diff --git a/IRaCIS.Core.Application/IRaCIS.Core.Application.xml b/IRaCIS.Core.Application/IRaCIS.Core.Application.xml
index 8a9e4ad66..b936e7141 100644
--- a/IRaCIS.Core.Application/IRaCIS.Core.Application.xml
+++ b/IRaCIS.Core.Application/IRaCIS.Core.Application.xml
@@ -1375,7 +1375,7 @@
         </member>
         <member name="M:IRaCIS.Core.Application.Service.ReadingCalculate.IRECIST1Point1CalculateService.GetComparedTriggeringSODChange(IRaCIS.Core.Application.Service.Reading.Dto.ReadingCalculateDto)">
             <summary>
-            与前一访视SOD相比变化量
+            与触发iRECIST访视相比SOD变化量
             </summary>
             <param name="inDto"></param>
             <returns></returns>
diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs
index 636b6fccc..9116e307c 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs
@@ -1321,16 +1321,16 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
         }
         #endregion
 
-        #region 与前一访视SOD相比变化量
+        #region 与触发iRECIST访视相比SOD变化量
         /// <summary>
-        /// 与前一访视SOD相比变化量
+        /// 与触发iRECIST访视相比SOD变化量
         /// </summary>
         /// <param name="inDto"></param>
         /// <returns></returns>
         public async Task<decimal?> GetComparedTriggeringSODChange(ReadingCalculateDto inDto)
         {
-            var lastTaskId = await this.GetLastVisitTaskId(inDto);
-            var lastSOD = (await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == lastTaskId && x.ReadingQuestionTrial.QuestionType == QuestionType.SOD).Select(x => x.Answer).FirstOrDefaultAsync()).IsNullOrEmptyReturn0();
+            var firstChangeTaskId = await this.GetFirstChangeTaskId(inDto);
+            var firstChangeSOD = (await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == firstChangeTaskId && x.ReadingQuestionTrial.QuestionType == QuestionType.SOD).Select(x => x.Answer).FirstOrDefaultAsync()).IsNullOrEmptyReturn0();
 
             var value = await GetSODData(inDto);
 
@@ -1338,7 +1338,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
             {
                 return null;
             }
-            return value.NullChange0() - lastSOD;
+            return value.NullChange0() - firstChangeSOD;
         }
         #endregion
 
@@ -2076,7 +2076,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
                 item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.Yes))
                 );
 
-                data.ExixtsOrLessNoLymphTarget = data.ExixtsLymphTarget || 
+                data.ExixtsOrLessNoLymphTarget = data.ExixtsOrLessNoLymphTarget || 
                     (
                     
                     (
@@ -2090,7 +2090,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
 
             }
 
-            NewTargetLesionAssessment? result = null;
+            NewTargetLesionAssessment? result = NewTargetLesionAssessment.ND;
 
             // if（所有新靶病灶消失或一直不存在任何新靶病灶） 
             if(data.NotExistsNewTargetLesion||data.AllVanish)
@@ -2105,7 +2105,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
                 result = NewTargetLesionAssessment.iCPD;
             }
             // else if (上一访视新靶病灶评估为“iCPD”&& （当有“存在”状态的淋巴结新靶病灶||当有“存在”或“太小”状态的非淋巴结新靶病灶）)
-            else if (data.LastTaskNewTargetLesion.EqEnum(NewTargetLesionAssessment.iCPD) && data.ExixtsLymphTarget && data.ExixtsOrLessNoLymphTarget)
+            else if (data.LastTaskNewTargetLesion.EqEnum(NewTargetLesionAssessment.iCPD) &&( data.ExixtsLymphTarget || data.ExixtsOrLessNoLymphTarget))
              {
                 //     疗效为 iCPD
                 result = NewTargetLesionAssessment.iCPD;
@@ -2827,6 +2827,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
                   && (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.iCR))
                     || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.iNN))
                       || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.NE))
+                       || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.ND))
 
                ) && (
                      inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.ND))