrimitive.Close)
+        className="max-w-2xl [&>button[aria-label='Close']]:hidden"
+      >
+        <DialogHeader>
+          <DialogTitle className="flex items-center gap-2">
+            <span className="inline-flex h-7 w-7 items-center justify-center rounded-md bg-teal-600 text-[12px] font-bold text-white">
+              PAC
+            </span>
+            <span>快速登录</span>
+            <span className="rounded-md bg-amber-100 px-1.5 py-0.5 text-[10.5px] font-medium text-amber-700">
+              模拟身份 · 试部署
+            </span>
+          </DialogTitle>
+          <DialogDescription className="text-[12px]">
+            生产环境会接宿主 SSO,这里是<strong>开发 / 试部署</strong>的快速通道。请选一个身份进入工作台:
+          </DialogDescription>
+        </DialogHeader>
+
+        <div className="grid gap-3 pt-2">
+          {TENANTS.map((t) => (
+            <div
+              key={t.slug}
+              className={cn('rounded-lg border p-3', t.tone)}
+            >
+              <div className="mb-2 flex items-center gap-2 text-[13px] font-semibold text-slate-800">
+                <span>{t.nameZh}</span>
+                <span className="text-[10.5px] font-normal text-slate-500">
+                  {t.slug === 'ruier' ? '3 家诊所(杭州大厦/高德 · 北京朝阳)' : '2 家诊所(通善学前街 · 上海世纪公园)'}
+                </span>
+              </div>
+              <div className="grid gap-2 sm:grid-cols-3">
+                {ROLES.map((r) => {
+                  const key = `${t.slug}:${r.key}`;
+                  const loading = busy === key;
+                  return (
+                    <button
+                      key={key}
+                      type="button"
+                      onClick={() => pick(t.slug, r.key)}
+                      disabled={!!busy}
+                      className={cn(
+                        'group flex flex-col items-start gap-1 rounded-md border bg-white px-3 py-2 text-left transition-all',
+                        loading
+                          ? 'border-teal-400 ring-2 ring-teal-200'
+                          : 'border-slate-200 hover:border-teal-400 hover:bg-teal-50/40',
+                        busy && !loading && 'opacity-50',
+                      )}
+                    >
+                      <div className="text-[12.5px] font-semibold text-slate-800">
+                        {loading ? '登录中…' : r.nameZh}
+                      </div>
+                      <div className="text-[10.5px] leading-tight text-slate-500">{r.desc}</div>
+                    </button>
+                  );
+                })}
+              </div>
+            </div>
+          ))}
+        </div>
+
+        <p className="pt-1 text-[10.5px] leading-relaxed text-slate-400">
+          提示:登录后 token 写入浏览器 localStorage(2h 有效 · 自动 refresh),
+          清浏览器数据或换浏览器会重新弹此对话框。
+        </p>
+      </DialogContent>
+    </Dialog>
+  );
+}

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

@@ -6,8 +6,8 @@
  */
 import { ExecutionChannel, UserRole, personaFeatureMeta, planScenarioLabel } from '@pac/types';
 import { fmtRel as sharedFmtRel } from '@pac/utils/format';
-import type { Chain, OutcomeOption, PersonaFeature, PlanReason } from './mock-data';
-import { mockScript, mockSummaries, outcomeOptions as mockOutcomes } from './mock-data';
+import type { Chain, PersonaFeature, PlanReason } from './mock-data';
+import { mockScript, mockSummaries } from './mock-data';
 import type { PlanDetailData } from './plan-detail-types';
 import type { TokenDictionary } from '@pac/types';
 
@@ -176,7 +176,7 @@ export function adaptData(real: PlanDetailData, dict?: TokenDictionary) {
           sections: real.script.sections,
         } as typeof mockScript)
       : mockScript,
-    outcomeOptions: mockOutcomes as OutcomeOption[],
+    // outcomeOptions 已迁移到 @pac/types EXECUTION_OUTCOME_META,outcome-form 直接 import
     fmtRel,
   };
 }

apps/pac-web/src/components/plan-detail/chain-viz.tsx

@@ -45,18 +45,21 @@ type ChainStatusVisual = {
   short: string;        // 短标签(badge / sidebar 用),如 "已进入"
   long: string;         // 长标签(全景卡 badge 用),如 "↻ 在管 · 治疗中"
   icon: string;         // ★ / ⏵ / ↻ / ✓
-  tone: 'rose' | 'amber' | 'sky' | 'emerald';
+  tone: 'rose' | 'amber' | 'sky' | 'emerald' | 'slate';
 };
 function chainStatusVisual(chain: Pick<Chain, 'status' | 'currentStage' | 'target'>): ChainStatusVisual {
-  // W4 末:SQL 为准 — target=true(SQL 召回了)优先显示"潜在新链",不管 chain 内部 status
-  // 临床场景:林兆星 K05 — 1 年前 fulfilled "牙周"预约让 chain 算 entered,但 SQL 召回该 K05
-  //         因为 1 年没坚持治疗;target 是 SQL 真理,优先级最高
-  if (chain.target && chain.status !== 'closed') {
-    return { short: '潜在新链', long: '★ 潜在新链', icon: '★', tone: 'rose' };
-  }
+  // W4 末:口径统一 — entered/ongoing/closed 都不该 ★(SQL ⑤d 已排除 entered,⑤a 排除 ongoing)
+  //   chain 内部状态 = 视觉真理源,target=true 只对 discovered 才上 ★
+  //   target+entered/ongoing 出现 = SQL 漏排或老 plan,按 chain 真实 status 显示更不误导
   if (chain.status === 'closed') return { short: '已闭环', long: '✓ 已闭环', icon: '✓', tone: 'emerald' };
   if (chain.status === 'entered') return { short: '已进入', long: '⏵ 已进入', icon: '⏵', tone: 'amber' };
-  if (chain.status === 'discovered') return { short: '潜在新链', long: '★ 潜在新链', icon: '★', tone: 'rose' };
+  if (chain.target && chain.status === 'discovered') {
+    return { short: '潜在新链', long: '★ 潜在新链', icon: '★', tone: 'rose' };
+  }
+  // W4 末:discovered + target=false(SQL 未召回 — 如同牙位拔除 ⑤c 排除 / cooldown 未过等)
+  //   不再 ★ 误导客服;改"已发现 · 暂不召回",中性灰色表示"已识别但 SQL 评估暂不进入主流程"
+  //   典型 case:季根财 K05 全口 — 所有牙位都被同期 surgical 拔除,牙周治疗已无意义
+  if (chain.status === 'discovered') return { short: '已发现', long: '已发现 · 暂不召回', icon: '⊙', tone: 'slate' };
   // ongoing — 按 stage 区分"治疗中" / "复查中" (业务上是不同语义,客服需要知道病人在做啥)
   const sub = chain.currentStage >= 4 ? '复查中' : '治疗中';
   return { short: `在管 · ${sub}`, long: `↻ 在管 · ${sub}`, icon: '↻', tone: 'sky' };
@@ -422,24 +425,27 @@ function ChainSidebarRow({ chain }: { chain: Chain }) {
 }
 
 // status 主色 → 卡片背景 / dot / 文字 三套类名(单一来源,免散写)
-type ChainTone = 'rose' | 'amber' | 'sky' | 'emerald';
+type ChainTone = 'rose' | 'amber' | 'sky' | 'emerald' | 'slate';
 const TONE_WRAP: Record<ChainTone, string> = {
   rose: 'bg-rose-50/40 border-rose-200/70',
   amber: 'bg-amber-50/40 border-amber-200/70',
   sky: 'bg-sky-50/40 border-sky-200/70',
   emerald: 'bg-emerald-50/40 border-emerald-200/70',
+  slate: 'bg-slate-50/40 border-slate-200/70',
 };
 const TONE_DOT: Record<ChainTone, string> = {
   rose: 'bg-rose-500 text-white',
   amber: 'bg-amber-500 text-white',
   sky: 'bg-sky-500 text-white',
   emerald: 'bg-emerald-500 text-white',
+  slate: 'bg-slate-400 text-white',
 };
 const TONE_TEXT: Record<ChainTone, string> = {
   rose: 'text-rose-700',
   amber: 'text-amber-700',
   sky: 'text-sky-700',
   emerald: 'text-emerald-700',
+  slate: 'text-slate-700',
 };
 
 // ──────────────────────────────────────────

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

@@ -117,7 +117,7 @@ export function Drawer({
 
   return (
     <div className="fixed inset-0 z-40 flex" onClick={onClose}>
-      <div className="flex-1 bg-slate-900/30 backdrop-blur-sm" />
+      <div className="flex-1 bg-slate-900/30" />
       <aside
         className={cn('max-w-[92vw] bg-white shadow-2xl border-l border-slate-200 flex flex-col', width)}
         onClick={(e) => e.stopPropagation()}

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

@@ -19,8 +19,7 @@ import {
   AlertOctagon,
 } from 'lucide-react';
 import { diagnosisCodeNameZh, treatmentCategoryNameZh } from '@pac/types';
-import { cn, formatToothPosition } from '@/lib/utils';
-import { Chip } from './shared';
+import { cn } from '@/lib/utils';
 import type { AdaptedFact } from './adapt-data';
 
 /**
@@ -66,37 +65,33 @@ export function FactsTimeline({ facts }: { facts: AdaptedFact[] }) {
     [facts, selected],
   );
 
+  // W4 末:sticky 顶部 — stats + filter 滚动时固定,时间轴在下方滚过
+  //   父容器(drawer body)已 overflow-y-auto,sticky 在该 scroll container 内生效
+  //   -mx-5 让 sticky 区域延伸到 drawer padding 边缘,bg-white 遮住下方时间轴
   return (
     <div className="space-y-3">
-      {/* 结构化统计摘要 — 资金 / 临床 / 行为 / 时间窗 四块,一眼看清患者画像 */}
-      <StatsSummary facts={facts} />
-
-      {/* 类型多选筛选 chip 行 */}
-      <div className="flex flex-wrap items-center gap-1.5 pb-2 border-b border-slate-100">
-        <FilterChip label="全部" count={facts.length} active={allOn} onClick={toggleAll} />
-        <span className="text-slate-200 mx-0.5">|</span>
-        {allTypes.map((t) => {
-          const meta = FACT_META[t] ?? FACT_META_FALLBACK;
-          return (
-            <FilterChip
-              key={t}
-              label={meta.label}
-              count={typeCounts.get(t) ?? 0}
-              active={selected.has(t)}
-              tone={meta.tone}
-              onClick={() => toggleType(t)}
-            />
-          );
-        })}
+      <div className="sticky top-0 z-10 -mx-5 px-5 pt-1 pb-2 bg-white space-y-3 border-b border-slate-100">
+        <StatsSummary facts={facts} />
+        <div className="flex flex-wrap items-center gap-1.5">
+          <FilterChip label="全部" count={facts.length} active={allOn} onClick={toggleAll} />
+          <span className="text-slate-200 mx-0.5">|</span>
+          {allTypes.map((t) => {
+            const meta = FACT_META[t] ?? FACT_META_FALLBACK;
+            return (
+              <FilterChip
+                key={t}
+                label={meta.label}
+                count={typeCounts.get(t) ?? 0}
+                active={selected.has(t)}
+                onClick={() => toggleType(t)}
+              />
+            );
+          })}
+        </div>
       </div>
-
-      {/* 选中类型为空的提示 */}
-      {sorted.length === 0 && (
+      {sorted.length === 0 ? (
         <div className="text-center py-12 text-sm text-slate-400">已勾选类型无事实</div>
-      )}
-
-      {/* 时间轴 */}
-      {sorted.length > 0 && (
+      ) : (
         <div className="relative pl-6">
           <div className="absolute left-[10px] top-1 bottom-1 w-px bg-slate-200" />
           {sorted.map((f) => (
@@ -240,8 +235,11 @@ function StatBlock({ label, children }: { label: string; children: React.ReactNo
 function TimelineRow({ fact }: { fact: AdaptedFact }) {
   const meta = FACT_META[fact.type] ?? FACT_META_FALLBACK;
   const Icon = meta.Icon;
-  const T = toneOf(meta.tone);
-  const { title, note } = factSummary(fact);
+
+  // W4 末视觉降噪 — 3 种语义色:rose(异常)/ emerald(钱进来)/ amber(爽约) — 其它 slate 灰
+  //   appointment 特例:status=no_show/cancelled 才转 amber,其它走 slate
+  const effectiveTone = computeEffectiveTone(fact, meta);
+  const T = toneOf(effectiveTone);
 
   // planned 事实(预约/计划治疗)显示 plannedFor;加"约"前缀以区分已发生
   const tIso = fact.occurredAt ?? fact.plannedFor;
@@ -249,8 +247,12 @@ function TimelineRow({ fact }: { fact: AdaptedFact }) {
     ? (fact.occurredAt ? '' : '约 ') + new Date(tIso).toLocaleDateString('zh-CN').replace(/\//g, '.')
     : '—';
 
