fix(health+dialysis): S2 smoke test 修复 — Entity 表名 + 透析状态转换

- 修复 6 个 Entity table_name 与迁移不匹配: shift, handoff_log,
  patient_assignment, blind_index, critical_alert, critical_alert_response
- 添加透析记录 draft→completed 状态转换 API (PUT /complete)
- 修复 family_proxy_service 告警状态过滤 (active→pending/acknowledged)
- dev.ps1 添加 RATE_LIMIT__FAIL_CLOSE=false 开发模式
- S2 透析日流程 smoke test 报告

crates/erp-dialysis/src/handler/dialysis_handler.rs

@@ -125,6 +125,24 @@ where
     Ok(Json(ApiResponse::ok(result)))
 }
 
+pub async fn complete_dialysis_record<S>(
+    State(state): State<DialysisState>,
+    Extension(ctx): Extension<TenantContext>,
+    Path(record_id): Path<Uuid>,
+    Json(req): Json<ReviewDialysisWithVersion>,
+) -> Result<Json<ApiResponse<DialysisRecordResp>>, AppError>
+where
+    DialysisState: FromRef<S>,
+    S: Clone + Send + Sync + 'static,
+{
+    require_permission(&ctx, "health.dialysis.manage")?;
+    let result = dialysis_service::complete_dialysis_record(
+        &state, ctx.tenant_id, record_id, Some(ctx.user_id), req.version,
+    )
+    .await?;
+    Ok(Json(ApiResponse::ok(result)))
+}
+
 pub async fn delete_dialysis_record<S>(
     State(state): State<DialysisState>,
     Extension(ctx): Extension<TenantContext>,

crates/erp-dialysis/src/module.rs

@@ -42,6 +42,10 @@ impl DialysisModule {
                 "/health/dialysis-records/{id}/review",
                 axum::routing::put(dialysis_handler::review_dialysis_record),
             )
+            .route(
+                "/health/dialysis-records/{id}/complete",
+                axum::routing::put(dialysis_handler::complete_dialysis_record),
+            )
             // 透析方案
             .route(
                 "/health/dialysis-prescriptions",

crates/erp-dialysis/src/service/dialysis_service.rs

@@ -211,6 +211,43 @@ pub async fn update_dialysis_record(
     Ok(to_resp(&state.crypto, m))
 }
 
+pub async fn complete_dialysis_record(
+    state: &DialysisState,
+    tenant_id: Uuid,
+    record_id: Uuid,
+    operator_id: Option<Uuid>,
+    expected_version: i32,
+) -> DialysisResult<DialysisRecordResp> {
+    let model = dialysis_record::Entity::find()
+        .filter(dialysis_record::Column::Id.eq(record_id))
+        .filter(dialysis_record::Column::TenantId.eq(tenant_id))
+        .filter(dialysis_record::Column::DeletedAt.is_null())
+        .one(&state.db)
+        .await?
+        .ok_or(DialysisError::DialysisRecordNotFound)?;
+
+    let next_ver = check_version(expected_version, model.version)
+        .map_err(|_| DialysisError::VersionMismatch)?;
+
+    validate_dialysis_status_transition(&model.status, "completed")?;
+
+    let now = Utc::now();
+    let mut active: dialysis_record::ActiveModel = model.into();
+    active.status = Set("completed".to_string());
+    active.updated_at = Set(now);
+    active.updated_by = Set(operator_id);
+    active.version = Set(next_ver);
+    let m = active.update(&state.db).await?;
+
+    audit_service::record(
+        AuditLog::new(tenant_id, operator_id, "dialysis_record.completed", "dialysis_record")
+            .with_resource_id(m.id),
+        &state.db,
+    ).await;
+
+    Ok(to_resp(&state.crypto, m))
+}
+
 pub async fn review_dialysis_record(
     state: &DialysisState,
     tenant_id: Uuid,

crates/erp-health/src/entity/blind_index.rs

@@ -2,7 +2,7 @@ use sea_orm::entity::prelude::*;
 use serde::{Deserialize, Serialize};
 
 #[derive(Clone, Debug, PartialEq, DeriveEntityModel, Serialize, Deserialize)]
-#[sea_orm(table_name = "blind_indexes")]
+#[sea_orm(table_name = "blind_index")]
 pub struct Model {
     #[sea_orm(primary_key, auto_increment = false)]
     pub id: Uuid,

crates/erp-health/src/entity/critical_alert.rs

@@ -2,7 +2,7 @@ use sea_orm::entity::prelude::*;
 use serde::{Deserialize, Serialize};
 
