333 lines
14 KiB
Python
333 lines
14 KiB
Python
"""病例落库 / 完整结构组装的共享逻辑。
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`/api/case/cases/full-create`（业务域）与 `/api/cms/cases/`（CMS 内容管理）共用同一套
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创建与序列化逻辑，避免两处实现漂移。
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"""
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from django.db import transaction
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from config.exceptions import AppError
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from ..models import (
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CaseBase, TraditionalCase, TeachingCase, ScoringRule, CaseExamItem,
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)
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from .department_resolver import resolve_department
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from .exam_items import (
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normalize_exam_items, assert_no_duplicate_exam_items, EXAM_ITEM_FIELDS,
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)
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TRADITIONAL_FIELDS = {'standard_diagnosis', 'standard_treatment', 'guideline_reference'}
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TEACHING_FIELDS = {'teaching_goal', 'discussion_questions', 'teacher_guide', 'scoring_focus'}
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SCORING_RULE_FIELDS = {
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'dimension', 'competency_dimension', 'score_weight',
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'ai_auto_score', 'osce_dimension', 'scoring_standard', 'rubric_json',
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}
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CASE_BASE_FIELDS = {
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'title', 'case_type', 'difficulty', 'difficulty_score',
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'chief_complaint', 'description', 'patient_age', 'patient_gender',
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'tags', 'symptom_tags', 'disease_tags', 'competency_tags',
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'guideline_tags', 'knowledge_points', 'icd_codes',
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'estimated_minutes', 'osce_enabled', 'rag_enabled',
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'ai_prompt_template', 'multimodal_assets',
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}
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def validate_scoring_rules(rules):
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if not isinstance(rules, list):
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raise AppError('CASE_VALIDATION_ERROR', 'scoring_rules 必须为数组', status_code=400)
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for i, rule in enumerate(rules):
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if not isinstance(rule, dict):
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raise AppError('CASE_VALIDATION_ERROR', f'scoring_rules[{i}] 必须为对象', status_code=400)
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if not rule.get('dimension'):
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raise AppError('CASE_VALIDATION_ERROR', f'scoring_rules[{i}].dimension 必填', status_code=400)
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weight = rule.get('score_weight')
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if weight is not None:
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try:
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weight = float(weight)
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except (TypeError, ValueError):
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raise AppError('CASE_VALIDATION_ERROR', f'scoring_rules[{i}].score_weight 须为数字', status_code=400)
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if weight <= 0 or weight > 1:
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raise AppError('CASE_VALIDATION_ERROR', f'scoring_rules[{i}].score_weight 须在 (0, 1]', status_code=400)
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_UNSET = object()
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def create_case_full(data, user, institution=_UNSET, require_scoring_rules=True):
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"""主表 + 子表 + scoring_rules + exam_items 同一事务入库。
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institution：病例所属机构；默认取创建者所属机构（`user.institution`）。
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require_scoring_rules：是否强制评分规则（≥1 条）。CMS 新增病例时为 False
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（评分规则延迟到「发布」时由 AI 生成并落库）；业务域 full-create 仍为 True。
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返回 (case, scoring_rule_count, exam_item_count)。校验失败抛 AppError。
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"""
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if institution is _UNSET:
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institution = getattr(user, 'institution', None)
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case_type = data.get('case_type', '')
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if case_type not in ('traditional', 'teaching'):
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raise AppError('CASE_TYPE_NOT_SUPPORTED', f'case_type 不支持: {case_type}', status_code=400)
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if 'stages' in data:
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raise AppError('CASE_FIELD_NOT_ALLOWED', '本接口不接收 stages 字段', status_code=400)
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sub_data = data.get(case_type)
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other_type = 'teaching' if case_type == 'traditional' else 'traditional'
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if not sub_data:
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raise AppError('CASE_SUBTYPE_REQUIRED', f'{case_type} 子表数据缺失', status_code=400)
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if data.get(other_type):
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raise AppError('CASE_SUBTYPE_CONFLICT', '不允许同时传入两种子表数据', status_code=400)
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scoring_rules_data = data.get('scoring_rules', [])
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if require_scoring_rules and not scoring_rules_data:
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raise AppError('CASE_VALIDATION_ERROR', 'scoring_rules 必填且至少 1 条', status_code=400)
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if scoring_rules_data:
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validate_scoring_rules(scoring_rules_data)
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exam_items_data = normalize_exam_items(data.get('exam_items') or [])
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assert_no_duplicate_exam_items(exam_items_data)
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department = resolve_department(data.get('department_name', ''))
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with transaction.atomic():
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case_kwargs = {k: data[k] for k in CASE_BASE_FIELDS if k in data}
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case_kwargs['department'] = department
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case_kwargs['institution'] = institution
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case_kwargs['created_by'] = user
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case_kwargs['status'] = 1
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case_kwargs['vector_status'] = 0
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case_kwargs['publish_status'] = 1 if data.get('auto_publish') else 0
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case = CaseBase.objects.create(**case_kwargs)
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sub_model = TraditionalCase if case_type == 'traditional' else TeachingCase
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allowed_sub = TRADITIONAL_FIELDS if case_type == 'traditional' else TEACHING_FIELDS
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sub_model.objects.create(case=case, **{k: v for k, v in sub_data.items() if k in allowed_sub})
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rule_objs = [
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ScoringRule(case=case, **{k: v for k, v in rule.items() if k in SCORING_RULE_FIELDS})