+  const { title, note } = factSummary(fact);
+  const rightLines = rightColumn(fact);
+
   return (
     <div className="relative pb-3">
+      {/* icon dot — 默认 slate 灰,异常类型(rose/emerald/amber)着色;ring-white 保持时间轴脉络感 */}
       <span
         className={cn(
           'absolute -left-[22px] top-0.5 w-5 h-5 rounded-full flex items-center justify-center ring-2 ring-white',
@@ -260,57 +262,145 @@ function TimelineRow({ fact }: { fact: AdaptedFact }) {
       >
         <Icon className="w-3 h-3" />
       </span>
-      <div className="flex items-center gap-2 flex-wrap">
-        <span className="text-[11px] text-slate-500 tabular-nums font-mono">{dateStr}</span>
-        <Chip tone={meta.tone} size="xs">
-          {meta.label}
-        </Chip>
-        {fact.status !== 'active' && (
-          <Chip tone="slate" size="xs">
-            {FACT_STATUS_ZH[fact.status] ?? fact.status}
-          </Chip>
+      {/* 2 列网格:左 1fr(时间/类型/标题/副字段),右 auto(牙位/金额/HH:MM/状态)*/}
+      <div className="grid grid-cols-[1fr_auto] gap-3 items-start">
+        <div className="min-w-0">
+          <div className="text-[10.5px] text-slate-500 tabular-nums">
+            <span className="font-mono">{dateStr}</span>
+            <span className="mx-1 text-slate-300">·</span>
+            <span>{meta.label}</span>
+          </div>
+          <div className="mt-0.5 text-[13px] font-medium text-slate-900 leading-tight">{title}</div>
+          {note && (
+            <div className="text-[11px] text-slate-500 leading-snug mt-0.5 line-clamp-2">{note}</div>
+          )}
+        </div>
+        {rightLines.length > 0 && (
+          <div className="flex flex-col items-end gap-0.5 text-[11.5px] text-slate-600 tabular-nums whitespace-nowrap">
+            {rightLines.map((line, i) => (
+              <span key={i} className={line.className}>{line.text}</span>
+            ))}
+          </div>
         )}
       </div>
-      <div className="mt-0.5 text-[12.5px] font-medium text-slate-900">{title}</div>
-      {note && <div className="text-[11px] text-slate-500 mt-0.5">{note}</div>}
     </div>
   );
 }
 
+// 计算 row 实际显示的 tone — appointment status 异常时升 amber
+function computeEffectiveTone(fact: AdaptedFact, meta: FactMeta): string {
+  if (fact.type === 'appointment_record') {
+    const st = String((fact.content as Record<string, unknown> | null)?.status ?? '');
+    if (st === 'no_show' || st === 'cancelled') return 'amber';
+    return 'slate'; // 普通预约不着色
+  }
+  return meta.tone;
+}
+
+// 状态 badge 统一样式(slate)— W4 末降噪:语义色集中在时间轴 icon dot,badge 不重复表达
+const STATUS_BADGE = 'px-1.5 py-px rounded border text-[10.5px] bg-slate-50 text-slate-600 border-slate-200';
+
+// 右列数据 — 按 fact 类型挑最关键的 1-2 行
+interface RightLine { text: string; className?: string }
+function rightColumn(fact: AdaptedFact): RightLine[] {
+  const c = (fact.content ?? {}) as Record<string, unknown>;
+  const out: RightLine[] = [];
+  switch (fact.type) {
+    case 'diagnosis_record':
+    case 'treatment_record':
+    case 'recommendation_record': {
+      const tooth = String(c.tooth_position ?? c.tooth_positions ?? '').trim();
+      if (tooth) {
+        const teeth = tooth.split(';').map((t) => t.trim()).filter(Boolean);
+        out.push({ text: teeth.length > 4 ? `${teeth.slice(0, 3).join(';')} 等 ${teeth.length} 颗` : teeth.join(';'), className: 'font-medium text-slate-700' });
+      }
+      if (fact.type === 'treatment_record') {
+        const st = String(c.status ?? '');
+        if (st === 'completed' || st === 'fulfilled') out.push({ text: '已完成', className: STATUS_BADGE });
+        else if (st === 'cancelled') out.push({ text: '已取消', className: STATUS_BADGE });
+      }
+      break;
+    }
+    case 'payment_record':
+    case 'order_record':
+    case 'recharge_record':
+    case 'refund_record': {
+      const cents = Number(c.amount_cents ?? 0);
+      const yuan = `¥${(Math.abs(cents) / 100).toLocaleString(undefined, { minimumFractionDigits: 2, maximumFractionDigits: 2 })}`;
+      const isNegative = fact.type === 'refund_record';
+      // 金额本身用 emerald/rose 色(语义信号,跟时间轴 icon dot 同色系)
+      out.push({ text: isNegative ? `- ${yuan}` : yuan, className: cn('font-semibold', isNegative ? 'text-rose-700' : 'text-emerald-700') });
+      break;
+    }
+    case 'appointment_record': {
+      const at = String(c.scheduled_at ?? '');
+      if (at) out.push({ text: hhmm(at), className: 'font-mono text-slate-700' });
+      const st = String(c.status ?? '');
+      const stZh = APPT_STATUS_ZH[st];
+      if (stZh) {
+        // W4 末:状态 badge 样式统一(slate),不同 status 不再有不同色
+        //   语义信号(爽约 amber / 异常 rose)走时间轴 icon dot,不重复在 badge 上表达
+        out.push({ text: stZh, className: STATUS_BADGE });
+      }
+      break;
+    }
+    case 'encounter_record': {
+      const etype = String(c.encounter_type ?? '');
+      const zh = ENCOUNTER_TYPE_ZH[etype];
+      if (zh) out.push({ text: zh, className: 'text-slate-500' });
+      break;
+    }
+    case 'image_record': {
+      const mod = String(c.modality ?? '');
+      const modZh = MODALITY_ZH[mod] ?? mod;
+      if (modZh) out.push({ text: modZh, className: 'text-slate-500' });
+      const tooths = c.tooth_positions;
+      const tooth = Array.isArray(tooths) ? tooths.join(';') : String(tooths ?? '');
+      if (tooth) {
+        const teeth = tooth.split(';').map((t) => t.trim()).filter(Boolean);
+        out.push({ text: teeth.length > 4 ? `${teeth.slice(0, 3).join(';')} 等 ${teeth.length}` : teeth.join(';'), className: 'text-slate-600' });
+      }
+      break;
+    }
+    default:
+      break;
+  }
+  return out;
+}
+
 // ─────────────────────────────────────────────
 // 顶部筛选 chip
 // ─────────────────────────────────────────────
 
+// W4 末:filter chip 配色统一 — 不再 per-meta-tone 着色(全 sky 主色作"激活"信号)
+//   语义色保留给时间轴 icon dot(rose/emerald/amber)— 顶部 chip 表"筛选状态"不表"语义"
 function FilterChip({
   label,
   count,
   active,
-  tone = 'slate',
   onClick,
 }: {
   label: string;
   count: number;
   active: boolean;
-  tone?: string;
   onClick: () => void;
 }) {
-  const T = toneOf(tone);
   return (
     <button
       type="button"
       onClick={onClick}
       className={cn(
-        'inline-flex items-center gap-1 px-2 py-0.5 rounded text-[11px] border transition-colors',
+        'inline-flex items-center gap-1 px-2 py-0.5 rounded-md text-[11px] border transition-colors',
         active
-          ? cn(T.bg, T.text, T.border, 'font-medium')
-          : 'bg-slate-50 text-slate-500 border-slate-200 hover:bg-slate-100',
+          ? 'bg-sky-50 text-sky-700 border-sky-200 font-medium'
+          : 'bg-white text-slate-500 border-slate-200 hover:bg-slate-50',
       )}
     >
       <span>{label}</span>
       <span
         className={cn(
           'tabular-nums text-[10px] px-1 rounded',
-          active ? 'bg-white/60' : 'bg-slate-200/60 text-slate-600',
+          active ? 'bg-sky-100 text-sky-700' : 'bg-slate-100 text-slate-500',
         )}
       >
         {count}
@@ -329,22 +419,26 @@ interface FactMeta {
   Icon: React.ComponentType<{ className?: string }>;
 }
 
+// W4 末降噪 — 全局只 3 语义色:rose(异常/警示)/emerald(钱进来)/amber(警告) — 其它 slate 灰
+//   icon 已表达类型,不再用颜色重复表达 fact 大类
+//   appointment.tone='slate' 默认,status=no_show/cancelled 时 TimelineRow.computeEffectiveTone 升 amber
 const FACT_META: Record<string, FactMeta> = {
   diagnosis_record: { label: '诊断', tone: 'rose', Icon: AlertTriangle },
-  treatment_record: { label: '治疗', tone: 'teal', Icon: Stethoscope },
-  recommendation_record: { label: '医嘱', tone: 'indigo', Icon: Pill },
-  encounter_record: { label: '接诊', tone: 'slate', Icon: UserRound },
-  emr_record: { label: '病历', tone: 'sky', Icon: FileText },
-  image_record: { label: '影像', tone: 'violet', Icon: ImageIcon },
-  appointment_record: { label: '预约', tone: 'amber', Icon: Calendar },
-  payment_record: { label: '收款', tone: 'emerald', Icon: CircleDollarSign },
+  complaint_record: { label: '投诉', tone: 'rose', Icon: AlertOctagon },
   refund_record: { label: '退费', tone: 'rose', Icon: Undo2 },
-  consultation_record: { label: '咨询', tone: 'sky', Icon: MessageCircle },
-  visit_registration_record: { label: '挂号', tone: 'slate', Icon: ClipboardList },
-  order_record: { label: '医嘱单', tone: 'emerald', Icon: Receipt },
+  payment_record: { label: '收款', tone: 'emerald', Icon: CircleDollarSign },
   recharge_record: { label: '充值', tone: 'emerald', Icon: Wallet },
-  complaint_record: { label: '投诉', tone: 'rose', Icon: AlertOctagon },
-  referral_record: { label: '转介', tone: 'indigo', Icon: Users },
+  // 其它一律 slate(默认),仅 icon 区分
+  treatment_record: { label: '治疗', tone: 'slate', Icon: Stethoscope },
+  recommendation_record: { label: '医嘱', tone: 'slate', Icon: Pill },
+  encounter_record: { label: '接诊', tone: 'slate', Icon: UserRound },
+  emr_record: { label: '病历', tone: 'slate', Icon: FileText },
+  image_record: { label: '影像', tone: 'slate', Icon: ImageIcon },
+  appointment_record: { label: '预约', tone: 'slate', Icon: Calendar },
+  consultation_record: { label: '咨询', tone: 'slate', Icon: MessageCircle },
+  visit_registration_record: { label: '挂号', tone: 'slate', Icon: ClipboardList },
+  order_record: { label: '医嘱单', tone: 'slate', Icon: Receipt },
+  referral_record: { label: '转介', tone: 'slate', Icon: Users },
 };
 
 const FACT_META_FALLBACK: FactMeta = { label: '事实', tone: 'slate', Icon: FileText };
@@ -370,14 +464,6 @@ const TONE = {
 
 const toneOf = (tone: string): ToneCls => (TONE as Record<string, ToneCls>)[tone] ?? TONE_FALLBACK;
 
-const FACT_STATUS_ZH: Record<string, string> = {
-  active: '当前',
-  superseded: '已替代',
-  cancelled: '已取消',
-  fulfilled: '已完成',
-  expired: '已过期',
-  invalidated: '已失效',
-};
 
 const APPT_STATUS_ZH: Record<string, string> = {
   scheduled: '待就诊',
@@ -390,14 +476,6 @@ const APPT_STATUS_ZH: Record<string, string> = {
   walk_in: '现场加号',
 };
 
