using IRaCIS.Core.Application.Service.Reading.Dto; using IRaCIS.Core.Domain.Share; using Microsoft.AspNetCore.Mvc; using IRaCIS.Core.Domain.Models; using IRaCIS.Core.Application.Interfaces; using IRaCIS.Core.Application.ViewModel; using Panda.DynamicWebApi.Attributes; using IRaCIS.Core.Infra.EFCore.Common; using Microsoft.Extensions.Caching.Memory; using IRaCIS.Core.Infrastructure; using MassTransit; namespace IRaCIS.Core.Application.Service.ReadingCalculate { [ApiExplorerSettings(GroupName = "Reading")] public class RECIST1Point1_BMCalculateService : BaseService, ICriterionCalculateService { private readonly IRepository _readingTableQuestionAnswerRepository; private readonly IRepository _visitTaskRepository; private readonly IRepository _readingQuestionCriterionTrialRepository; private readonly IRepository _readingTableQuestionTrialRepository; private readonly IRepository _readingTableAnswerRowInfoRepository; private readonly IRepository _readingQuestionTrialRepository; private readonly IRepository _organInfoRepository; private readonly IRepository _subjectVisitRepository; private readonly IRepository _tumorAssessment_RECIST1Point1BM; private readonly IGeneralCalculateService _generalCalculateService; private readonly IRepository _readingTaskQuestionAnswerRepository; public RECIST1Point1_BMCalculateService( IRepository readingTableQuestionAnswerRepository, IRepository visitTaskRepository, IRepository readingQuestionCriterionTrialRepository, IRepository readingTableQuestionTrialRepository, IRepository readingTableAnswerRowInfoRepository, IRepository readingQuestionTrialRepository, IRepository organInfoRepository, IRepository subjectVisitRepository, IRepository tumorAssessment_RECIST1Point1BM, IGeneralCalculateService generalCalculateService, IRepository readingTaskQuestionAnswerRepository ) { this._readingTableQuestionAnswerRepository = readingTableQuestionAnswerRepository; this._visitTaskRepository = visitTaskRepository; this._readingQuestionCriterionTrialRepository = readingQuestionCriterionTrialRepository; this._readingTableQuestionTrialRepository = readingTableQuestionTrialRepository; this._readingTableAnswerRowInfoRepository = readingTableAnswerRowInfoRepository; this._readingQuestionTrialRepository = readingQuestionTrialRepository; this._organInfoRepository = organInfoRepository; this._subjectVisitRepository = subjectVisitRepository; this._tumorAssessment_RECIST1Point1BM = tumorAssessment_RECIST1Point1BM; this._generalCalculateService = generalCalculateService; this._readingTaskQuestionAnswerRepository = readingTaskQuestionAnswerRepository; } #region 临时对象 单个请求的生命周期 避免重复查询数据库 private List visitTaskAnswerList; /// /// 获取Sod的值 /// private decimal? sODData; private string nAString = "NA"; #endregion #region 删除病灶获取起始病灶序号 /// /// 删除病灶获取起始病灶序号(RECIST1Point1 固定是1) /// /// public async Task GetDeleteLesionStatrIndex(DeleteReadingRowAnswerInDto inDto) { return 1; } #endregion #region 获取阅片报告 /// /// 获取阅片报告 /// /// /// [HttpPost] public async Task GetReadingReportEvaluation(GetReadingReportEvaluationInDto indto) { GetReadingReportEvaluationOutDto result = new GetReadingReportEvaluationOutDto(); result.CalculateResult = await this.GetReportVerify(new GetReportVerifyInDto() { VisitTaskId = indto.VisitTaskId }); var visitTaskInfo = await _visitTaskRepository.Where(x => x.Id == indto.VisitTaskId).FirstNotNullAsync(); result.ReadingTaskState = visitTaskInfo.ReadingTaskState; var taskInfoList = await _generalCalculateService.GetReadingReportTaskList(indto.VisitTaskId); result.VisitTaskList = taskInfoList; var visitTaskIds = taskInfoList.Select(x => x.VisitTaskId).ToList(); var criterionId = visitTaskInfo.TrialReadingCriterionId; var questionList = await _readingQuestionTrialRepository.Where(x => x.ReadingQuestionCriterionTrialId == criterionId && x.ShowQuestion != ShowQuestion.Hide).ToListAsync(); var tableQuestionList = await _readingTableQuestionTrialRepository.Where(x => x.TrialCriterionId == criterionId).OrderBy(x => x.ShowOrder).ToListAsync(); var tableAnsweRowInfos = await _readingTableAnswerRowInfoRepository.Where(x => x.VisitTaskId == indto.VisitTaskId).ProjectTo(_mapper.ConfigurationProvider).ToListAsync(); var answers = await _readingTaskQuestionAnswerRepository.Where(x => visitTaskIds.Contains(x.VisitTaskId)).ToListAsync(); var tableAnswers = await _readingTableQuestionAnswerRepository.Where(x => visitTaskIds.Contains(x.VisitTaskId)).ToListAsync(); var alltableAnsweRowInfos = await _readingTableAnswerRowInfoRepository.Where(x => visitTaskIds.Contains(x.VisitTaskId)).ToListAsync(); var organIds = alltableAnsweRowInfos.Where(x => x.OrganInfoId != null).Select(x => x.OrganInfoId).Distinct().ToList(); var organInfos = await _organInfoRepository.Where(x => organIds.Contains(x.Id)).ToListAsync(); var needChangeType = new List() { QuestionMark.Organ, QuestionMark.Location, QuestionMark.Part, }; // 第一级 #region 构造问题 List questions = questionList.Where(x => x.Type == ReadingQestionType.Group).OrderBy(x => x.ShowOrder).Select(x => new ReadingReportDto() { QuestionId = x.Id, GroupName = x.GroupName, GroupEnName=x.GroupEnName, IsShowInDicom = x.IsShowInDicom, Type = x.Type, GroupId=x.GroupId, QuestionType = x.QuestionType, LesionType = x.LesionType, QuestionGenre = x.QuestionGenre, DataSource = x.DataSource, DictionaryCode = x.DictionaryCode, TypeValue = x.TypeValue, QuestionName = x.QuestionName.LanguageName(x.QuestionEnName, _userInfo.IsEn_Us), ShowOrder = x.ShowOrder, ValueType = x.ValueType, Unit = x.Unit, CustomUnit=x.CustomUnit, ReportLayType= ReportLayType.Group, }).ToList(); // 分组 foreach (var item in questions) { item.Childrens = questionList.Where(x => x.GroupId==item.QuestionId).OrderBy(x => x.ShowOrder).Select(x => new ReadingReportDto() { GroupName = x.GroupName, QuestionId = x.Id, IsShowInDicom = x.IsShowInDicom, GroupEnName=x.GroupEnName, QuestionName = x.QuestionName.LanguageName(x.QuestionEnName, _userInfo.IsEn_Us), LesionType = x.LesionType, QuestionGenre = x.QuestionGenre, DataSource = x.DataSource, DictionaryCode = x.DictionaryCode, Type = x.Type, QuestionType = x.QuestionType, TypeValue = x.TypeValue, ShowOrder = x.ShowOrder, OrderMark = x.OrderMark, ValueType = x.ValueType, Unit = x.Unit, CustomUnit=x.CustomUnit, ReportLayType = ReportLayType.Question, }).ToList(); // 问题 foreach (var question in item.Childrens) { foreach (var task in taskInfoList) { var answer = answers.Where(x => x.VisitTaskId == task.VisitTaskId && x.ReadingQuestionTrialId == question.QuestionId).FirstOrDefault(); question.Answer.Add(new TaskQuestionAnswer() { Answer = answer==null?string.Empty:answer.Answer, IsGlobalChange = answer == null ? false : answer.IsGlobalChange, GlobalChangeAnswer = answer == null ? string.Empty : answer.GlobalChangeAnswer, TaskName = task.TaskName, VisitTaskId = task.VisitTaskId, }); } // 构造表格行数据 var rowlist = tableAnsweRowInfos.Where(x => x.QuestionId == question.QuestionId).OrderBy(x => x.RowIndex).ToList(); question.Childrens = rowlist.Select(x => new ReadingReportDto() { QuestionName = question.OrderMark + x.RowIndex.GetLesionMark(), SplitOrMergeLesionName = x.MergeName.IsNullOrEmpty() ? x.SplitName : x.MergeName, SplitOrMergeType = x.SplitOrMergeType, LesionType = question.LesionType, IsShowInDicom = question.IsShowInDicom, IsCanEditPosition = x.IsCanEditPosition, RowIndex = x.RowIndex, BlindName = x.BlindName, ReportLayType = ReportLayType.Lesions, }).ToList(); foreach (var row in question.Childrens) { // tableQuestion row.Childrens = tableQuestionList.Where(x => x.ReadingQuestionId == question.QuestionId).Select(x => new ReadingReportDto() { QuestionName = x.QuestionName.LanguageName(x.QuestionEnName, _userInfo.IsEn_Us), QuestionId = x.ReadingQuestionId, TableQuestionId = x.Id, Type = x.Type, LesionType = question.LesionType, TableQuestionType = x.TableQuestionType, RowId=row.RowId, IsShowInDicom = question.IsShowInDicom, DataSource = x.DataSource, DictionaryCode = x.DictionaryCode, QuestionMark = x.QuestionMark, TypeValue = x.TypeValue, RowIndex = row.RowIndex, ShowOrder = x.ShowOrder, ValueType = x.ValueType, Unit = x.Unit, ReportLayType = ReportLayType.TableQuestion, }).ToList(); foreach (var tableQuestion in row.Childrens) { foreach (var task in taskInfoList) { var rowinfo = alltableAnsweRowInfos.Where(x => x.VisitTaskId == task.VisitTaskId && x.QuestionId == tableQuestion.QuestionId && x.RowIndex == tableQuestion.RowIndex).FirstOrDefault(); var taskQuestionAnswer = new TaskQuestionAnswer() { Answer = tableAnswers.Where(x => x.VisitTaskId == task.VisitTaskId && x.QuestionId == tableQuestion.QuestionId && x.RowIndex == tableQuestion.RowIndex && x.TableQuestionId == tableQuestion.TableQuestionId).Select(x => x.Answer).FirstIsNullReturnEmpty(), TaskName = task.TaskName, VisitTaskId = task.VisitTaskId, }; if (rowinfo != null && rowinfo.OrganInfoId != null) { var organInfo = organInfos.Where(x => x.Id == rowinfo.OrganInfoId).FirstOrDefault(); if (organInfo != null && needChangeType.Contains(tableQuestion.QuestionMark)) { if (_userInfo.IsEn_Us) { switch (tableQuestion.QuestionMark) { case QuestionMark.Organ: taskQuestionAnswer.Answer= organInfo.TULOCEN; break; case QuestionMark.Location: if (organInfo.IsCanEditPosition) { } else { taskQuestionAnswer.Answer = organInfo.TULATEN; } break; case QuestionMark.Part: taskQuestionAnswer.Answer = organInfo.PartEN; break; } } else { switch (tableQuestion.QuestionMark) { case QuestionMark.Organ: taskQuestionAnswer.Answer = organInfo.TULOC; break; case QuestionMark.Location: if (organInfo.IsCanEditPosition) { } else { taskQuestionAnswer.Answer = organInfo.TULAT; } break; case QuestionMark.Part: taskQuestionAnswer.Answer = organInfo.Part; break; } } } } tableQuestion.Answer.Add(taskQuestionAnswer); } } } }; } #endregion result.TaskQuestions = questions; return result; } #endregion /// /// 测试计算 /// /// /// /// [HttpPost] public async Task TestCalculate(Guid visitTaskId, QuestionType type) { ReadingCalculateDto readingData = await _generalCalculateService.GetReadingCalculateDto(visitTaskId); await ReadingCalculate(readingData,new List() { type}); } /// /// 计算任务 /// /// /// [HttpPost] public async Task CalculateTask(CalculateTaskInDto inDto) { ReadingCalculateDto readingData = await _generalCalculateService.GetReadingCalculateDto(inDto.VisitTaskId); readingData.IsChangeOtherTask = inDto.IsChangeOtherTask; await ReadingCalculate(readingData); } /// /// 获取报告验证的信息(这里每个标准可能不一样 返回用object) /// /// /// public async Task GetReportVerify(GetReportVerifyInDto inDto) { return new GetReportVerifyOutDto() { TumorEvaluate = await this.GetReportTumor(inDto.VisitTaskId), IsExistDisease = await this.GetReportIsExistDisease(inDto.VisitTaskId), }; } /// /// 自动计算 /// /// /// /// public async Task ReadingCalculate(ReadingCalculateDto inDto,List? calculateType=null) { #region 计算 这里顺序非常重要 后面计算的值要依赖前面计算的结果 var needAddList = new List(); List calculateList = new List() { //靶病灶径线之和(SOD) new ReadingCalculateData (){QuestionType=QuestionType.SOD,GetDecimalNullFun=GetSODData}, //非淋巴结靶病灶长径之和 new ReadingCalculateData (){QuestionType=QuestionType.SumOfDiameter,GetDecimalNullFun=GetSumOfDiameter}, //与基线SOD相比变化量(mm) new ReadingCalculateData (){QuestionType=QuestionType.SODChange,GetDecimalNullFun=GetSODChange}, //与基线访视相比SOD变化百分比 new ReadingCalculateData (){QuestionType=QuestionType.SODPercent,GetDecimalNullFun=GetSODPercent}, //与整个访视期间SOD最低点相比增加的值(mm) //其他任务需要改 new ReadingCalculateData (){QuestionType=QuestionType.LowestIncrease,GetDecimalNullFun=GetLowestIncrease,/*ChangeAllTaskFun=ChangeAllLowestIncrease*/}, //与整个访视期间SOD最低点相比增加的百分比 //其他任务需要改 new ReadingCalculateData (){QuestionType=QuestionType.LowPercent,GetDecimalNullFun=GetLowPercent,/*ChangeAllTaskFun=ChangeAllLowPercent*/}, //整个访视期间SOD最低点访视名称 //其他任务需要改 new ReadingCalculateData (){QuestionType=QuestionType.LowVisit,GetStringFun=GetLowVisit,/*ChangeAllTaskFun=ChangeAllLowVisitName*/}, //是否存在非淋巴结靶病灶 new ReadingCalculateData (){QuestionType=QuestionType.IsLymphTarget,GetStringFun=GetIsLymphTarget}, //是否存在淋巴结靶病灶且该病灶比上一访视短径增加5MM以上 new ReadingCalculateData (){QuestionType=QuestionType.IsAddFive,GetStringFun=GetIsAddFive}, //被评估为NE的单个靶病灶 new ReadingCalculateData (){QuestionType=QuestionType.NETarget,GetStringFun=GetNETarget}, //靶病灶评估 new ReadingCalculateData (){QuestionType=QuestionType.TargetLesion,GetStringFun=GetTargetLesionEvaluate}, //非靶病灶评估 new ReadingCalculateData (){QuestionType=QuestionType.NoTargetLesion,GetStringFun=GetNoTargetLesionEvaluate}, //是否存在新病灶 new ReadingCalculateData (){QuestionType=QuestionType.NewLesions,GetStringFun=GetNewLesionEvaluate}, //整体肿瘤评估 new ReadingCalculateData (){QuestionType=QuestionType.Tumor,GetStringFun=GetTumor}, //是否存在疾病 new ReadingCalculateData (){QuestionType=QuestionType.ExistDisease,GetStringFun=GetIsExistDisease}, }; // 没有靶病灶只计算最后几个 if (inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).Sum(x => x.TableRowInfoList.Count()) == 0) { List questionTypes = new List() { QuestionType.TargetLesion, QuestionType.NoTargetLesion, QuestionType.NewLesions, QuestionType.Tumor, QuestionType.ExistDisease, }; // 没有靶病灶就删除其他几个答案的值 var isNeedDeleteTypes = calculateList.Where(x => !questionTypes.Contains(x.QuestionType)).Select(x => x.QuestionType).ToList(); var isNeedDeleteIds = inDto.QuestionInfo.Where(x =>x.QuestionType!=null&& isNeedDeleteTypes.Contains(x.QuestionType.Value)).Select(x => x.QuestionId).ToList(); await _readingTaskQuestionAnswerRepository.BatchUpdateNoTrackingAsync(x => x.VisitTaskId == inDto.VisitTaskId && isNeedDeleteIds.Contains(x.ReadingQuestionTrialId), x => new ReadingTaskQuestionAnswer { Answer = string.Empty }); calculateList = calculateList.Where(x => questionTypes.Contains(x.QuestionType)).ToList(); } if (calculateType != null) { calculateList = calculateList.Where(x => calculateType.Contains(x.QuestionType)).ToList(); } var typeNAList = new List { QuestionType.SODChange, QuestionType.SODPercent, QuestionType.LowestIncrease, QuestionType.LowPercent, }; foreach (var calculate in calculateList) { var item = inDto.QuestionInfo.FirstOrDefault(x => x.QuestionType == calculate.QuestionType); if (item != null) { //计算答案 if (inDto.IsOnlyChangeAllTask == false) { #region 计算答案 if (calculate.GetDecimalFun != null) { item.Answer = (await calculate.GetDecimalFun(inDto)).ToString(); } else if (calculate.GetDecimalNullFun != null) { var value = await calculate.GetDecimalNullFun(inDto); if (value == null) { if (typeNAList.Contains(item.QuestionType ?? QuestionType.SOD)) { item.Answer = nameof(YesOrNoOrNa.NA); } else { item.Answer = this.nAString; } } else { item.Answer = value==null?string.Empty: value.ToString(); } } else if (calculate.GetStringFun != null) { item.Answer = await calculate.GetStringFun(inDto); } #endregion // 修改修约小数位数 List valueOfTypes = new List() { ValueOfType.Decimals, ValueOfType.Percentage }; if (inDto.DigitPlaces != -1) { try { if (valueOfTypes.Contains(item.ValueType)) { item.Answer = decimal.Round(decimal.Parse(item.Answer ?? "0"), inDto.DigitPlaces).ToString(); } } catch (Exception) { } } needAddList.Add(new ReadingTaskQuestionAnswer() { Answer = item.Answer, ReadingQuestionTrialId = item.QuestionId, }); } // 修改全局 if (inDto.IsChangeOtherTask && calculate.ChangeAllTaskFun != null) { await calculate.ChangeAllTaskFun(new ChangeAllTaskDto() { calculateDto = inDto, QuestionId = item.QuestionId, }); } } } var questionIds = needAddList.Select(x => x.ReadingQuestionTrialId).ToList(); await _readingTaskQuestionAnswerRepository.BatchDeleteNoTrackingAsync(x => questionIds.Contains(x.ReadingQuestionTrialId) && x.VisitTaskId == inDto.VisitTaskId); needAddList.ForEach(x => { x.SubjectId = inDto.SubjectId; x.ReadingQuestionCriterionTrialId = inDto.CriterionId; x.VisitTaskId = inDto.VisitTaskId; x.TrialId = inDto.TrialId; x.SubjectId = inDto.SubjectId; }); await _readingTaskQuestionAnswerRepository.AddRangeAsync(needAddList); await _readingTaskQuestionAnswerRepository.SaveChangesAsync(); #endregion } /// /// 获取报告整体整体评估 /// /// /// public async Task GetReportTumor(Guid visitTaskId) { return await GetTumor(await _generalCalculateService.GetReadingCalculateDto(visitTaskId)); } /// /// 获取报告是否存在疾病 /// /// /// public async Task GetReportIsExistDisease(Guid visitTaskId) { return await GetIsExistDisease(await _generalCalculateService.GetReadingCalculateDto(visitTaskId)); } /// /// 验证访视提交 /// /// /// public async Task VerifyVisitTaskQuestions(VerifyVisitTaskQuestionsInDto inDto) { if (await _readingTaskQuestionAnswerRepository.AnyAsync(x => x.ReadingQuestionTrial.QuestionType == QuestionType.ImageQualityAssessment && x.VisitTaskId == inDto.VisitTaskId && x.Answer == ImageQualityEvaluation.Abnormal.GetEnumInt())) { return; } var tableAnswerList = await _readingTableQuestionAnswerRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId && (x.Answer == string.Empty || x.Answer == null) && x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.State ) .Select(x => new { x.ReadingQuestionTrial.OrderMark, x.RowIndex, QuestionMark = x.ReadingTableQuestionTrial.QuestionMark, Answer = x.Answer, }).ToListAsync(); string errorMassage = string.Empty; var rowAnswerList = await _readingTableAnswerRowInfoRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId && (x.MeasureData == string.Empty || x.MeasureData == null)) .Select(x => new { x.ReadingQuestionTrial.OrderMark, x.RowIndex, x.Id, }).ToListAsync(); var unableEvaluateRowIds = await _readingTableQuestionAnswerRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId && x.Answer == TargetState.UnableEvaluate.GetEnumInt() && x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.State ) .Select(x => x.RowId).Distinct().ToListAsync(); List measureDataList = rowAnswerList.Where(x => !unableEvaluateRowIds.Contains(x.Id)).Select(x => x.OrderMark + x.RowIndex.GetLesionMark()).ToList(); List stateIsNullList = tableAnswerList.Select(x => x.OrderMark + x.RowIndex.GetLesionMark()).ToList(); List allExists = measureDataList.Intersect(stateIsNullList).ToList(); measureDataList = measureDataList.Except(allExists).ToList(); stateIsNullList = stateIsNullList.Except(allExists).ToList(); if (measureDataList.Count() > 0) { errorMassage += _localizer["ReadingCalculate_NoMarker", string.Join(',', measureDataList)] + ","; } if (tableAnswerList.Count > 0) { errorMassage += _localizer["ReadingCalculate_StatusIsEmpty", string.Join(',', stateIsNullList)] + ","; } if (allExists.Count > 0) { errorMassage += _localizer["ReadingCalculate_NoMarkerEmpty", string.Join(',', stateIsNullList)] + ","; } if (errorMassage != string.Empty) { errorMassage = _localizer["ReadingCalculate_Questionable"] + errorMassage; throw new BusinessValidationFailedException(errorMassage); } } #region 将上一次的访视病灶添加到这一次 /// /// 将上一次的访视病灶添加到这一次 /// /// /// public async Task AddTaskLesionAnswerFromLastTask(AddTaskLesionAnswerFromLastTaskInDto inDto) { var visitTaskId = inDto.VisitTaskId; var taskinfo = await _visitTaskRepository.Where(x => x.Id == visitTaskId).FirstNotNullAsync(); var baseLineVisitId = await _subjectVisitRepository.Where(x => x.SubjectId == taskinfo.SubjectId && x.IsBaseLine).Select(x => x.Id).FirstOrDefaultAsync(); // 判断当前任务是否是基线 if (taskinfo.SourceSubjectVisitId != baseLineVisitId) { // 判断当前任务是是否有表格问题答案 if (!(await _readingTableQuestionAnswerRepository.AnyAsync(x => x.VisitTaskId == visitTaskId))) { var LastVisitTaskId = await _visitTaskRepository.Where(x => x.ReadingCategory == ReadingCategory.Visit && x.TrialReadingCriterionId == taskinfo.TrialReadingCriterionId && x.IsAnalysisCreate== taskinfo.IsAnalysisCreate&& x.DoctorUserId == taskinfo.DoctorUserId && x.IsSelfAnalysis== taskinfo.IsSelfAnalysis && x.SubjectId == taskinfo.SubjectId && x.ReadingTaskState == ReadingTaskState.HaveSigned && x.VisitTaskNum < taskinfo.VisitTaskNum && x.TaskState == TaskState.Effect && x.ArmEnum == taskinfo.ArmEnum ).OrderByDescending(x => x.VisitTaskNum).Select(x => x.Id).FirstOrDefaultAsync(); var copyTableAnswers = await _readingTableQuestionAnswerRepository.Where(x => x.VisitTaskId == LastVisitTaskId).Select(x => new CopyTableAnswerDto() { Answer = x.Answer, QuestionId = x.QuestionId, RowId = x.RowId, QuestionMark = x.ReadingTableQuestionTrial.QuestionMark, TableQuestionId = x.TableQuestionId, RowIndex = x.RowIndex, TrialId = x.TrialId }).ToListAsync(); var tableRowAnswers = await _readingTableAnswerRowInfoRepository.Where(x => x.VisitTaskId == LastVisitTaskId).ProjectTo(_mapper.ConfigurationProvider).ToListAsync(); tableRowAnswers.ForEach(x => { x.VisitTaskId = visitTaskId; x.IsCurrentTaskAdd = false; x.Id = NewId.NextGuid(); x.SeriesId = null; x.InstanceId = null; x.MeasureData = string.Empty; x.PicturePath= string.Empty; }); tableRowAnswers.ForEach(x => { x.SplitRowId = tableRowAnswers.Where(y => y.OriginalId == x.SplitRowId).Select(y => y.Id).FirstOrDefault(); x.MergeRowId = tableRowAnswers.Where(y => y.OriginalId == x.MergeRowId).Select(y => y.Id).FirstOrDefault(); }); List notNeedCopyMarks = new List() { QuestionMark.MajorAxis, QuestionMark.ShortAxis, QuestionMark.State, }; var tableAnswers = copyTableAnswers.Select(x => new ReadingTableQuestionAnswer { Id = NewId.NextGuid(), Answer = notNeedCopyMarks.Contains(x.QuestionMark) ? string.Empty : x.Answer, QuestionId = x.QuestionId, RowIndex = x.RowIndex, RowId = tableRowAnswers.Where(y => y.OriginalId == x.RowId).Select(x => x.Id).FirstOrDefault(), TableQuestionId = x.TableQuestionId, TrialId = x.TrialId, VisitTaskId = visitTaskId, }); var addList= _mapper.Map>(tableRowAnswers); await _readingTableAnswerRowInfoRepository.AddRangeAsync(addList); await _readingTableQuestionAnswerRepository.AddRangeAsync(tableAnswers); await _readingTableQuestionAnswerRepository.SaveChangesAsync(); } } return new AddTaskLesionAnswerFromLastTaskOutDto() { IsBaseLine = taskinfo.SourceSubjectVisitId == baseLineVisitId, }; } #endregion #region 获取SOD /// /// 获取SOD /// /// /// 靶病灶径线之和(SOD) /// 非淋巴结的长径 和淋巴结的短径 /// /// public async Task GetSODData(ReadingCalculateDto inDto) { if (sODData != null) { return sODData.Value; } var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).SelectMany(x => x.TableRowInfoList).ToList(); if (tableQuestion.Count() == 0) { return null; } decimal result = 0; foreach (var item in tableQuestion) { if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.Yes))) { // 淋巴结的短径 result += (item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.ShortAxis).Select(x => x.Answer).FirstOrDefault()).IsNullOrEmptyReturn0(); } if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.No))) { // 非淋巴结的长径 result += item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.MajorAxis).Select(x => x.Answer).FirstOrDefault().IsNullOrEmptyReturn0(); } } sODData = result; return sODData.Value; } #endregion #region 非淋巴结靶病灶长径之和 /// /// 非淋巴结靶病灶长径之和 /// /// /// public async Task GetSumOfDiameter(ReadingCalculateDto inDto) { var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).SelectMany(x => x.TableRowInfoList).ToList(); if (tableQuestion.Count() == 0) { return null; } decimal result = 0; foreach (var item in tableQuestion) { if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.No))) { // 