feat(ai): Phase 2B 洞察→推送→反馈闭环 — 风险评分+通知+建议反馈

- 风险评分引擎 load_patient_data 实装（体征+化验异常）
- refresh_all_patients 高风险自动创建洞察+事件推送
- erp-message 订阅 copilot.insight.created 推送医护通知
- 每日 cron 增加洞察过期清理+建议过期清理
- POST /ai/suggestions/{id}/feedback 建议反馈端点
- SuggestionFeedbackService 反馈服务层
- 小程序健康页建议卡片增加采纳/忽略/咨询医生按钮

crates/erp-ai/src/module.rs

@@ -352,14 +352,18 @@ impl ErpModule for AiModule {
 
         // 每日凌晨 2:00 批量刷新所有在管患者风险快照
         let refresh_db = ctx.db.clone();
+        let refresh_event_bus = ctx.event_bus.clone();
         tokio::spawn(async move {
             // 首次执行延迟到下一个凌晨 2:00（简单实现：延迟 6 小时后开始 24h 周期）
             tokio::time::sleep(std::time::Duration::from_secs(6 * 3600)).await;
             let mut interval = tokio::time::interval(std::time::Duration::from_secs(86400));
             loop {
                 interval.tick().await;
-                match crate::service::risk_service::RiskService::refresh_all_patients(&refresh_db)
-                    .await
+                match crate::service::risk_service::RiskService::refresh_all_patients(
+                    &refresh_db,
+                    Some(&refresh_event_bus),
+                )
+                .await
                 {
                     Ok(count) => {
                         tracing::info!(patient_count = count, "每日风险快照刷新完成");
@@ -368,6 +372,22 @@ impl ErpModule for AiModule {
                         tracing::warn!(error = %e, "每日风险快照刷新失败");
                     }
                 }
+                // 清理过期洞察 + 过期建议
+                match crate::service::insight_service::InsightService::cleanup_expired(&refresh_db)
+                    .await
+                {
+                    Ok(n) => tracing::info!(expired_count = n, "过期洞察清理完成"),
+                    Err(e) => tracing::warn!(error = %e, "过期洞察清理失败"),
+                }
+                match crate::service::suggestion::SuggestionService::expire_stale_all_tenants(
+                    &refresh_db,
+                    30,
+                )
+                .await
+                {
+                    Ok(n) => tracing::info!(expired_count = n, "过期建议清理完成"),
+                    Err(e) => tracing::warn!(error = %e, "过期建议清理失败"),
+                }
             }
         });
 
@@ -478,6 +498,10 @@ impl AiModule {
                 "/ai/suggestions/{id}/comparison",
                 axum::routing::get(crate::handler::suggestion_handler::get_comparison),
             )
+            .route(
+                "/ai/suggestions/{id}/feedback",
+                axum::routing::post(crate::handler::suggestion_handler::submit_feedback),
+            )
             .route(
                 "/ai/dialysis/risk-assessment",
                 axum::routing::post(crate::handler::assess_dialysis_risk),