-const TX_STATUS_ZH: Record<string, string> = {
-  planned: '计划中',
-  in_progress: '进行中',
-  completed: '已完成',
-  cancelled: '已取消',
-  failed: '失败',
-};
-
 const MODALITY_ZH: Record<string, string> = {
   pa: '根尖片',
   bw: '咬翼片',
@@ -478,114 +556,85 @@ function truncate(s: string, n: number): string {
 function factSummary(f: AdaptedFact): { title: string; note: string } {
   const c = (f.content ?? {}) as Record<string, unknown>;
   const doctor = (c.doctor_name as string | undefined) ?? '';
+  const dr = doctor ? `${doctor}医生` : '';
   switch (f.type) {
     case 'diagnosis_record': {
       const code = (c.code as string) ?? '?';
       const name = (c.name_zh as string) ?? (c.name as string) ?? '';
-      const tooth = (c.tooth_position as string) ?? '';
-      return {
-        title: name || code,
-        note: [tooth && `牙位 ${formatToothPosition(tooth, 4)}`, doctor && `${doctor}医生`].filter(Boolean).join(' · '),
-      };
+      return { title: name || code, note: dr };
     }
     case 'treatment_record': {
       const cat = (c.category as string) ?? '';
       const sub = (c.subtype as string) ?? '';
-      const tooth = (c.tooth_position as string) ?? '';
       const qty = c.quantity != null ? Number(c.quantity) : null;
       const unit = (c.unit_name as string) ?? '';
       const qtyStr = qty != null && qty > 0 ? `${qty}${unit ? ' ' + unit : ''}` : '';
-      // status 不在 note 显示:fact.status chip 已表达"已完成/已取消"
       return {
         title: sub || treatmentCategoryNameZh(cat) || '治疗',
-        note: [qtyStr, tooth && `牙位 ${formatToothPosition(tooth, 4)}`, doctor && `${doctor}医生`].filter(Boolean).join(' · '),
+        note: [qtyStr, dr].filter(Boolean).join(' · '),
       };
     }
     case 'recommendation_record': {
       const code = (c.code as string) ?? '?';
-      const tooth = (c.tooth_position as string) ?? '';
-      return {
-        title: `建议 ${code}`,
-        note: [tooth && `牙位 ${formatToothPosition(tooth, 4)}`, doctor && `${doctor}医生`].filter(Boolean).join(' · '),
-      };
+      return { title: `建议 ${code}`, note: dr };
     }
     case 'encounter_record': {
       const etype = (c.encounter_type as string) ?? '';
       const chief = (c.chief_complaint as string) ?? '';
       const etypeZh = etype ? ENCOUNTER_TYPE_ZH[etype] ?? etype : '';
-      // title 优先用 chief_complaint 主诉(最有信息),fallback 用初/复诊;不写"接诊"(chip 重复)
-      const title = chief
-        ? truncate(chief, 24)
-        : etypeZh
-          ? etypeZh
-          : '到诊';
-      return {
-        title,
-        note: [etypeZh && chief && etypeZh, doctor && `${doctor}医生`].filter(Boolean).join(' · '),
-      };
+      const title = chief ? truncate(chief, 32) : etypeZh || '到诊';
+      return { title, note: dr };
     }
     case 'emr_record': {
-      // 主诉(L1)+ 治疗计划/处置(L2)+ 医生 — raw id / pre_illness(跟 illness_desc 重复)移除
-      // title 不再加"病历"前缀(chip 已表达)
       const ill = (c.illness_desc as string) ?? '';
       const plan = (c.treatment_plan as string) ?? '';
       const disp = parseFirstMessage(c.disposal);
       const planText = plan || disp;
       return {
-        title: ill ? truncate(ill, 30) : '病历记录',
-        note: [planText && `计划:${truncate(planText, 30)}`, doctor && `${doctor}医生`].filter(Boolean).join(' · '),
+        title: ill ? truncate(ill, 36) : '病历记录',
+        note: [planText && `计划:${truncate(planText, 36)}`, dr].filter(Boolean).join(' · '),
       };
     }
     case 'image_record': {
       const mod = (c.modality as string) ?? '';
       const finding = (c.finding as string) ?? '';
-      const tooths = (c.tooth_positions as string | string[] | null) ?? null;
-      const toothStr = Array.isArray(tooths) ? tooths.join(';') : tooths || '';
       const modZh = MODALITY_ZH[mod] ?? mod ?? '影像';
+      // title 优先 finding(有内容时更直观),fallback modality
       return {
-        title: modZh,
-        note: [
-          toothStr && `牙位 ${formatToothPosition(toothStr, 4)}`,
-          finding && truncate(finding, 30),
-          doctor && `${doctor}医生`,
-        ]
-          .filter(Boolean)
-          .join(' · '),
+        title: finding ? truncate(finding, 32) : modZh,
+        note: [finding && modZh, dr].filter(Boolean).join(' · '),
       };
     }
     case 'appointment_record': {
-      const at = (c.scheduled_at as string) ?? '';
       const type = (c.appointment_type as string) ?? '';
-      const st = (c.status as string) ?? '';
       const cancel = (c.cancellation_reason as string) ?? '';
       const complaint = (c.complaint_text as string) ?? (c.complaint_category as string) ?? '';
-      const time = at ? hhmm(at) : '';
       const typeZh = type ? APPT_TYPE_ZH[type] ?? type : '';
-      // title 不加"预约"前缀(chip 已表达);用 type 翻译 + 时段
-      // status 仅在非默认态(no_show / cancelled / rescheduled / arrived)时显示,避免普通"scheduled" 噪音
-      const showStatus = st && st !== 'scheduled' && st !== 'completed';
+      // title:type + 主诉(时间/状态在右列展示)
       return {
-        title: [typeZh, time].filter(Boolean).join(' · ') || '预约',
-        note: [
-          complaint && truncate(complaint, 20),
-          showStatus && (APPT_STATUS_ZH[st] ?? st),
-          cancel && `取消原因:${truncate(cancel, 16)}`,
-        ]
-          .filter(Boolean)
-          .join(' · '),
+        title: [typeZh, complaint && truncate(complaint, 18)].filter(Boolean).join(' · ') || '预约',
+        note: [cancel && `取消原因:${truncate(cancel, 16)}`, dr].filter(Boolean).join(' · '),
       };
     }
     case 'payment_record': {
-      // title 不加"收款"前缀(chip 已表达),直接金额;note 显示渠道翻译
-      const cents = Number(c.amount_cents ?? 0);
+      // 金额在右列;title 用渠道翻译
+      const ch = (c.channel as string) ?? '';
+      const chZh = CHANNEL_ZH[ch] ?? ch;
+      return { title: chZh || '收款', note: dr };
+    }
+    case 'recharge_record': {
       const ch = (c.channel as string) ?? '';
       const chZh = CHANNEL_ZH[ch] ?? ch;
-      return { title: `¥${(cents / 100).toFixed(2)}`, note: chZh };
+      return { title: chZh || '充值', note: dr };
+    }
+    case 'order_record': {
+      const items = (c.items as Array<Record<string, unknown>> | undefined) ?? [];
+      const itemNames = items.map((i) => String(i?.name ?? '')).filter(Boolean);
+      return { title: itemNames.length > 0 ? truncate(itemNames.join(';'), 28) : '医嘱单', note: dr };
     }
     case 'refund_record': {
-      const cents = Number(c.amount_cents ?? 0);
       const reason = (c.reason as string) ?? '';
-      return { title: `¥${(cents / 100).toFixed(2)}`, note: reason };
+      return { title: reason || '退费', note: dr };
     }
     default: {
       return { title: f.title ?? f.type, note: f.summary ?? '' };

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

@@ -6,7 +6,6 @@
  */
 
 import {
-  ExecutionOutcome,
   ExecutionChannel,
   PersonaFeatureKey,
   PlanScenario,
@@ -452,29 +451,9 @@ export const mockScript = {
 };
 
 // ────────────────────────────────────────────────
-// Outcome 枚举(对齐系统 ExecutionOutcome + 演示扩展)
+// Outcome 枚举 — 已迁移到 @pac/types EXECUTION_OUTCOME_META(单一真理源)
+// outcome-form.tsx 直接从 types 拉,前后端共享 label / tone / drivesStatus
+// 这里不再维护;改 outcome 改 packages/types/src/enums/index.ts
 // ────────────────────────────────────────────────
-export type OutcomeOption = {
-  value: string;
-  label: string;
-  tone: string;
-  drives: 'completed' | 'assigned' | 'active' | 'abandoned';
-};
-
-export const outcomeOptions: OutcomeOption[] = [
-  { value: ExecutionOutcome.SUCCESS_APPOINTED, label: '成功转化为新预约', tone: 'emerald', drives: 'completed' },
-  { value: ExecutionOutcome.SCHEDULED_NEXT, label: '约定下次回访', tone: 'amber', drives: 'assigned' },
-  { value: 'considering', label: '考虑中,近期再跟进', tone: 'amber', drives: 'assigned' },
-  { value: 'needs_doctor', label: '需要找医生', tone: 'sky', drives: 'assigned' },
-  { value: 'rescheduled', label: '改约', tone: 'sky', drives: 'assigned' },
-  { value: ExecutionOutcome.NO_ANSWER, label: '未接通', tone: 'slate', drives: 'active' },
-  { value: 'sms_sent', label: '电话未接,已发短信', tone: 'slate', drives: 'active' },
-  { value: 'declined_recent', label: '近期不考虑', tone: 'rose', drives: 'abandoned' },
-  { value: 'refused', label: '明确拒绝', tone: 'rose', drives: 'abandoned' },
-  { value: 'external_treatment', label: '已在外院治疗', tone: 'rose', drives: 'abandoned' },
-  { value: 'pending_info', label: '需进一步确认信息', tone: 'slate', drives: 'assigned' },
-  { value: 'marked_invalid', label: '标记为无效', tone: 'rose', drives: 'abandoned' },
-  { value: ExecutionOutcome.ABANDONED, label: '客服放弃', tone: 'rose', drives: 'abandoned' },
-];
 
 export { NOW };

apps/pac-web/src/components/plan-detail/outcome-form.tsx

 'use client';
 
 import { useState } from 'react';
+import { EXECUTION_OUTCOME_META, type ExecutionOutcome } from '@pac/types';
 import { cn } from '@/lib/utils';
 import { tone } from './shared';
-import type { OutcomeOption } from './mock-data';
+
+/// outcome 选项从 @pac/types EXECUTION_OUTCOME_META 派生(单一真理源,跟后端共享)
+/// 改 enum / label / 状态机映射只在 packages/types 一处改,前后端同步生效
+const OUTCOME_OPTIONS = (
+  Object.entries(EXECUTION_OUTCOME_META) as Array<[ExecutionOutcome, (typeof EXECUTION_OUTCOME_META)[ExecutionOutcome]]>
+).map(([value, meta]) => ({
+  value,
+  label: meta.labelZh,
+  tone: meta.tone,
+  drives: meta.drivesStatus,
+}));
 
 const CHANNELS = [
   {
@@ -26,23 +37,24 @@ const CHANNELS = [
   },
 ];
 
+/// drivesStatus → 用户口径中文提示
+///   completed — 终态(成功转化 / 客户决策放弃跟进)
+///   abandoned — 终态(系统层面无效或客服主动放弃)
+///   keep      — 任务保留等下次跟进(熔断器到上限会自动 abandon)
 const STATE_HINTS: Record<string, string> = {
   completed: '本次任务将结案',
   abandoned: '本次任务将关闭(放弃)',
-  assigned: '本次任务保留,等下次跟进',
-  active: '本次任务退回召回池等下次',
+  keep: '本次任务保留,等下次跟进',
 };
 
 const ABANDON_REASONS = ['号码空号 / 错号', '已转介他人', '明确不需要治疗', '迁居外地', '投诉 / 不愿打扰', '其他'];
 
 export function OutcomeForm({
-  outcomeOptions,
   plan,
   onSubmit,
   onCreateAppointment,
   defaultChannel = 'phone',
 }: {
-  outcomeOptions: OutcomeOption[];
   plan: { contactAttempts: number };
   onSubmit: (data: {
     channel: string;
@@ -61,7 +73,7 @@ export function OutcomeForm({
   const [abandonReasons, setAbandonReasons] = useState<string[]>([]);
   const [submitted, setSubmitted] = useState(false);
 
-  const cur = outcomeOptions.find((o) => o.value === outcome);
+  const cur = OUTCOME_OPTIONS.find((o) => o.value === outcome);
   const needsScheduledNext =
     !!outcome && ['scheduled_next', 'considering', 'rescheduled', 'pending_info'].includes(outcome);
   const needsAbandonReasons = !!outcome && ['abandoned', 'refused', 'declined_recent'].includes(outcome);
@@ -127,7 +139,7 @@ export function OutcomeForm({
           通话结果 <span className="text-rose-500">*</span>
         </div>
         <div className="grid grid-cols-2 gap-1">
-          {outcomeOptions.map((o) => {
+          {OUTCOME_OPTIONS.map((o) => {
             const T = tone(o.tone);
             const selected = o.value === outcome;
             return (

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

@@ -2,6 +2,7 @@
 
 import { useEffect, useMemo, useState, type ReactNode } from 'react';
 import { toast } from 'sonner';
+import { RefreshCw } from 'lucide-react';
 import { plansApi } from '@/components/plans/plans-api';
 import { useAuthStore } from '@/stores/auth-store';
 import {
@@ -24,7 +25,6 @@ import {
   mockPlan,
   mockSummaries,
   mockScript,
-  outcomeOptions as mockOutcomes,
   fmtRel as mockFmtRel,
   type PlanReason,
 } from './mock-data';
@@ -42,7 +42,6 @@ export type PlanDetailAppData = {
   facts?: AdaptedFact[];
   summaries: typeof mockSummaries;
   script: typeof mockScript;
-  outcomeOptions: typeof mockOutcomes;
   fmtRel: typeof mockFmtRel;
 };
 
@@ -54,18 +53,22 @@ const FALLBACK_DATA: PlanDetailAppData = {
   facts: [],
   summaries: mockSummaries,
   script: mockScript,
-  outcomeOptions: mockOutcomes,
   fmtRel: mockFmtRel,
 };
 
 export function PlanDetailApp({
   data = FALLBACK_DATA,
   banner,
+  /// W4 末:单患者从 DW 直连刷新成功后,触发外层 usePlanAggregate.refresh()
+  /// 拉新 plan 详情 — 若 plan 已消失(scenario 不再命中),loader 层 useEffect
+  /// 会捕获 PLAN_NOT_FOUND 自动跳列表 + toast
+  onRefreshAggregate,
 }: {
   data?: PlanDetailAppData;
   banner?: ReactNode;
+  onRefreshAggregate?: () => void | Promise<void>;
 }) {
-  const { patient, chains, persona, plan, summaries, script, outcomeOptions, fmtRel } = data;
+  const { patient, chains, persona, plan, summaries, script, fmtRel } = data;
   const facts = data.facts ?? [];
   const [drawerOpen, setDrawerOpen] = useState<DrawerKind>(null);
   const [scriptMode, setScriptMode] = useState<ScriptViewMode>('markdown');
@@ -195,7 +198,13 @@ export function PlanDetailApp({
       style={{ fontFamily: '"PingFang SC", "Noto Sans CJK SC", system-ui, sans-serif' }}
     >
       {banner}
-      <TopBar plan={plan} reason={reasons[0]!} />
+      <TopBar
+        plan={plan}
+        reason={reasons[0]!}
+        patientId={patient.id}
+        onRefreshAggregate={onRefreshAggregate}
+        showToast={showToast}
+      />
 
