diff --git a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicineQuestionViewModel.cs b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicineQuestionViewModel.cs
index 763e4b7f9..f6f47de0d 100644
--- a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicineQuestionViewModel.cs
+++ b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicineQuestionViewModel.cs
@@ -89,7 +89,6 @@ namespace IRaCIS.Core.Application.ViewModel
 
     public class TrialDataFromSystem : ReadingMedicineTrialQuestion
     {
-        public Guid SystemQuestionId { get; set; }
     }
 
 
@@ -100,7 +99,7 @@ namespace IRaCIS.Core.Application.ViewModel
 		[NotDefault]
 		public Guid TrialReadingCriterionId { get; set; }
 
-        public bool IsEnglish { get; set; }
+		public LanguageType LanguageType { get; set; }
 	}
 
 	public class AddTrialDataFromSystemInDto
diff --git a/IRaCIS.Core.Application/Service/Reading/MedicalAudit/ReadingMedicineQuestionService.cs b/IRaCIS.Core.Application/Service/Reading/MedicalAudit/ReadingMedicineQuestionService.cs
index 4432c0499..030e34aa7 100644
--- a/IRaCIS.Core.Application/Service/Reading/MedicalAudit/ReadingMedicineQuestionService.cs
+++ b/IRaCIS.Core.Application/Service/Reading/MedicalAudit/ReadingMedicineQuestionService.cs
@@ -501,9 +501,13 @@ namespace IRaCIS.Core.Application.Service
 		[HttpPost]
 		public async Task<IResponseOutput> AddDefaultQuestions(AddDefaultQuestionsInDto inDto)
 		{
-			if (await _readingMedicineTrialQuestionRepository.AnyAsync(x => x.TrialReadingCriterionId == inDto.TrialReadingCriterionId))
+			if (await _readingMedicineTrialQuestionRepository.AnyAsync(x => x.TrialReadingCriterionId == inDto.TrialReadingCriterionId && x.LanguageType == inDto.LanguageType && x.SystemQuestionId != null))
 			{
-				throw new BusinessValidationFailedException(_localizer["Medicine_ExistsMedicineQuestion"]);
+				await _readingMedicineTrialQuestionRepository.BatchDeleteNoTrackingAsync(x => x.TrialReadingCriterionId == inDto.TrialReadingCriterionId && x.LanguageType == inDto.LanguageType && x.SystemQuestionId != null);
+			}
+			else
+			{
+				await _readingMedicineTrialQuestionRepository.BatchDeleteNoTrackingAsync(x => x.TrialReadingCriterionId == inDto.TrialReadingCriterionId && x.LanguageType != inDto.LanguageType);
 			}
 			var criterionInfo = await _readingQuestionCriterionTrialRepository.Where(x => x.Id == inDto.TrialReadingCriterionId).FirstNotNullAsync();
 			List<ReadingCategory> needAddCategory = new List<ReadingCategory>() { ReadingCategory.Visit };
@@ -522,8 +526,7 @@ namespace IRaCIS.Core.Application.Service
 
 			var maxOrder = await _readingMedicineTrialQuestionRepository.Where(x => x.TrialId == inDto.TrialId && x.TrialReadingCriterionId == inDto.TrialReadingCriterionId).OrderByDescending(x => x.ShowOrder).Select(x => x.ShowOrder).FirstOrDefaultAsync();
 			List<TrialDataFromSystem> needList = await _readingMedicineSystemQuestionRepository
-				.WhereIf(inDto.IsEnglish, x => x.LanguageType == LanguageType.English)
-				.WhereIf(!inDto.IsEnglish, x => x.LanguageType == LanguageType.Chinese)
+				.Where(x=>x.LanguageType==inDto.LanguageType)
 				.Where(x => x.CriterionTypeEnum == criterionInfo.CriterionType && needAddCategory.Contains(x.ReadingCategory))
 				.Select(x => new TrialDataFromSystem()
 				{
diff --git a/IRaCIS.Core.Domain/Reading/MedicalAudit/ReadingMedicineTrialQuestion.cs b/IRaCIS.Core.Domain/Reading/MedicalAudit/ReadingMedicineTrialQuestion.cs
index afc4cc6e9..e5f90f69c 100644
--- a/IRaCIS.Core.Domain/Reading/MedicalAudit/ReadingMedicineTrialQuestion.cs
+++ b/IRaCIS.Core.Domain/Reading/MedicalAudit/ReadingMedicineTrialQuestion.cs
@@ -101,6 +101,8 @@ namespace IRaCIS.Core.Domain.Models
 		/// </summary>
 		public Guid TrialReadingCriterionId { get; set; }
 
+		public Guid? SystemQuestionId { get; set; }
+
 		[JsonIgnore]
 		[ForeignKey("ParentId")]
 		public ReadingMedicineTrialQuestion ParentQuestion { get; set; }