diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs
index d62d88e18..dc6642fcb 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs
@@ -223,7 +223,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
              { "ImageProblem",imageProblem},
             }).ToList();
 
-
+            var patientIdStrList = await _dicomStudyRepository.Where(x => x.SubjectVisitId == taskinfo.SourceSubjectVisitId).Select(x => x.PatientIdStr).Distinct().ToListAsync();
             var subjectPatientList = await _subjectPatientRepository.Where(x => x.SubjectId == subjectInfo.Id).Include(x => x.Patient).ToListAsync();
 
 
@@ -270,7 +270,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
              { "SubjectName",subjectInfo.ShortName }, //患者姓名
              { "SubjectSex", subjectInfo.Sex==string.Empty?string.Empty:  subjectInfo.Sex=="M"?"男":"女" }, //患者性别
              { "SubjectAge",subjectInfo.Age==null?string.Empty: subjectInfo.Age +"岁" }, //患者年龄
-             { "SubjectCode",string.Join(",",subjectPatientList.Select(x=>x.Patient).OrderByDescending(x=>x.CreateTime).Select(x=>x.PatientIdStr).ToList())  }, //患者编号
+             { "SubjectCode",string.Join(",",patientIdStrList)  }, //患者编号
              { "VisitName",visitInfo.VisitName }, //访视名称
              { "LatestScanDate",visitInfo.StudyList.Min(x=>x.StudyTime)?.ToString("yyyy-MM-dd") }, //随访日期
              { "CriterionName",taskinfo.TrialReadingCriterion.CriterionName }, //评估标准
diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/MRECISTHCCCalculateService.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/MRECISTHCCCalculateService.cs
index 48fb27833..1b53e6db3 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/MRECISTHCCCalculateService.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/MRECISTHCCCalculateService.cs
@@ -56,6 +56,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
               .Include(x => x.TrialReadingCriterion).FirstNotNullAsync();
             var visitInfo = await _subjectVisitRepository.Where(x => x.Id == taskinfo.SourceSubjectVisitId).Include(x => x.StudyList).FirstNotNullAsync();
             var subjectInfo = await _subjectRepository.Where(x => x.Id == taskinfo.SubjectId).Include(x => x.Trial).Include(x => x.SubjectPatientList).FirstNotNullAsync();
+            var patientIdStrList = await _dicomStudyRepository.Where(x => x.SubjectVisitId == taskinfo.SourceSubjectVisitId).Select(x => x.PatientIdStr).Distinct().ToListAsync();
             var subjectPatientList = await _subjectPatientRepository.Where(x => x.SubjectId == subjectInfo.Id).Include(x => x.Patient).ToListAsync();
             var trialQuestion = await _readingQuestionTrialRepository.Where(x => x.ReadingQuestionCriterionTrialId == taskinfo.TrialReadingCriterionId).ToListAsync();
             var tableQuestion = await _readingTableQuestionTrialRepository.Where(x => x.ReadingQuestionTrial.ReadingQuestionCriterionTrialId == taskinfo.TrialReadingCriterionId).ToListAsync();
@@ -179,7 +180,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
 
             var researchProgramNo = subjectInfo.Trial.ResearchProgramNo;
             var subjectName = subjectInfo.ShortName;
-            var subjectCode = string.Join(",", subjectPatientList.Select(x => x.Patient).OrderByDescending(x => x.CreateTime).Select(x => x.PatientIdStr).ToList()); //患者编号;
+            var subjectCode = string.Join(",", patientIdStrList); //患者编号;
 
 
 
@@ -419,7 +420,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
              { "ImageProblem",imageProblem},
             }).ToList();
 
-
+            var patientIdStrList = await _dicomStudyRepository.Where(x => x.SubjectVisitId == taskinfo.SourceSubjectVisitId).Select(x => x.PatientIdStr).Distinct().ToListAsync();
             var subjectPatientList = await _subjectPatientRepository.Where(x => x.SubjectId == subjectInfo.Id).Include(x => x.Patient).ToListAsync();
 