       <div className="flex-1 min-h-0">
         <div className="h-full mx-auto px-5 py-3">
@@ -331,10 +340,24 @@ export function PlanDetailApp({
                   )}
                 </div>
                 <AIDisclaimerFooter
-                  onFeedback={(v) =>
-                    showToast(v === 'up' ? 'emerald' : 'amber', '感谢反馈',
-                      v === 'up' ? '该话术已标记为有用' : '该话术已标记为待改进 · 已上报给 AI 训练')
-                  }
+                  onFeedback={async (v) => {
+                    try {
+                      const r = await plansApi.submitScriptFeedback(plan.id, v);
+                      if (!r.ok) {
+                        // 后端找不到 invocation(纯模板兜底或老数据无 invocation 关联)
+                        showToast('slate', '本话术暂无 AI 调用记录', '兜底模板话术无法评价');
+                        return;
+                      }
+                      showToast(
+                        v === 'up' ? 'emerald' : 'amber',
+                        v === 'up' ? '感谢反馈 · 已标记为有用' : '感谢反馈 · 已标记为待改进',
+                        '用于后续 AI 话术优化',
+                      );
+                    } catch (err) {
+                      const msg = err instanceof Error ? err.message : String(err);
+                      showToast('rose', '反馈提交失败', msg.slice(0, 100));
+                    }
+                  }}
                 />
               </section>
             </main>
@@ -350,7 +373,6 @@ export function PlanDetailApp({
                 </header>
                 <div className="flex-1 min-h-0 overflow-y-auto p-3">
                   <OutcomeForm
-                    outcomeOptions={outcomeOptions}
                     plan={effectivePlan}
                     onSubmit={submitOutcome}
                     defaultChannel={effectivePlan.recommendedChannel}
@@ -389,11 +411,46 @@ export function PlanDetailApp({
 function TopBar({
   plan,
   reason,
+  patientId,
+  onRefreshAggregate,
+  showToast,
 }: {
   plan: typeof mockPlan;
   reason: typeof mockPlan.reasons[0];
+  patientId?: string;
+  onRefreshAggregate?: () => void | Promise<void>;
+  showToast?: (kind: string, title: string, msg: string) => void;
 }) {
   const user = useAuthStore((s) => s.user);
+  const [refreshing, setRefreshing] = useState(false);
+
+  /// W4 末:从 DW 直连重拉该 patient 全量数据 → 触发 persona + plan 重算
+  /// 完成后调外层 refresh() 拿新 plan;plan 没了(scenario 不再命中)由 loader 层
+  /// useEffect 捕获 PLAN_NOT_FOUND 自动跳列表
+  const handleRefresh = async () => {
+    if (refreshing || !patientId) return;
+    setRefreshing(true);
+    try {
+      const r = await plansApi.refreshPatient(patientId);
+      const facts = r.factsEmitted ?? 0;
+      // 用户口径(不暴露 txn / plan 内部计数):
+      //   - facts > 0  → 发现 N 项更新
+      //   - facts = 0  → 已是最新(数据无变化)
+      const msg = facts > 0
+        ? `发现 ${facts} 项更新`
+        : '本次同步未发现新数据';
+      showToast?.('emerald', '已同步该患者最新资料', msg);
+      // 触发外层 usePlanAggregate refetch — 若 plan 已被 supersede / abandoned,
+      // /full 返回 PLAN_NOT_FOUND → loader 层 useEffect 跳列表 + toast
+      if (onRefreshAggregate) await onRefreshAggregate();
+    } catch (err) {
+      const msg = err instanceof Error ? err.message : String(err);
+      showToast?.('rose', '刷新失败', msg.slice(0, 100));
+    } finally {
+      setRefreshing(false);
+    }
+  };
+
   return (
     <header className="flex flex-none items-center justify-between gap-3 border-b border-slate-200 bg-white px-5 py-3">
       <div className="flex min-w-0 items-center gap-3">
@@ -417,6 +474,24 @@ function TopBar({
         <PriorityBar score={plan.priorityScore} label="优先级" />
       </div>
       <div className="flex flex-none items-center gap-3 text-[11px] text-slate-600">
+        {/* W4 末:从 DW 直连重拉该 patient 最新数据(单患者,跟 daily incremental cursor 隔离)*/}
+        {patientId && (
+          <button
+            type="button"
+            onClick={handleRefresh}
+            disabled={refreshing}
+            title={refreshing ? '正在从 DW 拉数据并重算…' : '从 DW 直连重拉该患者最新数据 → 触发画像+召回重算'}
+            className={cn(
+              'inline-flex items-center gap-1.5 rounded-md border px-2.5 py-1 text-[11.5px] font-medium transition-colors',
+              refreshing
+                ? 'cursor-not-allowed border-slate-200 bg-slate-50 text-slate-400'
+                : 'border-slate-200 bg-white text-slate-700 hover:border-teal-300 hover:bg-teal-50 hover:text-teal-700',
+            )}
+          >
+            <RefreshCw className={cn('h-3.5 w-3.5', refreshing && 'animate-spin')} />
+            <span>{refreshing ? '同步中…' : '刷新'}</span>
+          </button>
+        )}
         {/* 保留要素:回收倒计时 */}
         <RecycleCountdown recycleAt={plan.recycleAt} />
         {/* 跟列表页一致:用户信息 + 头像 */}
@@ -438,7 +513,7 @@ function TopBar({
 function AIDisclaimerFooter({
   onFeedback,
 }: {
-  onFeedback: (v: 'up' | 'down') => void;
+  onFeedback: (v: 'up' | 'down') => void | Promise<void>;
 }) {
   const [chosen, setChosen] = useState<'up' | 'down' | null>(null);
   const click = (v: 'up' | 'down') => {

apps/pac-web/src/components/plans/plans-api.ts

@@ -49,4 +49,26 @@ export const plansApi = {
     api.get<{ phone: string | null }>(
       `/pac/v1/patients/${encodeURIComponent(patientId)}/phone-reveal`,
     ),
+
+  /** W4 末:话术 thumbs up/down 反馈("本段是否好用")
+   *  - POST /pac/v1/plans/:id/script-feedback { feedback: 'up'|'down' }
+   *  - 写入 agent_invocations.user_feedback;同 invocation 反复点会覆盖以最新为准 */
+  submitScriptFeedback: (planId: string, feedback: 'up' | 'down') =>
+    api.post<{ ok: boolean; invocationId?: string; reason?: string }>(
+      `/pac/v1/plans/${encodeURIComponent(planId)}/script-feedback`,
+      { feedback },
+    ),
+
+  /** W4 末:单患者按需刷新(从 DW 直连重拉该 patient 全量,触发 persona+plan recompute)
+   *  - POST /sync/patient/:id/refresh
+   *  - 跟 daily incremental cursor 完全隔离(resource='patient_refresh')
+   *  - 返回新 plansCreated:0 = plan 已消失(scenario 不再命中),前端应跳列表 */
+  refreshPatient: (patientId: string) =>
+    api.post<{
+      syncLogId: string;
+      status: string;
+      transactionsWritten?: number;
+      factsEmitted?: number;
+      plansCreated?: number;
+    }>(`/pac/v1/sync/patient/${encodeURIComponent(patientId)}/refresh`),
 };

apps/pac-web/src/components/ui/toaster.tsx

@@ -5,7 +5,7 @@ import { Toaster as SonnerToaster } from 'sonner';
 export function Toaster() {
   return (
     <SonnerToaster
-      position="bottom-right"
+      position="top-center"
       richColors
       closeButton
       toastOptions={{

apps/pac-web/src/lib/auth-api.ts

@@ -2,6 +2,8 @@
 
 import type {
   ExchangeCodeResponse,
+  MockLoginRequest,
+  MockLoginResponse,
   RefreshTokenResponse,
 } from '@pac/types';
 import { api } from './api-client';
@@ -21,3 +23,9 @@ export async function refreshToken(token: string): Promise<RefreshTokenResponse>
     { auth: false },
   );
 }
+
+/// Mock login(开发 / 试部署用)— 按 { tenant, role } 预制 user 直产 JWT
+/// 生产 host SSO 接入后,后端 env PAC_ENABLE_MOCK_LOGIN=false 关闭,此调用会返 10107
+export async function mockLogin(req: MockLoginRequest): Promise<MockLoginResponse> {
+  return api.post<MockLoginResponse>('/pac/v1/auth/mock-login', req, { auth: false });
+}

deploy/README.md

+# PAC 部署运维
+
+> W4 末:试部署阶段手动 ssh + 跑脚本;W5+ 接 CI/CD 自动化。
+
+## 文件清单
+
+| 文件 | 用途 |
+|---|---|
+| `deploy.sh` | 一键部署 — `bash deploy.sh staging|production` |
+| `systemd/pac-service.service` | NestJS 后端 systemd unit 模板 |
+| `systemd/pac-web.service` | Next.js 前端 systemd unit 模板 |
+
+跟 `docs/deployment-data-ingest.md` 配合看 — 那份讲数据 / 监控,本目录讲部署机制。
+
+---
+
+## 首次部署 SOP(staging / production 通用)
+
+### 1. 服务器基础环境
+
+```bash
+# Ubuntu 22.04 假设
+sudo apt update && sudo apt install -y curl git docker.io
+curl -fsSL https://deb.nodesource.com/setup_20.x | sudo -E bash -
+sudo apt install -y nodejs
+sudo npm i -g pnpm@9
+
+# 创建专用账号
+sudo useradd -m -s /bin/bash pac
+sudo mkdir -p /var/log/pac && sudo chown pac:pac /var/log/pac
+```
+
+### 2. 起 Postgres + Redis(docker 跑法,简单部署够用)
+
+```bash
+sudo docker run -d --name pac-postgres --restart unless-stopped \
+  -p 127.0.0.1:5432:5432 \
+  -e POSTGRES_USER=pac \
+  -e POSTGRES_PASSWORD=<强密码> \
+  -e POSTGRES_DB=pac \
+  -v pac-pg-data:/var/lib/postgresql/data \
+  postgres:15
+
+sudo docker run -d --name pac-redis --restart unless-stopped \
+  -p 127.0.0.1:6379:6379 \
+  -v pac-redis-data:/data \
+  redis:7-alpine
+```
+
+生产建议用托管 RDS / 云 Redis(本地 docker 数据风险)。
+
+### 3. 拉代码 + 配 env
+
+```bash
+sudo mkdir -p /opt/pac && sudo chown pac:pac /opt/pac
+sudo -u pac git clone <your-repo> /opt/pac
+
+# 后端 env
+sudo -u pac cp /opt/pac/apps/pac-service/.env.example /opt/pac/apps/pac-service/.env
+sudo -u pac vim /opt/pac/apps/pac-service/.env
+# → 改 NODE_ENV / DATABASE_URL / REDIS_URL / JWT_* / DW_* / DEEPSEEK_API_KEY
+# → staging 还要 PAC_ENABLE_MOCK_LOGIN=true / PAC_INCREMENTAL_CRON=30 3 * * *
+# → production 要 PAC_ENABLE_MOCK_LOGIN=false / 自己的 prod 配置
+sudo chmod 600 /opt/pac/apps/pac-service/.env
+
+# 前端 env(NEXT_PUBLIC_API_BASE_URL build-time 嵌入)
+sudo -u pac vim /opt/pac/apps/pac-web/.env
+# NEXT_PUBLIC_API_BASE_URL=https://pac-staging.your-domain.com
+# (staging / prod 必须各 build 一次,产物不可互换)
+```
+
+### 4. 安装 systemd unit
+
+```bash
+sudo cp /opt/pac/deploy/systemd/pac-service.service /etc/systemd/system/
+sudo cp /opt/pac/deploy/systemd/pac-web.service /etc/systemd/system/
+sudo systemctl daemon-reload
+sudo systemctl enable pac-service pac-web
+```
+
+允许 `pac` 用户 systemctl restart 这两个 service(deploy.sh 需要):
+
+```bash
+sudo visudo -f /etc/sudoers.d/pac
+# 加一行:
+# pac ALL=(root) NOPASSWD: /bin/systemctl restart pac-service, /bin/systemctl restart pac-web
+```
+
+### 5. 首次部署
+
+```bash
+sudo -u pac bash /opt/pac/deploy/deploy.sh staging
+# 或
+sudo -u pac bash /opt/pac/deploy/deploy.sh production
+```
+
+### 6. 验证
+
+```bash
+curl http://localhost:3001/health         # 应返 {"status":"ok"} 或类似
+curl http://localhost:3000                # Next.js 首页 HTML
+journalctl -u pac-service -n 50 -f        # 看日志
+journalctl -u pac-web -n 50 -f
+```
+
+浏览器开 `https://<your-domain>/plans` — staging 应看到"快速登录"对话框。
+
+---
+
+## 日常部署(代码改了重新部署)
+
+```bash
+ssh deploy@<server>
+sudo -u pac bash /opt/pac/deploy/deploy.sh staging
+```
+
+5-10 分钟完成,期间 service 短暂中断(restart 瞬时)。零停机部署需要 blue-green,W5+ 上。
+
+---
+
+## 数据冷启 / 首次 DW 灌库
+
+```bash
+sudo -u pac bash -c 'cd /opt/pac/apps/pac-service && pnpm cold-import -- --dir=./data/jvs-dw'
+# 生产首跑前:务必把 manifest.yaml 里 cohort 的 LIMIT 100 OFFSET 100 去掉(13 万患者全量)
+```
+
+完成后:
+```bash
+sudo -u pac bash -c 'cd /opt/pac/apps/pac-service && pnpm recompute-persona -- --host=jvs-dw'
+sudo -u pac bash -c 'cd /opt/pac/apps/pac-service && pnpm recompute-plans -- --host=jvs-dw'
+```
+
+之后 cron(02:30)自动维护增量,见 `docs/deployment-data-ingest.md` §三。
+
+---
+
+## 回滚
+
+```bash
+cd /opt/pac
+git log --oneline -10                       # 看历史
+git checkout <last-known-good-sha>
+sudo -u pac bash /opt/pac/deploy/deploy.sh staging   # 同 deploy 流程,只是 git pull 被 checkout 替换
+```
+
+⚠️ **DB schema 不会回退** — Prisma migration 是只前向,回滚老代码可能跟新 schema 不兼容。
+真要回滚 schema 得手写补 migration。生产 schema 变更前评估前向兼容。
+
+---
+
+## 监控 / 告警
+
+详见 `docs/deployment-data-ingest.md` §四。关键:
+- `journalctl -u pac-service -f | grep -E "ERROR|dw-lag"` 看错误 + 滞后告警
+- `psql -U pac -d pac -c "SELECT status, count(*) FROM sync_logs WHERE started_at > now()-'1d'::interval GROUP BY status;"` 看同步成功率
+- `/admin/queues` Bull Board 看队列

