diff --git a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicineQuestionViewModel.cs b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicineQuestionViewModel.cs
index 6b67b73bc..86782970a 100644
--- a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicineQuestionViewModel.cs
+++ b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicineQuestionViewModel.cs
@@ -117,6 +117,10 @@ namespace IRaCIS.Core.Application.ViewModel
 
 		public int? ParentShowOrder { get; set; }
 
+		/// <summary>
+		/// 任务类型
+		/// </summary>
+		public ReadingCategory ReadingCategory { get; set; }
 	}
 
 	/// <summary>
diff --git a/IRaCIS.Core.Application/Service/Reading/ReadModuleService.cs b/IRaCIS.Core.Application/Service/Reading/ReadModuleService.cs
index 797db83ec..1e3c4f453 100644
--- a/IRaCIS.Core.Application/Service/Reading/ReadModuleService.cs
+++ b/IRaCIS.Core.Application/Service/Reading/ReadModuleService.cs
@@ -205,7 +205,7 @@ namespace IRaCIS.Application.Services
                 OnlyExistsMedicalHistory = !(await _clinicalDataTrialSetRepository.AnyAsync(x => x.TrialId == dto.TrialId && x.ClinicalDataSetName != "既往局部治疗史" && x.IsConfirm)),
                 IsExistsSubjectClinicalData= await _clinicalDataTrialSetRepository.AnyAsync(x => x.TrialId == dto.TrialId&&x.ClinicalDataLevel== ClinicalLevel.Subject && x.IsConfirm),
                 IsExistsVisitClinicalData = await _clinicalDataTrialSetRepository.AnyAsync(x => x.TrialId == dto.TrialId && x.ClinicalDataLevel == ClinicalLevel.SubjectVisit && x.IsConfirm),
-                IsExistsReadingClinicalData = await _clinicalDataTrialSetRepository.AnyAsync(x => x.TrialId == dto.TrialId && x.ClinicalDataLevel == ClinicalLevel.Read && x.IsConfirm),
+                IsExistsReadingClinicalData = await _clinicalDataTrialSetRepository.AnyAsync(x => x.TrialId == dto.TrialId && x.ClinicalDataLevel == ClinicalLevel.ImageRead && x.IsConfirm),
                 IsGlobalReading= trialinfo.IsGlobalReading,
 
             }) ;
diff --git a/IRaCIS.Core.Application/Service/Reading/ReadingClinicalDataService.cs b/IRaCIS.Core.Application/Service/Reading/ReadingClinicalDataService.cs
index 914a02212..59e6416ee 100644
--- a/IRaCIS.Core.Application/Service/Reading/ReadingClinicalDataService.cs
+++ b/IRaCIS.Core.Application/Service/Reading/ReadingClinicalDataService.cs
@@ -137,7 +137,7 @@ namespace IRaCIS.Application.Services
             await this.AddCRCClinicalData(inDto);
 
             List<GetCRCClinicalDataOutDto> cRCClinicalDataList = await _readingClinicalDataRepository.Where(x => x.ReadingId == inDto.SubjectVisitId)
-                .Where(x => x.ClinicalDataTrialSet.TrialId == inDto.TrialId && x.ClinicalDataTrialSet.UploadRole == UploadRole.CRC && x.ClinicalDataTrialSet.ClinicalDataLevel != ClinicalLevel.Read && x.ClinicalDataTrialSet.IsConfirm)
+                .Where(x => x.ClinicalDataTrialSet.TrialId == inDto.TrialId && x.ClinicalDataTrialSet.UploadRole == UploadRole.CRC && x.ClinicalDataTrialSet.ClinicalDataLevel != ClinicalLevel.ImageRead && x.ClinicalDataTrialSet.ClinicalDataLevel != ClinicalLevel.OncologyRead && x.ClinicalDataTrialSet.IsConfirm)
                 .Select(x => new GetCRCClinicalDataOutDto()
                 {
                     Id = x.Id,
@@ -180,7 +180,7 @@ namespace IRaCIS.Application.Services
         /// <returns></returns>
         private async Task AddCRCClinicalData(GetCRCClinicalDataInDto inDto)
         {
-            var cRCClinicalDataIds = await _clinicalDataTrialSetRepository.Where(x => x.TrialId == inDto.TrialId && x.UploadRole == UploadRole.CRC && x.ClinicalDataLevel != ClinicalLevel.Read && x.IsConfirm).Select(x => x.Id).ToListAsync();
+            var cRCClinicalDataIds = await _clinicalDataTrialSetRepository.Where(x => x.TrialId == inDto.TrialId && x.UploadRole == UploadRole.CRC && x.ClinicalDataLevel != ClinicalLevel.ImageRead && x.ClinicalDataLevel != ClinicalLevel.OncologyRead && x.IsConfirm).Select(x => x.Id).ToListAsync();
 