             var assessmentResult = string.Empty;
@@ -442,7 +443,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
              { "SubjectName",subjectInfo.ShortName }, //患者姓名
              { "SubjectSex", subjectInfo.Sex==string.Empty?string.Empty:  subjectInfo.Sex=="M"?"男":"女" }, //患者性别
              { "SubjectAge",subjectInfo.Age==null?string.Empty: subjectInfo.Age +"岁" }, //患者年龄
-             { "SubjectCode",string.Join(",",subjectPatientList.Select(x=>x.Patient).OrderByDescending(x=>x.CreateTime).Select(x=>x.PatientIdStr).ToList())  }, //患者编号
+             { "SubjectCode",string.Join(",",patientIdStrList)  }, //患者编号
              { "VisitName",visitInfo.VisitName }, //访视名称
              { "LatestScanDate",visitInfo.StudyList.Min(x=>x.StudyTime)?.ToString("yyyy-MM-dd") }, //随访日期
              { "CriterionName",taskinfo.TrialReadingCriterion.CriterionName }, //评估标准
diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/PCWG3CalculateService.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/PCWG3CalculateService.cs
index 509a47ec6..0ee883fad 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/PCWG3CalculateService.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/PCWG3CalculateService.cs
@@ -194,7 +194,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
              { "ImageProblem",imageProblem},
             }).ToList();
 
-
+            var patientIdStrList = await _dicomStudyRepository.Where(x => x.SubjectVisitId == taskinfo.SourceSubjectVisitId).Select(x => x.PatientIdStr).Distinct().ToListAsync();
             var subjectPatientList = await _subjectPatientRepository.Where(x => x.SubjectId == subjectInfo.Id).Include(x => x.Patient).ToListAsync();
 
 
@@ -206,7 +206,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
              { "SubjectName",subjectInfo.ShortName }, //患者姓名
              { "SubjectSex", subjectInfo.Sex==string.Empty?string.Empty:  subjectInfo.Sex=="M"?"男":"女" }, //患者性别
              { "SubjectAge",subjectInfo.Age==null?string.Empty: subjectInfo.Age +"岁" }, //患者年龄
-             { "SubjectCode",string.Join(",",subjectPatientList.Select(x=>x.Patient).OrderByDescending(x=>x.CreateTime).Select(x=>x.PatientIdStr).ToList())  }, //患者编号
+             { "SubjectCode",string.Join(",",patientIdStrList)  }, //患者编号
              { "VisitName",visitInfo.VisitName }, //访视名称
              { "LatestScanDate",visitInfo.StudyList.Min(x=>x.StudyTime)?.ToString("yyyy-MM-dd") }, //随访日期
              { "CriterionName",taskinfo.TrialReadingCriterion.CriterionName }, //评估标准
diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1CalculateService.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1CalculateService.cs
index 2a26b6b48..17aaf8638 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1CalculateService.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1CalculateService.cs
@@ -72,6 +72,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
             var visitInfo = await _subjectVisitRepository.Where(x => x.Id == taskinfo.SourceSubjectVisitId).Include(x => x.StudyList).FirstNotNullAsync();
             var subjectInfo = await _subjectRepository.Where(x => x.Id == taskinfo.SubjectId).Include(x => x.Trial).Include(x => x.SubjectPatientList).FirstNotNullAsync();
             var subjectPatientList = await _subjectPatientRepository.Where(x => x.SubjectId == subjectInfo.Id).Include(x => x.Patient).ToListAsync();
+            var patientIdStrList = await _dicomStudyRepository.Where(x => x.SubjectVisitId == taskinfo.SourceSubjectVisitId).Select(x => x.PatientIdStr).Distinct().ToListAsync();
             var trialQuestion = await _readingQuestionTrialRepository.Where(x => x.ReadingQuestionCriterionTrialId == taskinfo.TrialReadingCriterionId).ToListAsync();
             var tableQuestion = await _readingTableQuestionTrialRepository.Where(x => x.ReadingQuestionTrial.ReadingQuestionCriterionTrialId == taskinfo.TrialReadingCriterionId).ToListAsync();
             var dicotionCode = trialQuestion.Where(x => x.DictionaryCode != string.Empty).Select(x => x.DictionaryCode).Distinct().ToList();
@@ -194,7 +195,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
 
             var researchProgramNo = subjectInfo.Trial.ResearchProgramNo;
             var subjectName = subjectInfo.ShortName;
-            var subjectCode = string.Join(",", subjectPatientList.Select(x => x.Patient).OrderByDescending(x => x.CreateTime).Select(x => x.PatientIdStr).ToList()); //患者编号;
+            var subjectCode = string.Join(",", patientIdStrList); //患者编号;
 
 
 
@@ -434,7 +435,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
              { "ImageProblem",imageProblem},
             }).ToList();
 