deploy/deploy.sh

+#!/usr/bin/env bash
+# ═══════════════════════════════════════════════════════════════════════
+# PAC 一键部署脚本(staging / production 通用)
+#
+# 用法(在服务器上):
+#   sudo -u pac bash /opt/pac/deploy/deploy.sh staging
+#   sudo -u pac bash /opt/pac/deploy/deploy.sh production
+#
+# 前置准备(首次):
+#   1. 服务器装 node 20+ / pnpm 9+ / docker / git
+#   2. git clone <repo> /opt/pac
+#   3. cp /opt/pac/apps/pac-service/.env.example /opt/pac/apps/pac-service/.env
+#      → vim 改:NODE_ENV / DATABASE_URL / REDIS_URL / JWT_* / DW_* / DEEPSEEK_*
+#      → chmod 600 .env
+#   4. cp /opt/pac/apps/pac-web/.env.example /opt/pac/apps/pac-web/.env  (NEXT_PUBLIC_*)
+#   5. docker run -d pac-postgres / pac-redis(或独立托管实例)
+#   6. systemctl enable pac-service pac-web(systemd unit 见 deploy/systemd/)
+#
+# 部署流程:
+#   git pull → install → build types → migrate deploy → build service+web → restart
+#
+# 安全:
+#   - 不会跑 prisma migrate dev / reset(生产数据安全)
+#   - 不会改 .env(只读)
+#   - 失败任一步立刻停(set -e)
+# ═══════════════════════════════════════════════════════════════════════
+set -euo pipefail
+
+ENV="${1:-}"
+if [[ "$ENV" != "staging" && "$ENV" != "production" ]]; then
+  echo "❌ 必须指定环境: bash $0 staging|production"
+  exit 1
+fi
+
+# 锁:防并发部署
+LOCK="/tmp/pac-deploy.lock"
+if [[ -e "$LOCK" ]]; then
+  echo "❌ 另一次部署正在跑(/tmp/pac-deploy.lock 存在)。如确定无并发,rm $LOCK 后重试"
+  exit 1
+fi
+touch "$LOCK"
+trap 'rm -f "$LOCK"' EXIT
+
+REPO_DIR="${PAC_REPO_DIR:-/opt/pac}"
+cd "$REPO_DIR"
+
+echo "═══════════════════════════════════════════════════════════"
+echo "▶ PAC 部署 — 环境: $ENV / repo: $REPO_DIR / $(date '+%F %T')"
+echo "═══════════════════════════════════════════════════════════"
+
+# ─── 1. git pull ───
+echo "▶ 1/7 git pull"
+BRANCH=$([[ "$ENV" == "production" ]] && echo "main" || echo "main")  # 都拉 main;后续可拆 staging 分支
+git fetch --quiet
+git checkout "$BRANCH"
+BEFORE_HEAD=$(git rev-parse --short HEAD)
+git pull --ff-only
+AFTER_HEAD=$(git rev-parse --short HEAD)
+echo "  $BEFORE_HEAD → $AFTER_HEAD"
+
+# ─── 2. 依赖 ───
+echo "▶ 2/7 pnpm install"
+pnpm install --frozen-lockfile
+
+# ─── 3. types 包 ───
+echo "▶ 3/7 build @pac/types"
+pnpm --filter @pac/types build
+
+# ─── 4. DB migrations(只 deploy,不 reset)───
+echo "▶ 4/7 prisma migrate deploy"
+cd apps/pac-service
+pnpm exec prisma generate
+pnpm exec prisma migrate deploy
+cd "$REPO_DIR"
+
+# ─── 5. 编译后端 ───
+echo "▶ 5/7 build @pac/service"
+cd apps/pac-service
+rm -f tsconfig.tsbuildinfo  # 防 incremental cache 不输出 dist
+pnpm build
+cd "$REPO_DIR"
+
+# ─── 6. 编译前端(NEXT_PUBLIC_* 必须 build-time 嵌入,所以每个环境独立 build)───
+echo "▶ 6/7 build @pac/web"
+pnpm --filter @pac/web build
+
+# ─── 7. 重启服务 ───
+echo "▶ 7/7 restart services"
+if command -v systemctl >/dev/null 2>&1; then
+  sudo systemctl restart pac-service
+  sudo systemctl restart pac-web
+  sleep 3
+  systemctl is-active pac-service && echo "  ✓ pac-service active"
+  systemctl is-active pac-web     && echo "  ✓ pac-web active"
+else
+  # 兜底:pm2 / 裸 node
+  echo "  ⚠️ 未装 systemctl,需要手动重启 pac-service / pac-web"
+  exit 1
+fi
+
+echo
+echo "═══════════════════════════════════════════════════════════"
+echo "✓ 部署完成 — $AFTER_HEAD ($(date '+%F %T'))"
+echo "═══════════════════════════════════════════════════════════"
+echo "验证:"
+echo "  curl http://localhost:3001/health"
+echo "  打开 https://<your-domain>/plans"

deploy/systemd/pac-service.service

+[Unit]
+Description=PAC Service (NestJS API + Cron + BullMQ Worker)
+After=network.target postgresql.service redis.service
+
+[Service]
+Type=simple
+User=pac
+Group=pac
+WorkingDirectory=/opt/pac/apps/pac-service
+EnvironmentFile=/opt/pac/apps/pac-service/.env
+ExecStart=/usr/bin/node --enable-source-maps dist/main.js
+Restart=on-failure
+RestartSec=5s
+StandardOutput=append:/var/log/pac/pac-service.log
+StandardError=append:/var/log/pac/pac-service.error.log
+
+# 安全加固
+NoNewPrivileges=true
+PrivateTmp=true
+ProtectSystem=full
+ProtectHome=true
+
+[Install]
+WantedBy=multi-user.target

deploy/systemd/pac-web.service

+[Unit]
+Description=PAC Web (Next.js production)
+After=network.target pac-service.service
+
+[Service]
+Type=simple
+User=pac
+Group=pac
+WorkingDirectory=/opt/pac/apps/pac-web
+EnvironmentFile=/opt/pac/apps/pac-web/.env
+ExecStart=/usr/bin/pnpm start
+Restart=on-failure
+RestartSec=5s
+StandardOutput=append:/var/log/pac/pac-web.log
+StandardError=append:/var/log/pac/pac-web.error.log
+
+NoNewPrivileges=true
+PrivateTmp=true
+ProtectSystem=full
+ProtectHome=true
+
+[Install]
+WantedBy=multi-user.target

docs/.obsidian/workspace.json

@@ -13,12 +13,12 @@
             "state": {
               "type": "markdown",
               "state": {
-                "file": "algorithm/potential-treatment-recall-flow.md",
+                "file": "deployment-data-ingest.md",
                 "mode": "source",
                 "source": false
               },
               "icon": "lucide-file",
-              "title": "potential-treatment-recall-flow"
+              "title": "deployment-data-ingest"
             }
           }
         ]
@@ -186,9 +186,9 @@
   },
   "active": "5c26df11b9d3d65c",
   "lastOpenFiles": [
+    "algorithm/potential-treatment-recall-flow.md",
     "dw-data-source-issues.md",
     "db-suggest-after-review.md",
-    "algorithm/potential-treatment-recall-flow.md",
     "algorithm/potential-treatment-recall.md",
     "algorithm/canonical-fact-layer.md",
     "host-data-request-checklist-v2.md",