             var needAddIds = cRCClinicalDataIds.Where(x => _readingClinicalDataRepository.Where(y => y.ReadingId == inDto.SubjectVisitId && x == y.ClinicalDataTrialSetId).Count() == 0).ToList();
 
@@ -248,7 +248,15 @@ namespace IRaCIS.Application.Services
                 inDto.UploadRole = UploadRole.PM;
             }
 
+            ReadModule readModule = null;
+            if (inDto.ReadingId != null)
+            {
+                readModule = await _readModuleRepository.Where(x => x.Id ==inDto.ReadingId).FirstNotNullAsync();
+            }
 
+            Dictionary<ModuleTypeEnum, ClinicalLevel> keyValuePairs = new Dictionary<ModuleTypeEnum, ClinicalLevel>();
+            keyValuePairs.Add(ModuleTypeEnum.Global, ClinicalLevel.ImageRead);
+            keyValuePairs.Add(ModuleTypeEnum.Oncology, ClinicalLevel.OncologyRead);
 
             var usedIdsQuery = _readingClinicalDataRepository.Where(x => x.ReadingId == inDto.ReadingId && x.Id != inDto.ReadingClinicalDataId).Select(x => x.ClinicalDataTrialSetId);
             List<GetTrialClinicalDataSelectOutDto> clinicalList = await _clinicalDataTrialSetRepository.Where(x => x.TrialId == inDto.TrialId && x.IsConfirm)
@@ -256,7 +264,8 @@ namespace IRaCIS.Application.Services
                 .Where(x => !usedIdsQuery.Contains(x.Id))
                 .WhereIf(inDto.IsVisit && inDto.IsBaseLine, x => x.ClinicalDataLevel == ClinicalLevel.Subject || x.ClinicalDataLevel == ClinicalLevel.SubjectVisit)
                 .WhereIf(inDto.IsVisit && !inDto.IsBaseLine, x => x.ClinicalDataLevel == ClinicalLevel.SubjectVisit)
-                .WhereIf(!inDto.IsVisit, x => x.ClinicalDataLevel == ClinicalLevel.Read)
+                .WhereIf(!inDto.IsVisit, x => x.ClinicalDataLevel == ClinicalLevel.ImageRead||x.ClinicalDataLevel==ClinicalLevel.OncologyRead)
+                .WhereIf(readModule!=null, x => x.ClinicalDataLevel == keyValuePairs[readModule.ModuleType])
                 .Select(x => new GetTrialClinicalDataSelectOutDto()
                 {
                     ClinicalDataLevel = x.ClinicalDataLevel,
diff --git a/IRaCIS.Core.Application/Service/Reading/ReadingMedicineQuestionService.cs b/IRaCIS.Core.Application/Service/Reading/ReadingMedicineQuestionService.cs
index 3ad41540a..251c08350 100644
--- a/IRaCIS.Core.Application/Service/Reading/ReadingMedicineQuestionService.cs
+++ b/IRaCIS.Core.Application/Service/Reading/ReadingMedicineQuestionService.cs
@@ -7,6 +7,7 @@ using IRaCIS.Core.Infra.EFCore.Common;
 using MassTransit;
 using IRaCIS.Core.Infrastructure;
 using IRaCIS.Core.Application.Contracts;
+using IRaCIS.Core.Domain.Share;
 
 namespace IRaCIS.Core.Application.Service
 {	
@@ -220,7 +221,7 @@ namespace IRaCIS.Core.Application.Service
 		   var needList= systemList.Select(x => new ReadingMedicineTrialQuestion()
 				{
 					Id = NewId.NextGuid(),
-					ShowOrder = maxOrder++,
+					ShowOrder = x.ShowOrder,
 					IsEnable = x.IsEnable,
 					IsRequired = x.IsRequired,
 					QuestionName = x.QuestionName,
@@ -230,7 +231,9 @@ namespace IRaCIS.Core.Application.Service
 					TrialId=inDto.TrialId,
 				}).ToList();
 