 #[derive(Clone, Debug, PartialEq, DeriveEntityModel, Serialize, Deserialize)]
-#[sea_orm(table_name = "critical_alerts")]
+#[sea_orm(table_name = "critical_alert")]
 pub struct Model {
     #[sea_orm(primary_key, auto_increment = false)]
     pub id: Uuid,

crates/erp-health/src/entity/critical_alert_response.rs

@@ -2,7 +2,7 @@ use sea_orm::entity::prelude::*;
 use serde::{Deserialize, Serialize};
 
 #[derive(Clone, Debug, PartialEq, DeriveEntityModel, Serialize, Deserialize)]
-#[sea_orm(table_name = "critical_alert_responses")]
+#[sea_orm(table_name = "critical_alert_response")]
 pub struct Model {
     #[sea_orm(primary_key, auto_increment = false)]
     pub id: Uuid,

crates/erp-health/src/entity/handoff_log.rs

@@ -3,7 +3,7 @@ use serde::{Deserialize, Serialize};
 
 #[derive(Clone, Debug, PartialEq, DeriveEntityModel, Serialize, Deserialize)]
 #[serde(rename_all = "camelCase")]
-#[sea_orm(table_name = "shift_handoff_log")]
+#[sea_orm(table_name = "handoff_log")]
 pub struct Model {
     #[sea_orm(primary_key, auto_increment = false)]
     pub id: Uuid,

crates/erp-health/src/entity/patient_assignment.rs

@@ -3,7 +3,7 @@ use serde::{Deserialize, Serialize};
 
 #[derive(Clone, Debug, PartialEq, DeriveEntityModel, Serialize, Deserialize)]
 #[serde(rename_all = "camelCase")]
-#[sea_orm(table_name = "patient_assignments")]
+#[sea_orm(table_name = "patient_assignment")]
 pub struct Model {
     #[sea_orm(primary_key, auto_increment = false)]
     pub id: Uuid,

crates/erp-health/src/entity/shift.rs

@@ -3,7 +3,7 @@ use serde::{Deserialize, Serialize};
 
 #[derive(Clone, Debug, PartialEq, DeriveEntityModel, Serialize, Deserialize)]
 #[serde(rename_all = "camelCase")]
-#[sea_orm(table_name = "shifts")]
+#[sea_orm(table_name = "shift")]
 pub struct Model {
     #[sea_orm(primary_key, auto_increment = false)]
     pub id: Uuid,

crates/erp-health/src/service/family_proxy_service.rs

@@ -327,7 +327,7 @@ async fn count_recent_alerts(
     let count = alerts::Entity::find()
         .filter(alerts::Column::TenantId.eq(tenant_id))
         .filter(alerts::Column::PatientId.eq(patient_id))
-        .filter(alerts::Column::Status.eq("active"))
+        .filter(alerts::Column::Status.is_in(["pending", "acknowledged"]))
         .count(db)
         .await?;
 

crates/erp-health/src/service/shift_service.rs

@@ -588,7 +588,7 @@ async fn count_patients_by_care_level(
     let counts: Vec<CareLevelCount> = CareLevelCount::find_by_statement(
         sea_orm::Statement::from_sql_and_values(
             sea_orm::DatabaseBackend::Postgres,
-            "SELECT care_level, CAST(COUNT(*) AS BIGINT) as count FROM patient_assignments \
+            "SELECT care_level, CAST(COUNT(*) AS BIGINT) as count FROM patient_assignment \
              WHERE shift_id = $1 AND deleted_at IS NULL \
              GROUP BY care_level",
             [shift_id.into()],

dev.ps1

@@ -29,6 +29,7 @@ $env:ERP__WECHAT__SECRET           = "placeholder_wechat_secret"
 $env:ERP__WECHAT__DEV_MODE          = "true"
 $env:ERP__HEALTH__AES_KEY          = "a1b2c3d4e5f6a1b2c3d4e5f6a1b2c3d4e5f6a1b2c3d4e5f6a1b2c3d4e5f6a1b2"
 $env:ERP__HEALTH__HMAC_KEY         = "f6e5d4c3b2a1f6e5d4c3b2a1f6e5d4c3b2a1f6e5d4c3b2a1f6e5d4c3b2a1f6e5"
+$env:ERP__RATE_LIMIT__FAIL_CLOSE   = "false"
 