非淋巴结的长径 result += item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.MajorAxis).Select(x => x.Answer).FirstOrDefault().IsNullOrEmptyReturn0(); } } return result; } #endregion #region 与基线SOD相比变化量(mm) /// /// 与基线SOD相比变化量(mm) /// /// /// public async Task GetSODChange(ReadingCalculateDto inDto) { var value = await GetSODData(inDto); if (value == null || inDto.IsBaseLine) { return null; } return value.NullChange0() - await GetBaseLineSOD(inDto); } #endregion #region 与基线访视相比SOD变化百分比 /// /// 与基线访视相比SOD变化百分比 /// /// /// public async Task GetSODPercent(ReadingCalculateDto inDto) { var thisSOD = await GetSODData(inDto); if (thisSOD == null || inDto.IsBaseLine) { return null; } var baseLineSOD = await GetBaseLineSOD(inDto); if (baseLineSOD == 0) { return 100; } else { return (thisSOD.NullChange0() - baseLineSOD) * 100 / baseLineSOD; } } #endregion #region 与整个访视期间SOD最低点相比增加的值(mm) /// /// 与整个访视期间SOD最低点相比增加的值(mm) /// /// /// /// 要更新之前的 /// /// public async Task GetLowestIncrease(ReadingCalculateDto inDto) { var value = await GetSODData(inDto); if (value == null || inDto.IsBaseLine) { return null; } var decimalAnswerList = await GetLowSODVisit(inDto); var minSOD = decimalAnswerList.OrderBy(x => x.SOD).Select(x => x.SOD).FirstOrDefault(); return value.NullChange0() - minSOD; } #endregion #region 与整个访视期间SOD最低点相比增加的百分比 /// /// 与整个访视期间SOD最低点相比增加的百分比 /// /// /// /// 要更新之前的 /// /// public async Task GetLowPercent(ReadingCalculateDto inDto) { var thisSOD = await GetSODData(inDto); if (thisSOD == null || inDto.IsBaseLine) { return null; } var decimalAnswerList = await GetLowSODVisit(inDto); var minSOD = decimalAnswerList.OrderBy(x => x.SOD).Select(x => x.SOD).FirstOrDefault(); if (minSOD == 0) { return 100; } else { return (thisSOD.NullChange0() - minSOD) * 100 / minSOD; } } #endregion #region 整个访视期间SOD最低点访视名称 /// /// 整个访视期间SOD最低点访视名称 /// /// /// /// 要更新之前的 /// /// public async Task GetLowVisit(ReadingCalculateDto inDto) { if (inDto.IsBaseLine) { return nameof(YesOrNoOrNa.NA); } var targetCount = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).SelectMany(x => x.TableRowInfoList).Count(); if (targetCount == 0) { return nameof(YesOrNoOrNa.NA); } var decimalAnswerList = await GetLowSODVisit(inDto); return decimalAnswerList.OrderBy(x => x.SOD).Select(x => x.BlindName).FirstOrDefault() ?? string.Empty; } #endregion #region 是否存在非淋巴结靶病灶 /// /// 是否存在非淋巴结靶病灶 /// /// /// public async Task GetIsLymphTarget(ReadingCalculateDto inDto) { var result = IsLymph.No.GetEnumInt(); var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).SelectMany(x => x.TableRowInfoList).ToList(); foreach (var item in tableQuestion) { if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(IsLymph.No))) { result = IsLymph.Yes.GetEnumInt(); } } return result; } #endregion #region 是否存在淋巴结靶病灶且该病灶比上一访视短径增加5MM以上 /// /// 是否存在淋巴结靶病灶且该病灶比上一访视短径增加5MM以上 /// /// /// public async Task GetIsAddFive(ReadingCalculateDto inDto) { if (inDto.IsBaseLine) { return YesOrNoOrNa.NA.GetEnumInt(); } var addFiveList = await GetIsAddFiveRowIndexs(inDto); var isExists = addFiveList.Count() > 0 ? true : false; return isExists ? YesOrNoOrNa.Yes.GetEnumInt() : YesOrNoOrNa.No.GetEnumInt(); } /// /// 获取存在淋巴结靶病灶且该病灶比上一访视短径增加5MM以上的病灶 /// /// /// public async Task> GetIsAddFiveRowIndexs(ReadingCalculateDto inDto) { List result = new List(); var LastVisitTaskId = await this.GetLastVisitTaskId(inDto); var questionIds = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).Select(x => x.QuestionId).ToList(); var lastQuestionAsnwer = await _readingTableQuestionAnswerRepository.Where(x => x.VisitTaskId == LastVisitTaskId && questionIds.Contains(x.QuestionId)).Include(x => x.ReadingQuestionTrial).Include(x => x.ReadingTableQuestionTrial).ToListAsync(); var rowIndexs = lastQuestionAsnwer.Where(x => x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.Yes)).Select(x => x.RowIndex).Distinct().OrderBy(x => x).ToList(); var thisQuestionAsnwer = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).SelectMany(x => x.TableRowInfoList).ToList(); foreach (var item in rowIndexs) { var lastValue = lastQuestionAsnwer.Where(x => x.RowIndex == item && x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.ShortAxis).Select(x => x.Answer).FirstOrDefault().IsNullOrEmptyReturn0(); var thisRowData = thisQuestionAsnwer.Where(x => x.RowIndex == item).SelectMany(x => x.TableQuestionList).ToList(); var thisValue = thisRowData.Where(x => x.QuestionMark == QuestionMark.ShortAxis).Select(x => x.Answer).FirstOrDefault().IsNullOrEmptyReturn0(); if (thisValue - lastValue >= 5) { result.Add(item); } } return result; } #endregion #region 被评估为NE的单个靶病灶 /// /// 被评估为NE的单个靶病灶 /// /// /// public async Task GetNETarget(ReadingCalculateDto inDto) { if (inDto.IsBaseLine) { return ExistOrNA.NA.GetEnumInt(); } var result = inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && x.Answer.EqEnum(TargetAssessment.NE)); return result ? ExistOrNA.Exist.GetEnumInt() : ExistOrNA.NotExist.GetEnumInt(); } #endregion #region 整体肿瘤评估 /// /// 整体肿瘤评估 /// /// /// public async Task GetTumor(ReadingCalculateDto inDto) { if (inDto.IsBaseLine) { return OverallAssessment.NA.GetEnumInt(); } var targetLesion = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.TargetLesion).Select(x => x.Answer).FirstOrDefault(); var noTargetLesion = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NoTargetLesion).Select(x => x.Answer).FirstOrDefault(); var newLesions = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NewLesions).Select(x => x.Answer).FirstOrDefault(); var result = await _tumorAssessment_RECIST1Point1BM.Where(x => x.TargetLesion == (TargetAssessment)int.Parse(targetLesion.IsNullOrEmpty() ? TargetAssessment.NA.GetEnumInt() : targetLesion) && x.NonTargetLesions == (NoTargetAssessment)int.Parse(noTargetLesion.IsNullOrEmpty() ? NoTargetAssessment.NA.GetEnumInt() : noTargetLesion) && x.NewLesion == (NewLesionAssessment)int.Parse(newLesions.IsNullOrEmpty() ? NewLesionAssessment.NA.GetEnumInt() : newLesions)).Select(x => x.OverallEfficacy).ToListAsync(); return result.Count == 0 ? OverallAssessment.NE.GetEnumInt() : result[0].GetEnumInt(); } #endregion #region 是否存在疾病 /// /// 是否存在疾病 /// /// /// public async Task GetIsExistDisease(ReadingCalculateDto inDto) { if (!inDto.IsBaseLine) { return string.Empty; } var lesionCount = inDto.QuestionInfo.SelectMany(x => x.TableRowInfoList).Count(); return lesionCount > 0 ? ExistDisease.Yes.GetEnumInt() : ExistDisease.No.GetEnumInt(); } #endregion #region 修改其他标准 #region 修改与整个访视期间SOD最低点相比增加的值(mm) /// /// 修改与整个访视期间SOD最低点相比增加的值(mm) /// /// /// public async Task ChangeAllLowestIncrease(ChangeAllTaskDto inDto) { var visitTaskList = await GetVisitTaskAnswerList(inDto.calculateDto); var lowSod = (await GetLowSODVisit(inDto.calculateDto)).Select(x => x.SOD).OrderBy(x => x).FirstOrDefault(); foreach (var item in visitTaskList.Where(x => x.VisitTaskId != inDto.calculateDto.BaseLineTaskId)) { await _readingTaskQuestionAnswerRepository.BatchUpdateNoTrackingAsync(x => x.VisitTaskId == item.VisitTaskId && x.ReadingQuestionTrialId == inDto.QuestionId, x => new ReadingTaskQuestionAnswer() { Answer = (item.SOD - lowSod).ToString() }); } } #endregion #region 修改整个访视期间SOD最低点相比增加的百分比 /// /// 修改整个访视期间SOD最低点相比增加的百分比 /// /// /// //public async Task ChangeAllLowPercent(ChangeAllTaskDto inDto) //{ // var visitTaskList = await GetVisitTaskAnswerList(inDto.calculateDto); // var lowSod = (await GetLowSODVisit(inDto.calculateDto)).Select(x => x.SOD).OrderBy(x => x).FirstOrDefault(); // foreach (var item in visitTaskList.Where(x => x.VisitTaskId != inDto.calculateDto.BaseLineTaskId)) // { // decimal percent = 0; // if (lowSod == 0) // { // percent = 100; // } // else // { // percent = decimal.Round((item.SOD - lowSod) * 100 / lowSod, 2); // } // await _readingTaskQuestionAnswerRepository.BatchUpdateNoTrackingAsync(x => x.VisitTaskId == item.VisitTaskId && x.ReadingQuestionTrialId == inDto.QuestionId, x => new ReadingTaskQuestionAnswer() // { // Answer = percent.ToString() // }); // } //} #endregion #region 修改最低方式点名称 /// /// 修改最低方式点名称 /// /// /// public async Task ChangeAllLowVisitName(ChangeAllTaskDto inDto) { // 找到所有访视任务的Id var visitTaskIds = await _visitTaskRepository.Where(x => x.IsAnalysisCreate == inDto.IsAnalysisCreate && x.ReadingCategory == ReadingCategory.Visit && x.TrialReadingCriterionId == inDto.calculateDto.TrialReadingCriterionId && x.TaskState == TaskState.Effect && x.ReadingTaskState == ReadingTaskState.HaveSigned && x.ArmEnum == inDto.calculateDto.ArmEnum).Select(x => x.Id).ToListAsync(); var answer = (await GetLowSODVisit(inDto.calculateDto)).OrderBy(x => x.SOD).Select(x => x.BlindName).FirstOrDefault(); visitTaskIds = visitTaskIds.Where(x => x != inDto.calculateDto.BaseLineTaskId).ToList(); await this.ChangeAllVisitTaskAnswer(visitTaskIds, inDto.QuestionId, answer); } #endregion #endregion #region 通用方法 #region 修改所有访视任务的答案 /// /// 修改所有访视任务的答案 /// /// /// /// /// private async Task ChangeAllVisitTaskAnswer(List visitTaskGuids, Guid questionId, string answer) { await _readingTaskQuestionAnswerRepository.BatchUpdateNoTrackingAsync(x => visitTaskGuids.Contains(x.VisitTaskId) && x.ReadingQuestionTrialId == questionId, x => new ReadingTaskQuestionAnswer() { Answer = answer }); } #endregion #region 获取基线SOD /// /// 获取基线SOD /// /// /// private async Task GetBaseLineSOD(ReadingCalculateDto inDto) { if (await _visitTaskRepository.AnyAsync(x => x.Id == inDto.VisitTaskId && x.SourceSubjectVisit.IsBaseLine && x.IsAnalysisCreate==inDto.IsAnalysisCreate && x.ArmEnum == inDto.ArmEnum)) { return 0; } // 先找到基线的任务 var baseLineTaskId = await _visitTaskRepository.Where(x => x.SubjectId == inDto.SubjectId && x.ReadingCategory == ReadingCategory.Visit && x.TrialReadingCriterionId == inDto.TrialReadingCriterionId && x.SourceSubjectVisit.IsBaseLine && x.TaskState == TaskState.Effect && x.IsAnalysisCreate == inDto.IsAnalysisCreate &&x.DoctorUserId==inDto.DoctorUserId && x.IsSelfAnalysis == inDto.IsSelfAnalysis && x.ArmEnum == inDto.ArmEnum) .Select(x => x.Id).FirstOrDefaultAsync(); var baseLineSOD = (await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == baseLineTaskId && x.ReadingQuestionTrial.QuestionType == QuestionType.SOD).Select(x => x.Answer).FirstOrDefaultAsync()).IsNullOrEmptyReturn0(); return baseLineSOD; } #endregion /// /// 获取最低方式 /// /// /// public async Task> GetLowSODVisit(ReadingCalculateDto inDto) { var taskAnswerList = await GetVisitTaskAnswerList(inDto); taskAnswerList = taskAnswerList.Where(x => x.VisitTaskId != inDto.VisitTaskId).ToList(); var taskIds = taskAnswerList.Select(x => x.VisitTaskId).ToList(); // 排除无法评估 var unableEvaluateTaskIds = await _readingTableQuestionAnswerRepository.Where(x => taskIds.Contains(x.VisitTaskId) && x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.State && x.ReadingQuestionTrial.LesionType == LesionType.TargetLesion && x.Answer == TargetState.UnableEvaluate.GetEnumInt() ) .Select(x => x.VisitTaskId).Distinct().ToListAsync(); taskAnswerList = taskAnswerList.Where(x => !unableEvaluateTaskIds.Contains(x.VisitTaskId)).ToList(); return taskAnswerList.OrderBy(x => x.SOD).ToList(); } #region 获取访视任务信息 /// /// 获取访视任务信息 /// /// /// public async Task> GetVisitTaskAnswerList(ReadingCalculateDto inDto) { if (visitTaskAnswerList == null) { // 查询的时候要把自己排除 因为查询出来的可能不是计算出的最新的 visitTaskAnswerList = await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId != inDto.VisitTaskId && x.VisitTask.ReadingCategory == ReadingCategory.Visit && x.VisitTask.IsAnalysisCreate == inDto.IsAnalysisCreate && x.VisitTask.IsSelfAnalysis == inDto.IsSelfAnalysis && x.ReadingQuestionCriterionTrialId == inDto.TrialReadingCriterionId && x.VisitTask.VisitTaskNum new VisitTaskAnswerInfo { VisitTaskId = x.VisitTaskId, QuestionId = x.ReadingQuestionTrialId, VisitName = x.VisitTask.SourceSubjectVisit.VisitName, BlindName = x.VisitTask.TaskBlindName, SOD = x.Answer.IsNullOrEmptyReturn0(), }).ToListAsync(); // 这里是需要加上自己的 基线不用管 if (visitTaskAnswerList.Count > 0) { visitTaskAnswerList.Add(new VisitTaskAnswerInfo() { VisitTaskId = inDto.VisitTaskId, BlindName=inDto.TaskBlindName, QuestionId = visitTaskAnswerList[0].QuestionId, VisitName = inDto.VisitName, SOD = (await GetSODData(inDto)).ToString().IsNullOrEmptyReturn0(), }); } } return visitTaskAnswerList; } #endregion /// /// 获取上一个访视任务Id /// /// private async Task GetLastVisitTaskId(ReadingCalculateDto inDto) { // 拿到这一个访视 var thisNum = await _subjectVisitRepository.Where(x => x.Id == inDto.SubjectVisitId).Select(x => x.VisitNum).FirstOrDefaultAsync(); // 先找到上一个访视 var lastVisitId = await _subjectVisitRepository.Where(x => x.SubjectId == inDto.SubjectId && !x.IsLostVisit && x.VisitNum < thisNum).OrderByDescending(x => x.VisitNum).Select(x => x.Id).FirstOrDefaultAsync(); // 找到访视任务Id var LastVisitTaskId = await _visitTaskRepository.Where(x => x.ReadingCategory == ReadingCategory.Visit && x.TrialReadingCriterionId == inDto.TrialReadingCriterionId && x.TaskState == TaskState.Effect && x.IsAnalysisCreate == inDto.IsAnalysisCreate && x.SourceSubjectVisitId == lastVisitId && x.ArmEnum==inDto.ArmEnum).Select(x => x.Id).FirstOrDefaultAsync(); return LastVisitTaskId; } #endregion #region 计算阅片问题 外层问题 #region 获取靶病灶评估 /// /// 获取靶病灶评估 /// /// /// /// if(基线没有靶病灶) ///{ /// 靶病灶疗效为 ND ///}else ///{ /// 初始化靶病灶疗效为 SD /// /// if (与基线期SOD相比减小≥30 %) /// { /// 靶病灶疗效为 PR /// /// } /// ///if (非淋巴结靶病灶长径之和 == 0) ///{ /// 靶病灶疗效为 CR /// /// } /// ///if (有被评估为NE的单个靶病灶) /// { /// 靶病灶疗效为 NE /// /// } /// ///if (最低点SOD > 0) ///{ /// if(比整体访视期间最低点SOD增加≥20 % 且与整个访视期间最低点相比增加的值≥5 mm) /// { /// 靶病灶疗效为 PD /// /// } ///} ///else ///{ /// //进入该分支最低点SOD=0 /// if (当前访视SOD > 0 且与整个访视期间最低点相比增加的值≥5 mm) /// { /// 靶病灶疗效为PD /// /// } ///} /// ///if(上次访视点评估是CR) /// { /// if (当前访视点非淋巴结病灶至少一个非淋巴结靶病灶的长径>0 mm。) /// { /// 靶病灶疗效为 PD /// /// } ///} ///} /// /// public async Task GetTargetLesionEvaluate(ReadingCalculateDto inDto) { var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).SelectMany(x => x.TableRowInfoList).ToList(); if (inDto.IsBaseLine) { return TargetAssessment.NA.GetEnumInt(); } TargetLesionCalculateDto resultData = new TargetLesionCalculateDto() { // 是否存在靶病灶 ExistsTargetLesion = tableQuestion.Count() > 0, // 最低SOD LowSod = (await GetLowSODVisit(inDto)).Select(x => x.SOD).FirstOrDefault(), // 当前Sod PresentSod = (await GetSODData(inDto)) ?? 0, //非淋巴结靶病灶长径之和 decimal SumOfDiameter = (await GetSumOfDiameter(inDto))??0, //所有淋巴结靶病灶的短径小于10mm bool DiameterLessThan10 = true, // SOD变化百分比 SODPercent = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SODPercent).Sum(x => x.Answer.IsNullOrEmptyReturn0()), // SOD 百分比与基线期SOD相比减小≥30% bool SODPercentBigger30 = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SODPercent).Sum(x => x.Answer.IsNullOrEmptyReturn0()) <= -30, // SOD 百分比 与基线期SOD相比减小<30% bool SODPercentLess30 = 0 > inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SODPercent).Sum(x => x.Answer.IsNullOrEmptyReturn0()) && inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SODPercent).Sum(x => x.Answer.IsNullOrEmptyReturn0()) > -30, // SOD 百分比 整体访视期间SOD最低点SOD相比增加<20% LowSODPercentLess20 = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.LowPercent).Sum(x => x.Answer.IsNullOrEmptyReturn0()) < 20, // SOD 百分比 比整体访视期间SOD最低点SOD增加≥20% LowSODPercentBigger20 = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.LowPercent).Sum(x => x.Answer.IsNullOrEmptyReturn0()) >= 20, // SOD 变化值 比整体访视期间SOD最低点SOD绝对增加值<5 mm LowSODChangeLess5 = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.LowestIncrease).Sum(x => x.Answer.IsNullOrEmptyReturn0()) < 5, // 比整体访视期间SOD最低点SOD绝对增加值≥5 mm LowSODChangeBigger5 = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.LowestIncrease).Sum(x => x.Answer.IsNullOrEmptyReturn0()) >= 5, // 被评估为NE的单个靶病灶 是否存在状态为不可评估的靶病灶 ExixtsNETargetLesion = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(TargetState.UnableEvaluate)), //// 上次访视点整体肿瘤评估 LastTargetLesionEvaluate = string.Empty, // 当前访视点非淋巴结病灶至少一个非淋巴结靶病灶的长径>0 mm CurrentMajoreBigger0 = false, // 当前访视点淋巴结病灶, 至少一个淋巴结靶病灶短径≥10 mm CurrenShortBigger10 = false, // 靶病灶短径增加值有5mm的Index AddFiveIndexs = await GetIsAddFiveRowIndexs(inDto), // 短径有10mm的Index ShortBigger10Indexs = new List(), //淋巴结非靶病灶状态全部为消失 NonTargetStateIsLoss = true, // 该淋巴结靶病灶短径绝对增加值≥5 mm IsAddFive = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.IsAddFive && x.Answer.EqEnum(YesOrNoOrNa.Yes)).Count() > 0, }; var nonTargetTableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NonTargetLesions).SelectMany(x => x.TableRowInfoList).ToList(); foreach (var item in nonTargetTableQuestion) { if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.Yes))) { // 淋巴结非靶病灶状态全部为消失 resultData.NonTargetStateIsLoss = resultData.NonTargetStateIsLoss&& item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.State).Select(x => x.Answer).FirstOrDefault()== NoTargetState.Loss.GetEnumInt(); } } foreach (var item in tableQuestion) { if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.Yes))) { // 淋巴结的短径 resultData.DiameterLessThan10 = resultData.DiameterLessThan10&&(item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.ShortAxis).Select(x => x.Answer).FirstOrDefault()).IsNullOrEmptyReturn0() < 10; var shortIsBigger10 = (item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.ShortAxis).Select(x => x.Answer).FirstOrDefault()).IsNullOrEmptyReturn0() >= 10; resultData.CurrenShortBigger10= resultData.CurrenShortBigger10|| shortIsBigger10; if (shortIsBigger10) { resultData.ShortBigger10Indexs.Add(item.RowIndex); } } if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && !x.Answer.EqEnum(YesOrNoOrNa.Yes))) { // 当前访视点非淋巴结病灶至少一个非淋巴结靶病灶的长径 resultData.CurrentMajoreBigger0 = resultData.CurrentMajoreBigger0|| (item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.MajorAxis).Select(x => x.Answer).FirstOrDefault()).IsNullOrEmptyReturn0() > 0; } } var lastVisitTaskId = await GetLastVisitTaskId(inDto); var questionId = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.Tumor).Select(x => x.QuestionId).FirstOrDefault(); resultData.LastTargetLesionEvaluate = (await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == lastVisitTaskId && x.ReadingQuestionTrialId == questionId) .Select(x => x.Answer).FirstOrDefaultAsync()) ?? string.Empty; TargetAssessment result = TargetAssessment.SD; //if(基线没有靶病灶) if (!resultData.ExistsTargetLesion) { // 靶病灶疗效为 ND result = TargetAssessment.ND; } else { //初始化靶病灶疗效为 SD result = TargetAssessment.SD; //if (与基线期SOD相比减小≥30 %) if (resultData.SODPercentBigger30) { //靶病灶疗效为 PR result = TargetAssessment.PR; } //if (非淋巴结靶病灶长径之和 == 0) if (resultData.SumOfDiameter == 0) { //靶病灶疗效为 CR result = TargetAssessment.CR; } // if (有被评估为NE的单个靶病灶) if (resultData.ExixtsNETargetLesion) { // 靶病灶疗效为 NE result = TargetAssessment.NE; } //if (最低点SOD > 0) if (resultData.LowSod > 0) { // if(比整体访视期间最低点SOD增加≥20 % 且与整个访视期间最低点相比增加的值≥5 mm) if (resultData.LowSODPercentBigger20 && resultData.LowSODChangeBigger5) { // 靶病灶疗效为 PD result = TargetAssessment.PD; } } else { //进入该分支最低点SOD=0 // if (当前访视SOD > 0 且与整个访视期间最低点相比增加的值≥5 mm) if (resultData.PresentSod > 0 && resultData.LowSODChangeBigger5) { // 靶病灶疗效为PD result = TargetAssessment.PD; } } //if(上次访视点评估是CR) if (resultData.LastTargetLesionEvaluate.EqEnum(TargetAssessment.CR)) { //if (当前访视点非淋巴结病灶至少一个非淋巴结靶病灶的长径>0 mm。) if (resultData.CurrentMajoreBigger0) { //靶病灶疗效为 PD result = TargetAssessment.PD; } } #region 之前的逻辑 备注 //if (resultData.LastTargetLesionEvaluate.EqEnum(TargetAssessment.CR)) //{ // if (resultData.ExixtsNETargetLesion) // { // result = TargetAssessment.NE; // } // if (resultData.CurrenShortBigger10 && resultData.IsAddFive) // { // result = TargetAssessment.PD; // } // if (resultData.CurrentMajoreBigger0) // { // result = TargetAssessment.PD; // } //} //else //{ // if (resultData.LowSod != 0 && resultData.LowPercentBigger20 && resultData.LowChangeBigger5) // { // result = TargetAssessment.PD; // } // else // { // if (resultData.ExixtsNETargetLesion) // { // result = TargetAssessment.NE; // } // else // { // if (resultData.SODPercentBigger30) // { // if (resultData.LowPercentLess20 || resultData.LowChangeLess5) // { // result = TargetAssessment.PR; // } // if (resultData.SumOfDiameter == 0 && resultData.DiameterLessThan10 && resultData.NonTargetStateIsLoss) // { // result = TargetAssessment.CR; // } // } // } // } //} #endregion } return result.GetEnumInt(); } #endregion #region 获取非靶病灶评估 /// /// 获取非靶病灶评估 /// /// /// public async Task GetNoTargetLesionEvaluate(ReadingCalculateDto inDto) { NoTargetAssessment result = NoTargetAssessment.NN; if (inDto.IsBaseLine) { return NoTargetAssessment.NA.GetEnumInt(); } var tableRows = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NonTargetLesions).SelectMany(x => x.TableRowInfoList).ToList(); var tableQuestions = tableRows.SelectMany(x => x.TableQuestionList).ToList(); //任意单个病灶 / 病灶组评估为“显著增大” if (tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NoTargetState.Increase))) { result = NoTargetAssessment.PD; } // 任意单个病灶/病灶组评估为“无法评估”并且没有“显著增大” else if (tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NoTargetState.UnableEvaluate)) && !tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NoTargetState.Increase)) ) { result = NoTargetAssessment.NE; } // 所有单个病灶/病灶组评估为”存在”或者有些评估为“消失”有些评估为“存在”,且没有“显著增大”和“无法评估”的病灶 else if (tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NoTargetState.Exist)) && !tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && (x.Answer.EqEnum(NoTargetState.Increase) || x.Answer.EqEnum(NoTargetState.UnableEvaluate))) ) { result = NoTargetAssessment.NN; } //所有单个病灶/病灶组状态评估状态为“消失” else if (tableQuestions.Count(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NoTargetState.Loss))== tableQuestions.Count(x=> x.QuestionMark == QuestionMark.State) && tableQuestions.Count(x => x.QuestionMark == QuestionMark.State)>0) { result = NoTargetAssessment.CR; } // 基线时没有非靶病灶 else if (tableQuestions.Count() == 0) { result = NoTargetAssessment.ND; } else { return string.Empty; } return result.GetEnumInt(); } #endregion #region 获取新病灶评估 /// /// 获取新病灶评估 /// /// /// public async Task GetNewLesionEvaluate(ReadingCalculateDto inDto) { NewLesionAssessment result = NewLesionAssessment.No; if (inDto.IsBaseLine) { return NewLesionAssessment.NA.GetEnumInt(); } var tableRows = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NewLesions).SelectMany(x => x.TableRowInfoList).ToList(); var tableQuestions = tableRows.SelectMany(x => x.TableQuestionList).ToList(); // 当前访视存在至少一个明确新病灶 if (tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionState.Exist))) { result = NewLesionAssessment.Yes; } //只要有任何一个新病灶状态为“无法评估” else if (tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionState.UnableEvaluate))) { result = NewLesionAssessment.NE; } //当前访视不存在明确新病灶且存在至少一个疑似新病灶 else if (!tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionState.Exist)) && tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionState.Suspected)) ) { result = NewLesionAssessment.Suspected; } else { result = NewLesionAssessment.No; } return result.GetEnumInt(); } #endregion #endregion } }