-			
+			needList.ForEach(x => {
+				x.ShowOrder = maxOrder++;
+			});
 
 			 await _readingMedicineTrialQuestionRepository.AddRangeAsync(needList);
 			 var result = await _readingMedicineTrialQuestionRepository.SaveChangesAsync();
@@ -255,18 +258,19 @@ namespace IRaCIS.Core.Application.Service
 		}
 
 
-        /// <summary>
-        /// 确认医学审核问题
-        /// </summary>
-        /// <returns></returns>
-        public async Task<IResponseOutput> ConfirmReadingMedicineQuestion(ConfirmReadingMedicineQuestionInDto inDto)
-        {
+		/// <summary>
+		/// 确认医学审核问题
+		/// </summary>
+		/// <returns></returns>
+		public async Task<IResponseOutput> ConfirmReadingMedicineQuestion(ConfirmReadingMedicineQuestionInDto inDto)
+		{
 			var readingMedicineQuestionList = await _readingMedicineTrialQuestionRepository.Where(x => x.TrialId == inDto.TrialId)
 				.Select(x => new TrialQuestion() {
 					Id = x.Id,
+					ReadingCategory = x.ReadingCategory,
 					ParentShowOrder = (int?)x.ParentQuestion.ShowOrder,
-					ShowOrder=x.ShowOrder,
-				}).ToListAsync();					
+					ShowOrder = x.ShowOrder,
+				}).ToListAsync();
 			if (readingMedicineQuestionList.Count == 0)
 			{
 				throw new BusinessValidationFailedException("当前未添加医学审核问题。请先添加医学审核问题，再进行确认。");
@@ -284,6 +288,25 @@ namespace IRaCIS.Core.Application.Service
 			}
 
 
+			var trialInfo = await _trialRepository.Where(x => x.Id == inDto.TrialId).FirstNotNullAsync();
+
+			if (trialInfo.IsGlobalReading && !readingMedicineQuestionList.Any(x => x.ReadingCategory == ReadingCategory.Global))
+			{
+				throw new BusinessValidationFailedException("当前项目启用了全局阅片,但未配置全局医学审核问题");
+			}
+
+			if (trialInfo.IsArbitrationReading??false && !readingMedicineQuestionList.Any(x => x.ReadingCategory == ReadingCategory.Judge))
+			{
+				throw new BusinessValidationFailedException("当前项目启用了仲裁阅片,但未配置仲裁医学审核问题");
+			}
+
+			if (trialInfo.IsClinicalReading && !readingMedicineQuestionList.Any(x => x.ReadingCategory == ReadingCategory.Oncology))
+			{
+				throw new BusinessValidationFailedException("当前项目启用了肿瘤学阅片,但未配置肿瘤学医学审核问题");
+			}
+
+
+
 			await _readingMedicineTrialQuestionRepository.BatchUpdateNoTrackingAsync(x => x.TrialId == inDto.TrialId, x => new ReadingMedicineTrialQuestion()
 			{
 				IsConfirm = true
diff --git a/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs b/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
index 2ce8e0b0a..0513fde29 100644
--- a/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
+++ b/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
@@ -173,10 +173,16 @@ namespace IRaCIS.Core.Domain.Share
         SubjectVisit = 1,
 
         /// <summary>
-        /// 阅片
+        /// 影像学阅片
         /// </summary>
-        [DisplayAttribute(Name = "阅片")]
-        Read = 2,
+        [DisplayAttribute(Name = "影像学阅片")]
+        ImageRead = 2,
+
+        /// <summary>
+        /// 肿瘤学阅片
+        /// </summary>
+        [DisplayAttribute(Name = "肿瘤学阅片")]
+        OncologyRead = 3,
     }
 
     /// <summary>