docs/deployment-data-ingest.md

+# PAC 服务器部署 + 数据摄入手册
+
+> **W4 起试部署:服务器架构 + 数据从 DW 一次冷启 → 日级增量自动跑 → 客服可见的全链路 SOP**
+> **目标读者**:运维 / 后端值班
+> **状态**:🟢 W4 末投产基线版
+
+---
+
+## 一、服务架构(单机最小版)
+
+```
+┌────────────────────────────────────────────────────────────────┐
+│ Server(2 核 8G 起步,生产建议 4 核 16G + SSD)                  │
+│                                                                 │
+│  ┌─────────────┐  ┌─────────────┐  ┌─────────────┐             │
+│  │ Postgres 15 │  │  Redis 7    │  │  pac-web    │             │
+│  │  :5432      │  │  :6379      │  │  :3000      │  Next.js    │
+│  │  pac DB     │  │ BullMQ /    │  │             │   prod build│
+│  │             │  │ session     │  │             │             │
+│  └──────┬──────┘  └──────┬──────┘  └──────┬──────┘             │
+│         │                │                │                     │
+│         └────────────────┼────────────────┘                     │
+│                          │                                       │
+│                  ┌───────▼────────┐                              │
+│                  │ pac-service    │  NestJS                      │
+│                  │  :3001         │   - HTTP API                 │
+│                  │                │   - BullMQ Worker            │
+│                  │                │   - Cron(增量同步/监控)    │
+│                  └───────┬────────┘                              │
+└──────────────────────────┼─────────────────────────────────────┘
+                           │ TCP/9000(ClickHouse 协议)
+                           ▼
+              ┌────────────────────────┐
+              │ 瑞尔 DW(阿里云 ADS)    │
+              │ cc-xxx.clickhouse.aliyuncs.com:9000 │
+              │ dw_group.fact_*_out     │
+              └────────────────────────┘
+```
+
+### 组件清单
+
+| 组件 | 端口 | 用途 | 数据敏感度 |
+|---|---|---|---|
+| Postgres 15 | 5432 | PAC 主数据(patients / facts / personas / plans / sync_logs) | 🔴 PII |
+| Redis 7 | 6379 | BullMQ 队列 + 会话 | 🟡 session token |
+| pac-service | 3001 | API + Cron + Worker | — |
+| pac-web | 3000 | 前端(Next.js) | — |
+| (远程)瑞尔 DW | 9000 | 数据源(只读),PAC 主动连 | 🔴 PII(只读) |
+
+**NOT 部署在 PAC 这边**:
+- 瑞尔 DW(host 那边维护)
+
+---
+
+## 二、首次部署 SOP
+
+### 2.1 环境准备
+
+```bash
+# 1. Docker / Docker Compose
+docker --version  # >= 24
+docker compose version
+
+# 2. Node.js 跟 pnpm(若不用 docker 跑 pac-service)
+node --version  # >= 20
+pnpm --version  # >= 9
+```
+
+### 2.2 拉代码 + 配 env
+
+```bash
+git clone <repo> /opt/pac && cd /opt/pac
+cp apps/pac-service/.env.example apps/pac-service/.env
+```
+
+**必填 env**(`apps/pac-service/.env`):
+
+```ini
+# ─── 基础 ───
+NODE_ENV=production
+PORT=3001
+LOG_LEVEL=info
+DATABASE_URL=postgresql://pac:<pwd>@localhost:5432/pac?schema=public
+REDIS_URL=redis://localhost:6379
+JWT_SECRET=<openssl rand -hex 32>
+JWT_REFRESH_SECRET=<openssl rand -hex 32>
+CORS_ORIGINS=https://<your-pac-web-domain>
+
+# ─── DW 直连 ───
+JVS_DW_CLICKHOUSE_PASSWORD=<DW 团队给的密码>
+# manifest.yaml 里 password_env: JVS_DW_CLICKHOUSE_PASSWORD
+
+# ─── AI(DeepSeek)───
+DEEPSEEK_API_KEY=<vendor 给的 key>
+DEEPSEEK_BASE_URL=https://api.deepseek.com
+AI_DEFAULT_MODEL=deepseek-v4-flash
+
+# ─── 增量同步定时 ───
+PAC_INCREMENTAL_CRON=30 2 * * *           # 每天 02:30(DW 02:00 刷完后)
+PAC_INCREMENTAL_HOSTS=jvs-dw              # 多 host 用逗号分隔
+PAC_INCREMENTAL_DATA_DIR=/opt/pac/apps/pac-service/data
+
+# ─── 数据滞后告警阈值 ───
+PAC_LAG_WARN_HOURS=24                     # > 24h 黄色 WARN
+PAC_LAG_ERROR_HOURS=48                    # > 48h 红色 ERROR
+```
+
+### 2.3 起 Postgres + Redis
+
+```bash
+docker run -d --name pac-postgres -p 5432:5432 \
+  -e POSTGRES_USER=pac -e POSTGRES_PASSWORD=<pwd> -e POSTGRES_DB=pac \
+  -v pac-pg-data:/var/lib/postgresql/data postgres:15
+
+docker run -d --name pac-redis -p 6379:6379 \
+  -v pac-redis-data:/data redis:7-alpine
+```
+
+### 2.4 构建 + 启动
+
+```bash
+cd /opt/pac
+pnpm install --frozen-lockfile
+pnpm --filter @pac/types build
+pnpm --filter @pac/service exec prisma migrate deploy
+pnpm --filter @pac/service exec prisma seed   # 写入 demo / jvs-dw host 行
+pnpm --filter @pac/service build              # 编译 NestJS
+pnpm --filter @pac/web build                  # Next.js prod build
+
+# 起 pac-service(systemd / pm2 二选一)
+cd apps/pac-service && node --enable-source-maps dist/src/main &
+
+# 起 pac-web
+cd apps/pac-web && pnpm start &
+```
+
+---
+
+## 三、数据摄入 SOP
+
+### 3.1 首次冷启动(Cold Import)— 把全量历史拉进 PAC
+
+**用途**:首次部署 / 重建库 / yaml 改大版本时
+
+**配置**:`apps/pac-service/data/jvs-dw/manifest.yaml` 里 `sql_source.queries` 各表 SQL。Dev 期间带 `LIMIT 100 OFFSET 100` 控量,**生产首跑前必须去掉 LIMIT**。
+
+```bash
+cd /opt/pac/apps/pac-service
+pnpm cold-import -- --dir=./data/jvs-dw
+# → 患者 100% 拉 / facts 全量 / 各表去重
+# 预估:13 万 patients ≈ 10-30 min,内存峰值 ~2GB
+```
+
+**verify**:
+```sql
+SELECT 'patients' AS t, count(*) FROM patients
+UNION ALL SELECT 'facts', count(*) FROM patient_facts
+UNION ALL SELECT 'failed_in_sync_log', failed FROM sync_logs ORDER BY started_at DESC LIMIT 1;
+-- failed 应当 = 0
+```
+
+冷启完成后,**手动触发一次 persona + plan**:
+```bash
+pnpm recompute-persona -- --host=jvs-dw
+pnpm recompute-plans -- --host=jvs-dw
+```
+
+### 3.2 日级增量(Incremental Sync)— 自动跑,无需人工
+
+**机制**:`SyncIncrementalSchedulerService` `@Cron` 注解,服务起来自动注册。
+
+```
+每天 02:30(可改 PAC_INCREMENTAL_CRON env)
+   ↓
+ColdImportService.importDirectory({ incremental: true })
+   - 读 sync_logs 上次 cursor_after → SQL 注入 WHERE updated_date > '...'
+   - 拉到新/改的 fact 行 + 反向拉主档(C 方案)+ stub auto-create(A 方案)
+   - 写新 cursor 到 sync_logs
+   ↓
+Persona recompute(本次涉及的 distinct patient)
+   ↓
+Plan recompute(per tenant — SQL 召回 + 6 因子打分)
+   ↓
+Sync log status=success,带每表 cursor_after JSON
+```
+
+**结果可见**:DW 今天的新数据 → 明天早晨 03:00 ± 客服工作台可见。
+
+**手动触发**(debug / 紧急补跑):
+```bash
+pnpm sync-incremental -- --dir=./data/jvs-dw
+# 跳过 persona/plan(只拉数据):
+pnpm sync-incremental -- --dir=./data/jvs-dw --no-recompute
+# dry-run(不写库,看 SQL cursor 注入预览):
+pnpm sync-incremental -- --dir=./data/jvs-dw --dry-run
+```
+
+### 3.3 数据完整性保证 — A+C 双修
+
+**A:Patient Stub Auto-Create**
+- 增量拉 fact 但 patient 主档 cursor 没动 → 用 `(hostId, tenantId, externalId)` 三段建空 stub
+- 真实主档 upsert 时填上姓名/电话(W4 加固)
+
+**C:反向拉主档**
+- 每次跑完 fact 表,收集 `(patient_id, brand)` 集合 → 追加 `WHERE (patient_id, brand) IN (...)` 强拉主档
+- 跟 fact 同 run,主档跟事实 100% 同步
+
+**实测**(W3 末):
+- 修前:51% transactions patient_id 为 null
+- 修后:**0%** patient_id 为 null
+
+---
+
+## 四、监控 / 告警
+
+### 4.1 DW 数据滞后监控
+
+`DwLagMonitorService` `@Cron(HOURLY)` 自动跑:
+
+```
+读最近一次 incremental_bundle.cursor_after JSON
+   ↓
+算 max(cursor) vs now() 差 (小时)
+   ↓
+🟢 < 24h    LOG info
+🟡 24-48h   LOG warn  (DW 没刷新,提醒值班)
+🔴 > 48h    LOG ERROR (严重滞后,事件可能漏召)
+```
+
+阈值改 env:`PAC_LAG_WARN_HOURS` / `PAC_LAG_ERROR_HOURS`。
+
+**接告警通道**(W5+ TODO):log ERROR 后接 webhook → 钉钉/飞书。当前阶段值班看 `journalctl -u pac-service | grep dw-lag` 即可。
+
+### 4.2 BullMQ Bull Board(看队列健康度)
+
+`/admin/queues` 路径(需登录 admin),实时看:
+- persona-recompute / plan-recompute / plan-asset-generate 三队列
+- 各 worker 处理速度 / 失败重试 / 死信
+
+### 4.3 关键 SQL 检查
+
+```sql
+-- 最近一次 sync 结果(应当 success / failed=0)
+SELECT to_char(started_at,'YYYY-MM-DD HH24:MI') AS t, resource, status, fetched, failed, error_message
+FROM sync_logs ORDER BY started_at DESC LIMIT 5;
+
+-- 数据规模
+SELECT 'patients' AS k, count(*) FROM patients
+UNION ALL SELECT 'facts', count(*) FROM patient_facts
+UNION ALL SELECT 'active_plans', count(*) FROM followup_plans WHERE status IN ('active','assigned');
+
+-- 数据滞后(跟 monitor 一致)
+SELECT to_char(started_at,'HH24:MI') AS sync_t, cursor_after
+FROM sync_logs WHERE resource='incremental_bundle' AND status='success'
+ORDER BY started_at DESC LIMIT 1;
+```
+
+---
+
+## 五、运维常见操作
+
+| 场景 | 命令 |
+|---|---|
+| **重启 pac-service** | `systemctl restart pac-service`(或 pm2 reload pac-service) |
+| **手动补跑昨日增量** | `pnpm sync-incremental -- --dir=./data/jvs-dw` |
+| **某 patient 召回不对,临时单刷** | `pnpm recompute-plans -- --host=jvs-dw`(全 host)/ 详情页 "刷新" 按钮(单 patient) |
+| **看某 patient 治疗链** | `pnpm exec ts-node src/cli/verify-chain.cli.ts --id=<uuid>` |
+| **改 yaml/scenario 后强制重算 plan** | 删旧 plan: `TRUNCATE followup_plans CASCADE;` + `pnpm recompute-plans -- --host=jvs-dw` |
+| **改 yaml 后强制 reparse 旧数据** | (task #46 待做)目前只能 truncate facts + 重 cold-import |
+
+---
+
+## 六、Yaml 变更管理 SOP
+
+数据/术语 yaml 改了(`apps/pac-service/data/<host>/`)?
+
+| 改动类型 | 影响 | 处理 |
+|---|---|---|
+| **enum_mapping 加 host 术式** | 新数据生效,老数据需要 reparse | 配 task #46 / 暂时 truncate facts 重导 |
+| **field_mapping 改字段名** | 同上 | 同上 |
+| **transforms 改 split/derive** | 影响管道 | 同上 |
+| **scenario SQL 改召回口径** | 立即生效(下次 cron 跑就用) | 删旧 plan + 等 cron 或手动 recompute-plans |
+| **canonical-codes.ts 改字典** | 立即生效(chain composer 用) | 重启 pac-service |
+
+---
+
+## 七、灾备 / 回滚
+
+### 7.1 数据备份
+
+```bash
+# 每天凌晨 04:00 备份(增量 03:30 完成后)
+pg_dump -U pac -d pac -F c -f /backup/pac-$(date +%F).dump
+# 保留 7 天
+find /backup -name 'pac-*.dump' -mtime +7 -delete
+```
+
+### 7.2 回滚代码版本
+
+```bash
+cd /opt/pac && git fetch && git checkout <last-known-good-tag>
+pnpm install && pnpm --filter @pac/types build && pnpm --filter @pac/service build
+systemctl restart pac-service
+```
+
+### 7.3 cursor 倒退(数据要重跑某窗口)
+
+```sql
+-- 把最近一次 sync_log 的 cursor_after 改到目标时间
+UPDATE sync_logs SET cursor_after = '{"fact_emr_treatment_out":"2026-04-01",...}'
+WHERE id = (SELECT id FROM sync_logs WHERE resource='incremental_bundle' AND status='success' ORDER BY started_at DESC LIMIT 1);
+```
+
+下次 cron 自动从这个 cursor 拉。
+
+---
+
+## 八、当前已知边界(W4 末)
+
+| 项 | 现状 | 影响 | 何时解决 |
+|---|---|---|---|
+| 首跑全量 cohort LIMIT 100 | dev manifest 里写死 LIMIT | 生产首跑必须去掉 LIMIT(可能 30 min 跑 13 万 patient) | 部署前手动改 |
+| sync-incremental reparse 模式缺 | yaml 改后历史数据需要 truncate 重导 | 改 yaml 不能"原地补"老 facts | task #46(W5+) |
+| 告警接通道 | log ERROR + 人工看 | 滞后无即时告警 | W5+ 加 webhook 钉钉/飞书 |
+| 多 host 部署 | 支持(`PAC_INCREMENTAL_HOSTS=jvs-dw,friday`)| — | 已就绪 |
+| 单机 vs 集群 | 当前单机 | 高 QPS 时 pac-service 可水平扩展(无状态) | 试点期不需要 |
+
+---
+
+## ▎一句话归纳
+
+> **PAC 部署 = Postgres + Redis + pac-service + pac-web 四件套。数据摄入 = 首次 cold-import(一次性)+ 日级 sync-incremental(自动 cron)。监控 = lag monitor + Bull Board + 日常 SQL 检查。**

