diff --git a/IRaCIS.Core.Application/IRaCIS.Core.Application.xml b/IRaCIS.Core.Application/IRaCIS.Core.Application.xml
index 14b1b310a..74965fa7a 100644
--- a/IRaCIS.Core.Application/IRaCIS.Core.Application.xml
+++ b/IRaCIS.Core.Application/IRaCIS.Core.Application.xml
@@ -1531,7 +1531,7 @@
             TrialEmailNoticeConfigService
             </summary>	
         </member>
-        <member name="M:IRaCIS.Core.Application.Service.TrialEmailNoticeConfigService.#ctor(IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.TrialEmailNoticeConfig},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.TrialEmailBlackUser},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.EmailNoticeConfig},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.Trial},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.TaskMedicalReview},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.ReadingGlobalTaskInfo},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.VisitTask},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.TrialUserRole},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.TrialEmailNoticeUser},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.Subject},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.ReadModule},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.ReadingTableQuestionAnswer},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.SubjectVisit},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.ReadingTaskQuestionAnswer},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.ReadingQuestionCriterionTrial},Microsoft.Extensions.Options.IOptionsMonitor{IRaCIS.Core.Domain.Share.SystemEmailSendConfig},IRaCIS.Core.Application.Service.IEmailSendService,AutoMapper.IMapper,IRaCIS.Core.Domain.Share.IUserInfo,Microsoft.Extensions.Localization.IStringLocalizer,Microsoft.AspNetCore.Hosting.IWebHostEnvironment)">
+        <member name="M:IRaCIS.Core.Application.Service.TrialEmailNoticeConfigService.#ctor(IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.TrialEmailNoticeConfig},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.TrialEmailBlackUser},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.EmailNoticeConfig},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.Trial},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.TaskMedicalReview},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.ReadingGlobalTaskInfo},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.VisitTask},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.TrialUserRole},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.TrialEmailNoticeUser},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.Subject},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.ReadModule},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.ReadingTableQuestionAnswer},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.SubjectVisit},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.ReadingTaskQuestionAnswer},IRaCIS.Core.Infra.EFCore.IRepository{IRaCIS.Core.Domain.Models.ReadingQuestionCriterionTrial},Microsoft.Extensions.Options.IOptionsMonitor{IRaCIS.Core.Domain.Share.SystemEmailSendConfig},IRaCIS.Application.Interfaces.IDictionaryService,IRaCIS.Core.Application.Service.IEmailSendService,AutoMapper.IMapper,IRaCIS.Core.Domain.Share.IUserInfo,Microsoft.Extensions.Localization.IStringLocalizer,Microsoft.AspNetCore.Hosting.IWebHostEnvironment)">
             <summary>
             TrialEmailNoticeConfigService
             </summary>	
diff --git a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs
index a462dbfd6..0af8e743f 100644
--- a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs
+++ b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs
@@ -1215,7 +1215,7 @@ namespace IRaCIS.Core.Application.Service.Reading.Dto
         /// <summary>
         /// 问题Id
         /// </summary>
-        public Guid QuestionId { get; set; }
+        public Guid? QuestionId { get; set; }
 
         /// <summary>
         /// InstanceId
diff --git a/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs b/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs
index 9549eae8d..c1ad12ded 100644
--- a/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs
+++ b/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs
@@ -1898,6 +1898,24 @@ namespace IRaCIS.Core.Application.Service
         [HttpPost]
         public async Task<IResponseOutput> SaveTaskQuestion(ChangeDicomReadingQuestionAnswerInDto inDto, string param)
         {
+            // 当 param == -10 时，为自定义标准 需要区分  绑定  更改 标记 
+            //if (param == "-10")
+            //{
+            //    var questionMarkList = inDto.QuestionMarkInfoList.Select(x => x.QuestionId ).ToList();
+            //    if (!(await _readingTaskQuestionMarkRepository.AnyAsync(x => x.VisitTaskId == inDto.VisitTaskId && questionMarkList.Contains(x.QuestionId))) && inDto.QuestionMarkInfoList.Count() > 0)
+            //    {
+            //        _userInfo.AuditIdentification = "AddMark";
+            //    }
+            //    else if (await _readingTaskQuestionMarkRepository.AnyAsync(x => x.VisitTaskId == inDto.VisitTaskId && questionMarkList.Contains(x.QuestionId)))
+            //    {
+            //        _userInfo.AuditIdentification = "UpdateMark";
+            //    }
+            //    else
+            //    {
+            //        _userInfo.AuditIdentification = "DeleteMark";
+            //    }
+            //}
+
             var taskinfo = await _visitTaskRepository.Where(x => x.Id == inDto.VisitTaskId).Include(x => x.TrialReadingCriterion).FirstNotNullAsync();
             try
             {
@@ -1994,7 +2012,7 @@ namespace IRaCIS.Core.Application.Service
 
             }).ToList();
             await _readingTaskQuestionAnswerRepository.AddRangeAsync(needAddAnswer);
-
+         
             if (inDto.UpdateMark)
             {
                 var questionMarkList = await _readingTaskQuestionMarkRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId).Select(x => new