diff --git a/IRaCIS.Core.Application/Service/Visit/PatientService.cs b/IRaCIS.Core.Application/Service/Visit/PatientService.cs
index ac3eceb09..e7945cfad 100644
--- a/IRaCIS.Core.Application/Service/Visit/PatientService.cs
+++ b/IRaCIS.Core.Application/Service/Visit/PatientService.cs
@@ -139,7 +139,7 @@ namespace IRaCIS.Application.Services
         {
             var exp = new EntityVerifyExp<HIRHospital>()
             {
-                VerifyExp = h => h.IsDefault.Equals(addOrEditHIRHospital.IsDefault),
+                VerifyExp = h => h.IsDefault.Equals(addOrEditHIRHospital.IsDefault) && addOrEditHIRHospital.IsDefault = true,
 
                 //"默认医院只允许一个"
                 VerifyMsg = _localizer["Patient_OnlyOneDefaultHospital"]
@@ -662,7 +662,7 @@ namespace IRaCIS.Application.Services
                               };
 
 
-            var allHospitalGroupList = _hospitalGroupRepository.Where(t => t.IsEnable).Select(t =>  t.Name).ToList();
+            var allHospitalGroupList = _hospitalGroupRepository.Where(t => t.IsEnable).Select(t => t.Name).ToList();
 
             var pageList = await resultQuery.ToPagedListAsync(inQuery, nameof(PatientQueryView.PatientIdStr));
 
@@ -794,7 +794,7 @@ namespace IRaCIS.Application.Services
 
             var pageList = await query.ToPagedListAsync(inQuery, nameof(PatientStudySimpleView.StudyTime));
 
-            var allHospitalGroupList= _hospitalGroupRepository.Where(t=>t.IsEnable).Select(t=> new HospitalGroupInfo() { Id = t.Id, Code = t.Code, Name = t.Name }).ToList();
+            var allHospitalGroupList = _hospitalGroupRepository.Where(t => t.IsEnable).Select(t => new HospitalGroupInfo() { Id = t.Id, Code = t.Code, Name = t.Name }).ToList();
 
             foreach (var item in pageList.CurrentPageData)
             {
@@ -828,7 +828,10 @@ namespace IRaCIS.Application.Services
                 {
                     foreach (var hospitalGroupId in incommand.HospitalGroupIdList)
                     {
-                        await _SCPStudyHospitalGroupRepository.AddAsync(new SCPStudyHospitalGroup() { SCPStudyId = item, HospitalGroupId = hospitalGroupId });
+                        if (!_SCPStudyHospitalGroupRepository.Any(t => t.SCPStudyId == item && hospitalGroupId == t.HospitalGroupId))
+                        {
+                            await _SCPStudyHospitalGroupRepository.AddAsync(new SCPStudyHospitalGroup() { SCPStudyId = item, HospitalGroupId = hospitalGroupId });
+                        }
 
                     }
 
@@ -844,7 +847,6 @@ namespace IRaCIS.Application.Services
                     {
                         await _SCPStudyHospitalGroupRepository.DeleteFromQueryAsync(t => t.HospitalGroupId == hospitalGroupId && t.SCPStudyId == item);
 
-
                     }