diff --git a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicineQuestionViewModel.cs b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicineQuestionViewModel.cs
index 56867ac30..655a89854 100644
--- a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicineQuestionViewModel.cs
+++ b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicineQuestionViewModel.cs
@@ -110,6 +110,9 @@ namespace IRaCIS.Core.Application.ViewModel
 	{
 		public Guid TrialId { get; set; }
 
+		[NotDefault]
+		public Guid TrialReadingCriterionId { get; set; }
+
 		public List<Guid> SystemQuestionIds { get; set; }
 	}
 
@@ -163,6 +166,10 @@ namespace IRaCIS.Core.Application.ViewModel
 
 		public int? ShowOrder { get; set; }
 
+
+		[NotDefault]
+		public Guid TrialReadingCriterionId { get; set; }
+
 		/// <summary>
 		/// 任务类型
 		/// </summary>
@@ -252,6 +259,9 @@ namespace IRaCIS.Core.Application.ViewModel
 	{
 		public Guid TrialId { get; set; }
 
+		[NotDefault]
+		public Guid TrialReadingCriterionId { get; set; }
+
 		/// <summary>
 		/// 任务类型
 		/// </summary>
@@ -330,6 +340,8 @@ namespace IRaCIS.Core.Application.ViewModel
 		/// </summary>
 		public Guid TrialId { get; set; }
 
+		public Guid TrialReadingCriterionId { get; set; }
+
 		public string Type { get; set; } = string.Empty;
 
 		public string ParentTriggerValue { get; set; } = string.Empty;
@@ -349,8 +361,11 @@ namespace IRaCIS.Core.Application.ViewModel
     public class  ReadingMedicineTrialQuestionAddOrEdit
 	 {
 	 		public Guid? Id { get; set; }
-	 	
-	 		public string Type { get; set; }
+
+		[NotDefault]
+		public Guid TrialReadingCriterionId { get; set; }
+
+		public string Type { get; set; }
 	 		public string? ParentTriggerValue { get; set; }=string.Empty;
 	 		public string QuestionName { get; set; }
 	 		public string TypeValue { get; set; }
diff --git a/IRaCIS.Core.Application/Service/Reading/ReadingMedicineQuestionService.cs b/IRaCIS.Core.Application/Service/Reading/ReadingMedicineQuestionService.cs
index c857c23c3..46668fca3 100644
--- a/IRaCIS.Core.Application/Service/Reading/ReadingMedicineQuestionService.cs
+++ b/IRaCIS.Core.Application/Service/Reading/ReadingMedicineQuestionService.cs
@@ -134,7 +134,7 @@ namespace IRaCIS.Core.Application.Service
 		public async Task<(List<ReadingMedicineTrialQuestionView>,object)>  GetReadingMedicineTrialQuestionList(ReadingMedicineTrialQuestionQuery inDto)
 		{
 			var query = _readingMedicineTrialQuestionRepository.AsQueryable()
-				   .Where(x=>x.TrialId==inDto.TrialId)
+				   .Where(x=>x.TrialId==inDto.TrialId&&x.TrialReadingCriterionId==inDto.TrialReadingCriterionId)
 				   .WhereIf(!inDto.TypeValue.IsNullOrEmpty(), x => x.TypeValue.Contains(inDto.TypeValue))
 				   .WhereIf(!inDto.ParentTriggerValue.IsNullOrEmpty(), x => x.ParentTriggerValue.Contains(inDto.ParentTriggerValue))
 				   .WhereIf(!inDto.QuestionName.IsNullOrEmpty(), x => x.QuestionName.Contains(inDto.QuestionName))
@@ -143,7 +143,7 @@ namespace IRaCIS.Core.Application.Service
 				   .ProjectTo<ReadingMedicineTrialQuestionView>(_mapper.ConfigurationProvider).OrderBy(x=>x.ShowOrder);
 
 
-			var isConfirmMedicineQuestion = await _trialRepository.Where(x => x.Id == inDto.TrialId).Select(x => x.IsConfirmMedicineQuestion).FirstOrDefaultAsync();
+			var isConfirmMedicineQuestion = await _readingQuestionCriterionTrialRepository.Where(x => x.Id==inDto.TrialReadingCriterionId).Select(x => x.IsConfirmMedicineQuestion).FirstOrDefaultAsync();
 			var questionList = await query.ToListAsync();
 			return (questionList, new {
 				IsConfirmMedicineQuestion= isConfirmMedicineQuestion,
@@ -159,7 +159,7 @@ namespace IRaCIS.Core.Application.Service
 		[HttpPost]
 		public async Task<List<GetMedicineQuestionPreviewOutDto>> GetMedicineQuestionPreview(GetMedicineQuestionPreviewInDto inDto)
 		{
-			var trialQuestionList = await _readingMedicineTrialQuestionRepository.Where(x=>x.TrialId==inDto.TrialId)
+			var trialQuestionList = await _readingMedicineTrialQuestionRepository.Where(x=>x.TrialId==inDto.TrialId&&x.TrialReadingCriterionId==inDto.TrialReadingCriterionId)
 					.WhereIf(inDto.ReadingCategory != null, x => x.ReadingCategory == inDto.ReadingCategory)
 				 .ProjectTo<GetMedicineQuestionPreviewOutDto>(_mapper.ConfigurationProvider).OrderBy(x=>x.ShowOrder).ToListAsync();
 		