docs/w3-report.md

+# 疗效保障(PAC)项目 W3 进展报告
+
+> **报告周期**:第 3 周(W3)
+> **汇报路径**:PAC(luoqi)→ CTO(于总)→ 管委会
+> **报告人**:luoqi
+> **状态**:🟢 W3 目标 100% 达成 + W4(DW 直连增量)提前到位
+
+---
+
+## Page 1 · 一句话 + 里程碑路线
+
+### ▎本周一句话
+
+> **PAC 已直接连瑞尔 DW 真实数据跑通完整闭环 — 100 个真实患者进来,自动算出 25 条召回任务 + 病史链 + AI 话术,业务方可现场点评。W4 起做客服工作台试点对接。**
+
+### ▎答复
+
+| 问 | 答 |
+|---|---|
+| W3 承诺达到没? | ✅ 全部达成 — 真实(脱敏)数据进 PAC、潜在新链召回出来、话术按医生主诉量身定 |
+| W4 承诺呢? | ⭐ DW 直连增量管道已建好,等明天 DW 那边日级刷新启动即可上线 |
+| 还差什么才能给试点? | 5i5ya 前端联系人 1 人(W5 把 iframe 嵌进去 2 小时) + 1 家试点 3-5 名客服(W5 末联调半天) |
+
+### ▎6 周走向终态(从 W6 倒推)
+
+```
+W6 ⭐ 1 家试点诊所端到端演示(真实患者 / 真实客服 / 真实回写 / 真实营收对照)
+   ↑ 需要:客服培训完成 + 主管 dashboard 上线
+W5 客服工作台嵌入 5i5ya(iframe)+ 1 家试点客服联调
+   ↑ 需要:5i5ya 前端联系人就位
+W4 客服工作台对接试点 + DW 真实日增量自动刷新数据(本周已 ready,等 DW 启动)
+   ↑ 需要:DW 团队明天起每日全量刷新落地
+W3 ✅ 真实数据 demo + 潜在新链召回 + AI 话术 + 治疗链 5 阶段可视化(本次报告)
+W2 ✅ 数据接入文档 + 演示能力提前到位 + 召回算法策略落地
+W1 ✅ 框架定稿 + 60+ 评审 closure
+```
+
+### ▎本周必须推动(求 CTO 协调)
+
+```
+🆘 1. DW 团队"每日全量刷新"启动(明天预定)
+       - 现状:DW 当前数据滞后 6 天(每周左右刷一次),不影响算法但影响实时性
+       - 影响:启动后客服当天打的电话当天能看到结果
+       - PAC 这边的增量管道已就位,DW 那边按时启动即可
+
+🆘 2. 5i5ya 前端联系人确认(W5 启动前)
+       - 用量:2 小时 — 贴 iframe + 配置一次性 code 换 token
+       - 影响:不到位 W5/W6 试点跑不通,只能停在 PAC 自己的演示页
+```
+
+---
+
+## Page 2 · 现场 Demo · 真实患者跑出来的潜在新链召回
+
+> **演示对象**:从瑞尔 DW 100 个真实患者中按规则筛出的 25 个召回案例,任选一例
+> **典型样例**:姚嘉萍 / 王永明 / 张澜(都是真实患者,脱敏展示)
+> **召回类型**:潜在新链发现(诊断 → 未启动治疗)
+
+### ▎管委会可现场验证的 6 项能力
+
+| # | 能力 | 真实数据下的表现 |
+|---|---|---|
+| 1 | **真实数据进得来** | 瑞尔 DW(13 万患者池)按 cohort 拉 100 个真实患者 → 6215 条事实写入 PAC、0 失败 |
+| 2 | **潜在新链发现准** | 100 个真实患者中 25 个被精准召回:K08 缺牙未做种植 / K04 牙髓未做根管 / K07 错颌未启动正畸 等 5 个子场景全跑通 |
+| 3 | **治疗链 5 阶段** | 每个患者的所有治疗链按"发现 → 进入 → 执行 → 复查 → 闭环"5 阶段可视化(陈化冰、季根财、范萍莉等老人多链 case 都正确展示) |
+| 4 | **AI 话术按事实定制** | 话术 4 段(开场 / 切入话题 / 异议处理 / 结束确认),自动喂入真实主诊医生名 / 诊所名 / 患者称呼 / 友好牙位(不会说"FDI 36 号牙",会说"右下后牙") |
+| 5 | **多品牌隔离** | 瑞尔 / 瑞泰双品牌跨同一 DW,患者 ID 跨品牌重复也自动按 tenant 隔离,A 客服看不到 B 品牌的患者 |
+| 6 | **召回准度可解释** | 每条召回都展示"为什么召":诊断码 + 时间窗 + 价值评分 + 不召的理由(冷静期 / 已拔除 / 已进入治疗链) — 业务方能针对每一条评对错 |
+
+### ▎跟 W2 demo(张志远虚构样例)的区别
+
+```
+W2 demo:                              W3 demo:
+  虚构患者 + Mock 数据                  100 个瑞尔真实患者
+  PAC 后端无业务数据                    DW 直连 ClickHouse,数据 100% 真实
+  靠人脑判断 demo 是否合理              业务方按真实案例点对错(可挑刺、可反对)
+  1 个固定演示样例                      25 个真实召回任意挑(包括边界 case)
+```
+
+**演示要点**:这次 demo 完全是"指着真实诊所的真实患者看 PAC 怎么判的",不再是"理论上能这样做"。
+
+---
+
+## Page 3 · W3 交付清单(说结果)
+
+### ▎对照 W2 承诺,W3 完成度 100%
+
+| W2 承诺 W3 要做的 | 状态 | 实际成果 |
+|---|---|---|
+| 真实(脱敏)患者数据进 PAC | ✅ | 直接连瑞尔 DW,100 真实患者跑通 |
+| PAC 自动识别"潜在新链" | ✅ | 25 条召回(5 个子场景全覆盖:种植 / 根管 / 充填 / 牙周 / 正畸) |
+| 业务方可点评 | ✅ | 每条召回有完整可解释链,业务方按真实姓名讨论 |
+| 召回任务进工作台 + 详情可点开 | ✅ | 工作台 / 详情 / 话术 / 治疗链 / 时间轴 全跑通 |
+| W4 DW 直连方案确认 | ⭐ 提前 | 不只确认方案,**直接把 DW 增量管道做完了**(等 DW 启动每日刷新即上线) |
+
+### ▎W3 期间业务能力提升要点(管委会角度)
+
+| 能力 | W2 末 → W3 末 |
+|---|---|
+| 数据源 | mock 数据 → **瑞尔 DW 真实 100 患者**(可扩到全量 13 万) |
+| 治疗链 | 简单 3 状态(发现 / 在管 / 闭环)→ **5 阶段精细判定**(每条链清楚指出"待哪一步""为什么没闭环") |
+| 召回算法 | 1 个子场景 → **5 个子场景**(种植 / 根管 / 充填 / 牙周 / 正畸都召) + 4 道排除闸(冷静期 / 已拔牙 / 已预约 / 已进入治疗链 → 噪音 0) |
+| AI 话术 | 模板拼接(机器人感)→ **大模型按患者事实生成 4 段 markdown**(看到诊所名 / 主诊医生 / 友好牙位) |
+| 数据时效性 | 一次性导入 → **DW 增量管道就绪**(等 DW 启动日刷新即秒级跟新) |
+
+### ▎W3 期间发现并解决的真实临床问题(业务方关心)
+
+> 这些 case 来自真实患者数据,跑出来发现的边界,W3 一边跑一边修
+
+| 真实 case | 临床问题 | PAC 处理 |
+|---|---|---|
+| 季根财(77 岁老人) | 全口拔得差不多,诊断后被拔的牙仍然在召回 → 客服会打扰 | ⑤c 闸:同牙位有拔牙 actual → 整条信号排除,**他从召回池消失** |
+| 林菲菲(已预约正畸) | 已经预约了正畸方案沟通,但仍然在 K07 召回列表里 | ⑤d 闸:诊断后有"正畸"主诉的预约 → 视为已进入治疗链,**不重复召回** |
+| 杨明昊(K04 做了部分牙髓切断术) | 临床上算完成治疗(VPT)但被误判"未做根管" | 加 pulpotomy 为正畸合法终末术式,**链直接判闭环** |
+| 范萍莉(实际有 6 次种植) | host 字段叫"简单种植术",PAC 字典原来没收 → 看不到 | 字典补 100+ 高频术式,**真种过的患者不再误报** |
+| 罗国标(14/15 已拔已种) | 旧的召回列表还有 K04 根管召回 | DW 数据流转后自动 supersede,**SQL 算 ⑤c 不再召** |
+
+**业务方价值**:这些都是"如果不上真实数据永远发现不了的 bug",W3 跑通真实数据 = PAC 算法在临床上真正可信。
+
+---
+
+## Page 4 · 里程碑预告(W4 → W6)
+
+### ▎W4 末(下次报告)· 试点对接启动 + DW 日增量自动跑
+
+```
+🎯 给管委会看
+  1. DW 增量管道日级运行 — 今天的真实数据,明天早晨 PAC 自动可见
+  2. 1 家试点诊所的真实召回名单(数据规模 ×N)+ 主管/客服角色权限分离
+  3. 召回准度跟踪指标(本周召了多少 / 重复了多少 / 排除了多少)
+  4. 5i5ya 前端联系人 / iframe 嵌入方案最终确认
+
+🎯 需要资源到位
+  - DW 团队启动每日全量刷新(明天预定)
+  - 5i5ya 前端联系人(2 小时贴 iframe)
+  - 试点诊所联系人确认(1 家先行)
+```
+
+### ▎W5 末 · 客服工作台正式嵌入 5i5ya + 联调
+
+```
+🎯 给管委会看
+  - 客服在 5i5ya 自己界面里看 PAC 召回任务(单点登录,无感跳转)
+  - 3-5 名客服真实使用,打第一批电话,实际回写结果
+  - 客服反馈"算得准不准 / 顺不顺手 / 话术地不地道"
+```
+
+### ▎W6 末 ⭐ · 1 家试点诊所端到端演示
+
+```
+🎯 给管委会看
+  - 累计召回 N 单 / 触达 M 单 / 成功转化 K 单
+  - 转化患者带来的实际营收(对照基线)
+  - 主管 dashboard:团队执行效果可视化
+  - 业务方最终 GO / NO-GO 决策依据
+```
+
+---
+
+## Page 5 · 风险 + 依赖
+
+### ▎本周新发现 / 升级的风险
+
+| # | 风险 | 等级 | 现状 | 求 CTO |
+|---|---|---|---|---|
+| 1 | **DW 数据新鲜度** | 🟢 已收敛 | 当前 DW 数据滞后 6 天;PAC 这边的增量管道已就绪,等明天 DW 启动日刷新 | 跟 DW 团队确认"明天起每日全量刷新"按时上 |
+| 2 | **5i5ya 前端联系人** | 🟡 中 | W5 启动前必到位 | 本周内指定联系人 |
+| 3 | **试点诊所联系人** | 🟡 中 | W4 末选 1 家先行 | 业务方建议选 |
+| 4 | **召回准度业务方校准** | 🟢 已规避 | W3 跑真实数据已发现 5 类边界并修复(见 Page 3) | 持续 — W4 加场景化抽样审查 |
+| 5 | **持续维护字典 / scenario** | 🟢 已规避 | 新增 host 术式 / 新临床场景按需 PR,流程顺畅 | 无 |
+
+### ▎不报喜不报忧(W3 实际遇到的问题 + 怎么解的)
+
+| 问题 | 现象 | 处理 |
+|---|---|---|
+| host 数据有隐藏 upsert 行为 | 同一行预约从"已约"到"已到诊"会被 DW 直接覆盖 | PAC 用 `updated_date` 做幂等键,host 每次 UPDATE 当新事件处理(版本流) |
+| 真实临床有"姑息治疗"边界 | 部分牙髓切断术算不算"治完了"? | 引入"终末术式"概念,临床合法终末算闭环;字典持续扩 |
+| 老人全口拔牙工作流 | 诊断后被拔的牙还在召回 → 骚扰 | ⑤c 同牙位 surgical 排除 |
+| 已进入治疗链的患者还在新链召回 | 林菲菲预约了正畸还在召 | ⑤d 同口径排除 — chain 跟 SQL 完全对齐 |
+| Palmer 乳牙记号(1A/1D等)在算法里互相误匹配 | 5 颗乳牙被当成 1 颗 | 牙位规范化升级,儿童 case 也精准 |
+
+### ▎资源依赖矩阵
+
+```
+W3 ✅:1 人 + AI 全部完成(没借力)
+W4   :PAC 1 人 + DW 1 人(启动日刷新) + 5i5ya 1 人(2 小时贴 iframe)(轻借力)
+W5   :PAC 1 人 + 试点 1 家客服 3-5 人 (半天联调)(中借力)
+W6   :PAC 1 人 + 客服培训 1 人 + 试点店长配合(重借力)
+```
+
+---
+
+## ▎下一份报告(W4 末)预告
+
+**承诺给管委会看**:
+1. DW 日级增量自动跑(今天的真实数据,明天可见)
+2. 1 家试点诊所的真实召回列表(数据规模 ×N) + 角色权限分离
+3. 5i5ya iframe 嵌入方案最终确认
+4. 召回准度跟踪指标(召回/排除/重复)
+
+**汇报形式**:沿用"一页 Demo + 业务语言"风格,继续 Demo over Memo。
+
+---
+
+## ▎附件(留参考)
+
+| 附件 | 内容 |
+|---|---|
+| algorithm/canonical-fact-layer.md | 数据规范化层 v2(9 道闸 + Layer A.5 transforms) |
+| algorithm/treatment-chain-5-stages.md | 5 阶段治疗链模型(W3 末确立) |
+| algorithm/potential-treatment-recall.md | 潜在新链召回算法(5 子场景 + 4 道排除闸) |
+| dw-data-source-issues.md | 真实数据踩坑 + 字段语义勘误记录 |
+
+---
+
+> **核心信号**:真实数据真的跑通了 + W4 提前到位 + 边界案例边跑边修 + 下次见就是试点起步

eslint.config.mjs

@@ -35,7 +35,7 @@ export default tseslint.config(
     // NestJS relies on `emitDecoratorMetadata` for DI — `import type` would
     // erase the value at runtime and break Reflect metadata. Disable the
     // rule for backend source so the linter doesn't push us off that cliff.
-    files: ['apps/recall-service/**/*.ts'],
+    files: ['apps/pac-service/**/*.ts'],
     rules: {
       '@typescript-eslint/consistent-type-imports': 'off',
     },

package.json

 {
-  "name": "pac-platform",
+  "name": "pac",
   "version": "0.1.0",
   "private": true,
   "packageManager": "pnpm@10.13.1",