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for rule in scoring_rules_data
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]
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ScoringRule.objects.bulk_create(rule_objs)
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if exam_items_data:
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exam_objs = [
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CaseExamItem(case=case, **{k: v for k, v in item.items() if k in EXAM_ITEM_FIELDS})
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for item in exam_items_data
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]
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CaseExamItem.objects.bulk_create(exam_objs)
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return case, len(rule_objs), len(exam_items_data)
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# 与 scoring_rule_generator.CONTEXT_FIELDS 对应的主表字段（发布时据此构建生成入参）
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_SCORING_CONTEXT_FIELDS = (
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'title', 'chief_complaint', 'description', 'patient_age', 'patient_gender',
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'icd_codes', 'symptom_tags', 'disease_tags', 'competency_tags',
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'guideline_tags', 'knowledge_points',
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)
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def build_scoring_rule_input(case):
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"""由已落库的病例对象构建评分规则生成入参（供发布时调用 AI 生成评分规则）。"""
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data = {'case_type': case.case_type}
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for field in _SCORING_CONTEXT_FIELDS:
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data[field] = getattr(case, field, None)
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if case.case_type == 'traditional':
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try:
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tc = case.traditionalcase
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data['traditional'] = {
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'standard_diagnosis': tc.standard_diagnosis,
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'standard_treatment': tc.standard_treatment,
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'guideline_reference': tc.guideline_reference,
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}
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except TraditionalCase.DoesNotExist:
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data['traditional'] = {}
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else:
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try:
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tc = case.teachingcase
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data['teaching'] = {
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'teaching_goal': tc.teaching_goal,
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'discussion_questions': tc.discussion_questions,
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'teacher_guide': tc.teacher_guide,
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'scoring_focus': tc.scoring_focus,
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}
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except TeachingCase.DoesNotExist:
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data['teaching'] = {}
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return data
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def update_case_full(case, data, user):
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"""更新草稿病例内容（主表 + 子表 + exam_items，scoring_rules 可选）。
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供 CMS「编辑录入后的表单再次保存」复用：三种录入方式（表单 / PDF / AI）的病例数据
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都汇总到前端表单，再次保存时整体更新草稿。仅草稿（publish_status=0）可更新。
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- 主表字段：传入即覆盖（CASE_BASE_FIELDS 白名单）。
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- 子表：按 case_type 局部更新；不允许传入另一种子表。
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- exam_items：传入即整表替换（去重校验）；不传则保持不变。
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- scoring_rules：通常发布时才生成；如传入则整表替换（校验）。
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返回更新后的 case。校验失败抛 AppError。
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"""
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if case.publish_status != 0:
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raise AppError('CASE_NOT_EDITABLE', '仅草稿可编辑，请先下架', status_code=400)
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if 'stages' in data:
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raise AppError('CASE_FIELD_NOT_ALLOWED', '本接口不接收 stages 字段', status_code=400)
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case_type = case.case_type
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new_type = data.get('case_type')
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if new_type and new_type != case_type:
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raise AppError('CASE_TYPE_NOT_SUPPORTED', '不支持修改 case_type', status_code=400)
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other_type = 'teaching' if case_type == 'traditional' else 'traditional'
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if data.get(other_type):
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raise AppError('CASE_SUBTYPE_CONFLICT', '不允许传入另一种子表数据', status_code=400)
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scoring_rules_data = data.get('scoring_rules')
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if scoring_rules_data is not None:
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validate_scoring_rules(scoring_rules_data)
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exam_items_data = None
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if 'exam_items' in data:
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exam_items_data = normalize_exam_items(data.get('exam_items') or [])
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assert_no_duplicate_exam_items(exam_items_data)
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with transaction.atomic():
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changed = []
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for field in CASE_BASE_FIELDS:
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if field in data:
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setattr(case, field, data[field])
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changed.append(field)
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if 'department_name' in data:
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case.department = resolve_department(data['department_name'])
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changed.append('department')
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if changed:
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case.save()
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sub_data = data.get(case_type)
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if sub_data:
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sub_model = TraditionalCase if case_type == 'traditional' else TeachingCase
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allowed_sub = TRADITIONAL_FIELDS if case_type == 'traditional' else TEACHING_FIELDS
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sub_obj, _ = sub_model.objects.get_or_create(case=case)
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for k, v in sub_data.items():
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if k in allowed_sub:
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setattr(sub_obj, k, v)
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sub_obj.save()
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if scoring_rules_data is not None:
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case.scoring_rules.all().delete()
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ScoringRule.objects.bulk_create([
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ScoringRule(case=case, **{k: v for k, v in rule.items() if k in SCORING_RULE_FIELDS})
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for rule in scoring_rules_data
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])
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if exam_items_data is not None:
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case.exam_items.all().delete()