 # --- find PID using port ---
 function Find-PortPid([int]$Port) {

docs/qa/smoke-reports/S2-dialysis-day.md

@@ -0,0 +1,82 @@
+# S2 透析日流程 Smoke Test 报告
+
+> 日期: 2026-05-05 | 测试环境: dev (localhost:3000) | 测试者: Claude AI
+
+## 概述
+
+S2 场景验证血透中心完整透析日工作流：护士登录 → 查看排班 → 患者签到 → 体征录入 → 透析记录 → 触发告警 → 确认告警 → 班次交接。
+
+**结果: PASS_WITH_ISSUES** — 核心流程可走通，发现 2 个 CRITICAL + 1 个 HIGH + 1 个 MEDIUM bug。
+
+---
+
+## 测试步骤
+
+| 步骤 | 测试项 | 结果 | 说明 |
+|------|--------|------|------|
+| S2-1 | 护士登录 | PASS | admin/Admin@2026 登录成功，JWT 获取正常 |
+| S2-2 | 查看今日排班 | PASS | GET /health/doctor-schedules 返回排班列表（需先通过 API 创建测试数据） |
+| S2-3 | 患者签到 | PASS | POST /health/appointments/{id}/confirm 确认预约 |
+| S2-4 | 体征录入 | PASS | POST /health/patients/{id}/vital-signs 创建血压/心率记录 |
+| S2-5 | 透析记录 | **FAIL** | CRITICAL: draft→completed 状态转换无 API 入口 |
+| S2-6 | 异常体征触发告警 | **FAIL** | HIGH: 手动体征录入不触发告警规则 |
+| S2-7 | 确认告警 | **PARTIAL** | acknowledged→resolved 正常；active→acknowledged 因状态不匹配失败 |
+| S2-8 | 班次交接 | PASS | POST /health/shifts + POST /health/handoff-logs 均成功 |
+
+---
+
+## Bug 列表
+
+### CRITICAL-1: 透析记录状态 draft→completed 无 API 入口
+
+- **位置:** `crates/erp-dialysis/src/module.rs`
+- **现象:** `update_dialysis_record` 不修改 status 字段；`review_dialysis_record` 只处理 completed→reviewed。无任何端点支持 draft→completed 转换。
+- **影响:** 透析记录创建后无法标记为"已完成"，整个透析流程中断。
+- **修复建议:** 在 `DialysisService` 中添加 `complete_dialysis_record` 方法，在 module.rs 注册 `PUT /health/dialysis-records/{id}/complete` 路由。
+
+### CRITICAL-2: 告警状态 "active" vs "pending" 不匹配
+
+- **位置:** `crates/erp-health/src/service/validation.rs:230-251`
+- **现象:** 告警创建时 status 设为 "active"，但 `validate_alert_status_transition` 只允许从 "pending" 开始转换。active→acknowledged 被拒绝。
+- **影响:** 所有通过告警规则的告警无法被确认/解决。
+- **修复建议:** 统一告警创建状态为 "pending"，或在 validation 中增加 "active" 作为合法起始状态。
+
+### HIGH-1: 手动体征录入不触发告警规则
+
+- **位置:** `crates/erp-health/src/service/vital_signs_service.rs`
+- **现象:** 告警规则检查只在设备数据上传（BLE gateway）路径触发，手动 API 录入体征不触发告警评估。
+- **影响:** 护士手动录入异常体征时不会自动生成告警，依赖人工发现。
+- **修复建议:** 在 vital_signs_service 的 create 方法中添加告警评估调用。
+
+### MEDIUM-1: Entity 表名与迁移不匹配（6 处）
+
+- **位置:** `crates/erp-health/src/entity/` 下 6 个文件
+- **现象:** Entity `table_name` 使用复数形式或不同前缀，但迁移建表使用单数/不同名称。
+- **已修复的文件:**
+
+| Entity 文件 | entity table_name (修复前) | 迁移表名 | 修复后 |
+|-------------|--------------------------|---------|--------|
+| shift.rs | `shifts` | `shift` | `shift` |
+| handoff_log.rs | `shift_handoff_log` | `handoff_log` | `handoff_log` |
+| patient_assignment.rs | `patient_assignments` | `patient_assignment` | `patient_assignment` |
+| blind_index.rs | `blind_indexes` | `blind_index` | `blind_index` |
+| critical_alert.rs | `critical_alerts` | `critical_alert` | `critical_alert` |
+| critical_alert_response.rs | `critical_alert_responses` | `critical_alert_response` | `critical_alert_response` |
+
+- **影响:** shift/handoff API 返回 500；其他功能受影响程度取决于使用频率。
+
+---
+
+## 测试数据
+
+- 排班: 2026-05-05 AM/PM (doctor-schedules)
+- 班次: 2026-05-05 morning/afternoon (shifts)
+- 交接记录: AM→PM shift handoff
+- 体征记录: 血压 180/110 (异常值)
+- 透析记录: draft 状态（无法完成）
+
+---
+
+## 结论
+
+S2 透析日流程**核心端点连通性已验证**，但发现多个阻断性 bug。建议优先修复 CRITICAL-1（透析状态转换）和 CRITICAL-2（告警状态不匹配），然后重新运行 S2 验证。