packages/types/src/canonical-codes.ts

@@ -299,6 +299,11 @@ export const PACTreatmentStep = {
   canal_preparation:   '根管预备',
   canal_filling:       '根管充填',
   post_endo_filling:   '根管后充填',
+  /// 活髓 / 部分牙髓切断术(vital pulpotomy / partial pulpotomy / 干髓术 — 等价术式)
+  /// 临床:保留根髓,冠髓切除 + MTA/Biodentine 封盖,成年恒牙 80-90% 成功率(AAE/ESE 2019+ 认可为终末术式)
+  /// 跟 canal_filling 并列作为 endodontic 的 terminalSteps —— 任一命中即 s3Reached
+  /// 命中 pulpotomy 不要求冠保护(根髓活,牙不变脆)
+  pulpotomy:           '牙髓切断术(活髓 / 部分 / 干髓)',
   // 种植
   implant_placement:   '种植体植入',
   abutment_placement:  '基台连接',
@@ -343,13 +348,24 @@ export interface TreatmentMilestone {
   minSteps: number;
   /// 生命周期类型 → 查 TreatmentLifecycles 拿 maxStage / expectedSpanMonths
   lifecycle: TreatmentLifecycleKey;
+  /// W4 末新增:**任一命中即视为治疗已完整收尾**(s3Reached=true,跳过 minSteps 检查)
+  ///
+  /// 用于支持"多路径终末"的临床现实:
+  ///   endodontic:
+  ///     Path A — 完整 RCT  (开髓 → 根管预备 → 根管充填) ✅ canal_filling 命中即收尾
+  ///     Path B — 牙髓切断术(活髓 / 部分 / 干髓 — VPT 终末术式)✅ pulpotomy 命中即收尾
+  ///
+  /// 跟 requiresCrownProtection 配合:
+  ///   命中 canal_filling → 仍需冠保护(linear_then_crown 规则)
+  ///   命中 pulpotomy     → 不需冠保护(局部 override,chain-composer 处理)
+  terminalSteps?: readonly PACTreatmentStepKey[];
 }
 
 export const TreatmentMilestones = {
   implant:       { steps: ['implant_placement', 'crown_placement'],                        minSteps: 2, lifecycle: 'linear' },
   // endodontic 3 步 + minSteps=2(开髓 + 根充至少);patient 真做了开髓+根备+根充才算完整
   // lifecycle=linear_then_crown:闭环额外要求 prosthodontic 冠保护(临床:根管后不戴冠折裂率 ~30%)
-  endodontic:    { steps: ['pulp_extirpation', 'canal_preparation', 'canal_filling'],     minSteps: 2, lifecycle: 'linear_then_crown' },
+  endodontic:    { steps: ['pulp_extirpation', 'canal_preparation', 'canal_filling', 'pulpotomy'], minSteps: 2, lifecycle: 'linear_then_crown', terminalSteps: ['canal_filling', 'pulpotomy'] },
   orthodontic:   { steps: ['bracket_placement', 'retainer'],                              minSteps: 1, lifecycle: 'long_term' },
   periodontic:   { steps: ['supragingival_scaling', 'subgingival_scaling', 'periodontal_maintenance'], minSteps: 1, lifecycle: 'lifelong_maintenance' },
   restorative:   { steps: ['composite_filling', 'inlay'],                                 minSteps: 1, lifecycle: 'one_shot' },
@@ -367,8 +383,11 @@ export const LegacyStepSubtypeKeywords: Partial<Record<PACTreatmentStepKey, read
   pulp_extirpation: ['开髓', '拔髓'],
   canal_preparation: ['根备', '根管预备'],
   canal_filling: ['根充', '根管充填'],
-  implant_placement: ['种植体植入', '种植手术', '种植一期'],
-  crown_placement: ['种植上部修复', '种植冠修复', '种植戴牙'],
+  // pulpotomy 类:活髓切断 / 部分活髓切断 / 部分牙髓切断 / 冠髓切断 / 干髓 / 盖髓 / 牙髓血运重建
+  // 这些都是"保留根髓"的终末术式(VPT — vital pulp therapy),临床等价
+  pulpotomy: ['活髓切断', '部分活髓切断', '部分牙髓切断', '冠髓切断', '干髓', '盖髓', '牙髓血运重建', '活髓保存'],
+  implant_placement: ['种植体植入', '种植手术', '种植一期', '简单种植', '复杂种植', '即刻种植', '延期种植', '拔除后种植'],
+  crown_placement: ['种植上部修复', '种植冠修复', '种植戴牙', '种植二期', '种植三期'],
   supragingival_scaling: ['洁治', '洁牙', '洗牙'],
   subgingival_scaling: ['刮治', '龈下'],
   periodontal_maintenance: ['维护'],

packages/types/src/enums/index.ts

@@ -463,26 +463,29 @@ export const PlanStatusSchema = z.enum([
 // Plan Execution(接口 2 客服回写)
 // =============================================================
 
-/// plan_executions.outcome — 4 起步 + 8 产品收集 = 12 类
+/// plan_executions.outcome — 4 起步 + 7 产品收集 = 11 类
 /// 形式:`英文_key`(中文含义)
+///
+/// W4 末调整(2026-05):
+///   - 删 PROACTIVE_SMS:前端无对应按钮,生产用不到 → 清理
+///   - MARKED_INVALID 状态机映射改 → abandoned(原 completed 语义错;标记无效不该算"成功完成")
 export const ExecutionOutcome = {
   // 4 起步(W2 设计)
   ABANDONED: 'abandoned', // 已联系,客服放弃 → Plan abandoned
   NO_ANSWER: 'no_answer', // 未接通,未回复 → Plan 仍 active 等下次
   SCHEDULED_NEXT: 'scheduled_next', // 已联系,约定下次 → Plan 仍 assigned
-  SUCCESS_APPOINTED: 'success_appointed', // 已联系,成功新预约 → Plan completed
+  SUCCESS_APPOINTED: 'success_appointed', // 已联系,成功新预约 → Plan completed(新预约跳到宿主创建,本表不冗余存)
 
-  // ── 产品收集(回访中心信息字段.docx — 14 类执行结果细化)──
+  // ── 产品收集(回访中心信息字段.docx — 执行结果细化)──
   RESCHEDULED: 'rescheduled', // 已联系,改约
   CONSIDERING: 'considering', // 已联系,考虑中(近期再跟进)
   DECLINED_RECENT: 'declined_recent', // 已联系,近期不考虑
   NEEDS_DOCTOR: 'needs_doctor', // 已联系,需要找医生
-  EXTERNAL_TREATMENT: 'external_treatment', // 已联系,已在外院治疗(suggestion 应关闭)
+  EXTERNAL_TREATMENT: 'external_treatment', // 已联系,已在外院治疗
   REFUSED: 'refused', // 已联系,明确拒绝,不需要治疗
   PENDING_INFO: 'pending_info', // 已联系,需进一步确认信息后回复
   SMS_SENT: 'sms_sent', // 电话未接,已发短信跟进
-  PROACTIVE_SMS: 'proactive_sms', // 主动短信沟通(未发起电话)
-  MARKED_INVALID: 'marked_invalid', // 标记为无效(配 invalidReason)
+  MARKED_INVALID: 'marked_invalid', // 标记为无效(数据错 / 不该召回)→ abandoned
 } as const;
 export type ExecutionOutcome = (typeof ExecutionOutcome)[keyof typeof ExecutionOutcome];
 export const ExecutionOutcomeSchema = z.enum([
@@ -499,10 +502,52 @@ export const ExecutionOutcomeSchema = z.enum([
   'refused',
   'pending_info',
   'sms_sent',
-  'proactive_sms',
   'marked_invalid',
 ]);
 
+/// outcome 提交后 Plan.status 怎么变(状态机决策)
+///   completed — 任务结案(成功 / 终态客户决策)
+///   abandoned — 任务关闭(放弃 / 无效)
+///   keep      — Plan 状态不变(active 还是 active / assigned 还是 assigned),等下次跟进
+///                注:keep 模式下熔断器仍可能介入 — contactAttempts 达上限自动 abandoned
+export type ExecutionOutcomeDrives = 'completed' | 'abandoned' | 'keep';
+
+/// outcome 的 UI tone(对应 shadcn 调色板),前端按按钮渲染
+export type ExecutionOutcomeTone = 'emerald' | 'amber' | 'sky' | 'slate' | 'rose';
+
+/// ExecutionOutcome 单一真理源(label / tone / 状态机)
+///
+/// 用法:
+///   - 前端 outcome-form 直接遍历这个 map 渲染按钮 + state hint
+///   - 后端 execution.service.ts OUTCOME_TO_STATUS 派生自 drivesStatus
+///   → 前后端口径完全对齐,改 enum / 改 drivesStatus 一处改完处处生效
+///
+/// 顺序 = UI 显示顺序(JS 对象迭代保留插入顺序),按业务"喜好度 / 终态优先"排:
+///   1. 成功类(emerald)→ 2. 在途类(amber/sky)→ 3. 未触达(slate)→ 4. 终态拒绝(rose)
+export const EXECUTION_OUTCOME_META: Record<
+  ExecutionOutcome,
+  { labelZh: string; tone: ExecutionOutcomeTone; drivesStatus: ExecutionOutcomeDrives }
+> = {
+  // ── 成功转化 ──
+  success_appointed:  { labelZh: '成功转化为新预约', tone: 'emerald', drivesStatus: 'completed' },
+  // ── 在途(下次再跟)──
+  scheduled_next:     { labelZh: '约定下次回访',     tone: 'amber',   drivesStatus: 'keep' },
+  considering:        { labelZh: '考虑中,近期再跟进', tone: 'amber',  drivesStatus: 'keep' },
+  needs_doctor:       { labelZh: '需要找医生',       tone: 'sky',     drivesStatus: 'keep' },
+  rescheduled:        { labelZh: '改约',             tone: 'sky',     drivesStatus: 'keep' },
+  pending_info:       { labelZh: '需进一步确认信息', tone: 'slate',   drivesStatus: 'keep' },
+  // ── 未触达 / 弱触达 ──
+  no_answer:          { labelZh: '未接通',           tone: 'slate',   drivesStatus: 'keep' },
+  sms_sent:           { labelZh: '电话未接,已发短信', tone: 'slate',  drivesStatus: 'keep' },
+  // ── 终态(客户决策)──
+  declined_recent:    { labelZh: '近期不考虑',       tone: 'rose',    drivesStatus: 'keep' },
+  refused:            { labelZh: '明确拒绝',         tone: 'rose',    drivesStatus: 'completed' },
+  external_treatment: { labelZh: '已在外院治疗',     tone: 'rose',    drivesStatus: 'completed' },
+  // ── 终态(系统决策)──
+  marked_invalid:     { labelZh: '标记为无效',       tone: 'rose',    drivesStatus: 'abandoned' },
+  abandoned:          { labelZh: '客服放弃',         tone: 'rose',    drivesStatus: 'abandoned' },
+};
+
 export const ExecutionChannel = {
   PHONE: 'phone',
   WECOM: 'wecom',

packages/types/src/schemas/auth.ts

@@ -101,6 +101,27 @@ export const RefreshTokenResponseSchema = z.object({
 export type RefreshTokenResponse = z.infer<typeof RefreshTokenResponseSchema>;
 
 // =============================================================
+// Mock Login  (POST /pac/v1/auth/mock-login) ⭐ 开发 / 试部署用
+// =============================================================
+//
+// 用途:试部署 / 内部演示场景 — 用户访问 /plans 无 token 时,前端弹"快速登录"对话框,
+// 后端按 { tenant, role } 预制 user payload 直接产 JWT(跳过 host SSO)
+//
+// 安全:env 门控 — 只在 NODE_ENV != 'production' 或 PAC_ENABLE_MOCK_LOGIN=true 时启用,
+// 生产 host 真接入后置 false / 删该 endpoint
+export const MockLoginRequestSchema = z.strictObject({
+  /// 租户 slug — 'ruier'(瑞尔) / 'ruitai'(瑞泰),后端映射到 tenant UUID + clinics
+  tenant: z.enum(['ruier', 'ruitai']),
+  /// PAC 角色 — staff / leader / admin
+  role: UserRoleSchema,
+});
+export type MockLoginRequest = z.infer<typeof MockLoginRequestSchema>;
+
+/// 跟 ExchangeCodeResponse 同形(前端直接 setTokens 用)
+export const MockLoginResponseSchema = ExchangeCodeResponseSchema;
+export type MockLoginResponse = z.infer<typeof MockLoginResponseSchema>;
+
+// =============================================================
 // JWT payload — server-only; never sent to host
 // =============================================================
 

packages/types/src/schemas/sync.ts

@@ -30,6 +30,11 @@ export const RefreshPatientResponseSchema = z.object({
   status: z.string(),
   /// true = 调用方请求被合并到正在进行中的 run(30s 内去重)
   dedupedFromExisting: z.boolean().optional(),
+  /// W4 末:本次写入的 transaction / fact 条数(UI toast 显示)
+  transactionsWritten: z.number().int().optional(),
+  factsEmitted: z.number().int().optional(),
+  /// W4 末:本次刷新后新生成 plan 数(<= 1,plan = patient 级触达单元)
+  plansCreated: z.number().int().optional(),
 });
 export type RefreshPatientResponse = z.infer<typeof RefreshPatientResponseSchema>;
 

turbo.json

@@ -21,10 +21,10 @@
       "persistent": true,
       "dependsOn": ["^build"]
     },
-    "@recall/shared-types#build": {
+    "@pac/types#build": {
       "outputs": ["dist/**"]
     },
-    "@recall/shared-utils#build": {
+    "@pac/utils#build": {
       "outputs": ["dist/**"]
     },
     "lint": {