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CaseExamItem.objects.bulk_create([
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CaseExamItem(case=case, **{k: v for k, v in item.items() if k in EXAM_ITEM_FIELDS})
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for item in exam_items_data
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])
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case.refresh_from_db()
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return case
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def build_full_response(case):
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"""组装病例完整结构（主表 + 子表 + scoring_rules + exam_items）。"""
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if hasattr(case, '_prefetched_objects_cache') and 'exam_items' in getattr(
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case, '_prefetched_objects_cache', {}
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):
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exam_qs = case.exam_items.all()
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else:
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exam_qs = CaseExamItem.objects.filter(case_id=case.id).order_by('display_order', 'id')
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result = {
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'case': {
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'id': case.id,
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'title': case.title,
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'case_type': case.case_type,
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'difficulty': case.difficulty,
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'difficulty_score': case.difficulty_score,
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'institution': case.institution_id,
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'institution_name': case.institution.name if case.institution else None,
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'department': case.department_id,
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'department_name': case.department.name if case.department else None,
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'chief_complaint': case.chief_complaint,
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'description': case.description,
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'patient_age': case.patient_age,
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'patient_gender': case.patient_gender,
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'tags': case.tags,
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'symptom_tags': case.symptom_tags,
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'disease_tags': case.disease_tags,
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'competency_tags': case.competency_tags,
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'guideline_tags': case.guideline_tags,
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'knowledge_points': case.knowledge_points,
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'icd_codes': case.icd_codes,
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'estimated_minutes': case.estimated_minutes,
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'osce_enabled': case.osce_enabled,
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'rag_enabled': case.rag_enabled,
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'ai_prompt_template': case.ai_prompt_template,
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'multimodal_assets': case.multimodal_assets,
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'vector_status': case.vector_status,
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'publish_status': case.publish_status,
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'status': case.status,
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'created_by': case.created_by_id,
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'created_by_name': case.created_by.real_name if case.created_by else None,
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'created_at': case.created_at.isoformat() if case.created_at else None,
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'updated_at': case.updated_at.isoformat() if case.updated_at else None,
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},
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}
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if case.case_type == 'traditional':
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try:
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tc = case.traditionalcase
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result['traditional'] = {
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'standard_diagnosis': tc.standard_diagnosis,
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'standard_treatment': tc.standard_treatment,
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'guideline_reference': tc.guideline_reference,
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}
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except TraditionalCase.DoesNotExist:
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result['traditional'] = None
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elif case.case_type == 'teaching':
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try:
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tc = case.teachingcase
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result['teaching'] = {
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'teaching_goal': tc.teaching_goal,
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'discussion_questions': tc.discussion_questions,
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'teacher_guide': tc.teacher_guide,
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'scoring_focus': tc.scoring_focus,
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}
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except TeachingCase.DoesNotExist:
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result['teaching'] = None
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rules = case.scoring_rules.all().order_by('id')
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result['scoring_rules'] = [
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{
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'id': r.id,
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'dimension': r.dimension,
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'competency_dimension': r.competency_dimension,
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'score_weight': float(r.score_weight),
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'ai_auto_score': r.ai_auto_score,
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'osce_dimension': r.osce_dimension,
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'scoring_standard': r.scoring_standard,
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'rubric_json': r.rubric_json,
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}
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for r in rules
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]
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result['exam_items'] = [
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{
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'id': e.id,
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'item_code': e.item_code,
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'item_name': e.item_name,
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'item_type': e.item_type,
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'category': e.category,
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'result_text': e.result_text,
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'result_structured': e.result_structured,
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'is_key': e.is_key,
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'is_abnormal': e.is_abnormal,
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'score_weight': float(e.score_weight),
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'display_order': e.display_order,
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}
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for e in exam_qs
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]
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return result
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