@@ -194,7 +194,7 @@ namespace IRaCIS.Core.Application.Service
 		{
 			var existsQuery = _readingMedicineTrialQuestionRepository
 		   .WhereIf(inDto.Id != null, x => x.Id != inDto.Id)
-		   .Where(x => x.TrialId==inDto.TrialId)
+		   .Where(x => x.TrialId==inDto.TrialId&&x.TrialReadingCriterionId==inDto.TrialReadingCriterionId)
 		   .Where(x =>  x.ShowOrder == inDto.ShowOrder);
 
 			if (await existsQuery.AnyAsync())
@@ -220,7 +220,7 @@ namespace IRaCIS.Core.Application.Service
 				"select","radio"
 			};
 
-			var questionList = await _readingMedicineTrialQuestionRepository.Where(x => x.TrialId == inDto.TrialId)
+			var questionList = await _readingMedicineTrialQuestionRepository.Where(x => x.TrialId == inDto.TrialId&&x.TrialReadingCriterionId==inDto.TrialReadingCriterionId)
 				.Where(x => types.Contains(x.Type))
 				.WhereIf(inDto.Id != null, x => x.Id != inDto.Id && x.ParentId != inDto.Id)
 				.WhereIf(inDto.ShowOrder != null, x => x.ShowOrder <inDto.ShowOrder)
@@ -257,6 +257,7 @@ namespace IRaCIS.Core.Application.Service
 					IsEnable = x.IsEnable,
 					IsRequired = x.IsRequired,
 					QuestionName = x.QuestionName,
+					TrialReadingCriterionId=inDto.TrialReadingCriterionId,
 					Type = x.Type,
 					ParentId=x.ParentId,
 					SystemQuestionId=x.Id,
@@ -430,7 +431,7 @@ namespace IRaCIS.Core.Application.Service
 				IsConfirm = true
 			});
 
-			await _trialRepository.UpdatePartialFromQueryAsync(inDto.TrialId, x => new Trial()
+			await _readingQuestionCriterionTrialRepository.UpdatePartialFromQueryAsync(inDto.TrialReadingCriterionId, x => new ReadingQuestionCriterionTrial()
 			{
 				IsConfirmMedicineQuestion = true
 			});
diff --git a/IRaCIS.Core.Domain/Reading/ReadingQuestionCriterionTrial.cs b/IRaCIS.Core.Domain/Reading/ReadingQuestionCriterionTrial.cs
index 49439e17e..126ed3c6d 100644
--- a/IRaCIS.Core.Domain/Reading/ReadingQuestionCriterionTrial.cs
+++ b/IRaCIS.Core.Domain/Reading/ReadingQuestionCriterionTrial.cs
@@ -143,6 +143,13 @@ namespace IRaCIS.Core.Domain.Models
 		public bool IsReadingShowPreviousResults { get; set; } = false;
 
 
+		/// <summary>
+		/// 是确认医学审核问题
+		/// </summary>
+
+		public bool IsConfirmMedicineQuestion { get; set; } = false;
+
+
 		/// <summary>
 		/// 仲裁对象
 		/// </summary>
diff --git a/IRaCIS.Core.Domain/Trial/Trial.cs b/IRaCIS.Core.Domain/Trial/Trial.cs
index fc9b92283..b791b4041 100644
--- a/IRaCIS.Core.Domain/Trial/Trial.cs
+++ b/IRaCIS.Core.Domain/Trial/Trial.cs
@@ -379,11 +379,11 @@ namespace IRaCIS.Core.Domain.Models
         /// </summary>
         public DateTime? SyncClinicalDataTime { get; set; }
 
-        /// <summary>
-        /// ��ȷ��ҽѧ�������
-        /// </summary>
+        ///// <summary>
+        ///// ��ȷ��ҽѧ�������
+        ///// </summary>
 
-        public bool IsConfirmMedicineQuestion { get; set; } = false;
+        //public bool IsConfirmMedicineQuestion { get; set; } = false;
 
         /// <summary>
         /// ͼ���Ƿ��б�ע