-
+            var patientIdStrList = await _dicomStudyRepository.Where(x => x.SubjectVisitId == taskinfo.SourceSubjectVisitId).Select(x => x.PatientIdStr).Distinct().ToListAsync();
             var subjectPatientList = await _subjectPatientRepository.Where(x => x.SubjectId == subjectInfo.Id).Include(x => x.Patient).ToListAsync();
 
             var assessmentResult = string.Empty;
@@ -457,7 +458,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
              { "SubjectName",subjectInfo.ShortName }, //患者姓名
              { "SubjectSex", subjectInfo.Sex==string.Empty?string.Empty:  subjectInfo.Sex=="M"?"男":"女" }, //患者性别
              { "SubjectAge",subjectInfo.Age==null?string.Empty: subjectInfo.Age +"岁" }, //患者年龄
-              { "SubjectCode",string.Join(",",subjectPatientList.Select(x=>x.Patient).OrderByDescending(x=>x.CreateTime).Select(x=>x.PatientIdStr).ToList())  }, //患者编号
+             { "SubjectCode",string.Join(",",patientIdStrList)  }, //患者编号
              { "VisitName",visitInfo.VisitName }, //访视名称
              { "LatestScanDate",visitInfo.StudyList.Min(x=>x.StudyTime)?.ToString("yyyy-MM-dd") }, //随访日期
              { "CriterionName",taskinfo.TrialReadingCriterion.CriterionName }, //评估标准
diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1_BMCalculateService.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1_BMCalculateService.cs
index bbfa9ac77..1edf1f21a 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1_BMCalculateService.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/RECIST1Point1_BMCalculateService.cs
@@ -67,6 +67,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
               .Include(x => x.TrialReadingCriterion).FirstNotNullAsync();
             var visitInfo = await _subjectVisitRepository.Where(x => x.Id == taskinfo.SourceSubjectVisitId).Include(x => x.StudyList).FirstNotNullAsync();
             var subjectInfo = await _subjectRepository.Where(x => x.Id == taskinfo.SubjectId).Include(x => x.Trial).Include(x => x.SubjectPatientList).FirstNotNullAsync();
+            var patientIdStrList = await _dicomStudyRepository.Where(x => x.SubjectVisitId == taskinfo.SourceSubjectVisitId).Select(x => x.PatientIdStr).Distinct().ToListAsync();
             var subjectPatientList = await _subjectPatientRepository.Where(x => x.SubjectId == subjectInfo.Id).Include(x => x.Patient).ToListAsync();
             var trialQuestion = await _readingQuestionTrialRepository.Where(x => x.ReadingQuestionCriterionTrialId == taskinfo.TrialReadingCriterionId).ToListAsync();
             var tableQuestion = await _readingTableQuestionTrialRepository.Where(x => x.ReadingQuestionTrial.ReadingQuestionCriterionTrialId == taskinfo.TrialReadingCriterionId).ToListAsync();
@@ -190,7 +191,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
 
             var researchProgramNo = subjectInfo.Trial.ResearchProgramNo;
             var subjectName = subjectInfo.ShortName;
-            var subjectCode = string.Join(",", subjectPatientList.Select(x => x.Patient).OrderByDescending(x => x.CreateTime).Select(x => x.PatientIdStr).ToList()); //患者编号;
+            var subjectCode = string.Join(",", patientIdStrList); //患者编号;
 
 
 
@@ -428,7 +429,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
              { "ImageProblem",imageProblem},
             }).ToList();
 
-
+            var patientIdStrList = await _dicomStudyRepository.Where(x => x.SubjectVisitId == taskinfo.SourceSubjectVisitId).Select(x => x.PatientIdStr).Distinct().ToListAsync();
             var subjectPatientList = await _subjectPatientRepository.Where(x => x.SubjectId == subjectInfo.Id).Include(x => x.Patient).ToListAsync();
 
             var assessmentResult = string.Empty;
@@ -452,7 +453,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
              { "SubjectName",subjectInfo.ShortName }, //患者姓名
              { "SubjectSex", subjectInfo.Sex==string.Empty?string.Empty:  subjectInfo.Sex=="M"?"男":"女" }, //患者性别
              { "SubjectAge",subjectInfo.Age==null?string.Empty: subjectInfo.Age +"岁" }, //患者年龄
-             { "SubjectCode",string.Join(",",subjectPatientList.Select(x=>x.Patient).OrderByDescending(x=>x.CreateTime).Select(x=>x.PatientIdStr).ToList())  }, //患者编号
+             { "SubjectCode",string.Join(",",patientIdStrList)  }, //患者编号
              { "VisitName",visitInfo.VisitName }, //访视名称
              { "LatestScanDate",visitInfo.StudyList.Min(x=>x.StudyTime)?.ToString("yyyy-MM-dd") }, //随访日期
              { "CriterionName",taskinfo.TrialReadingCriterion.CriterionName }, //评估标准