diff --git a/IRaCIS.Core.Application/Service/Allocation/VisitTaskService.cs b/IRaCIS.Core.Application/Service/Allocation/VisitTaskService.cs
index eb467c64e..17dd8b18f 100644
--- a/IRaCIS.Core.Application/Service/Allocation/VisitTaskService.cs
+++ b/IRaCIS.Core.Application/Service/Allocation/VisitTaskService.cs
@@ -1717,12 +1717,12 @@ public class VisitTaskService(IRepository<VisitTask> _visitTaskRepository,
         if (criterionConfig.CriterionType == CriterionType.RECIST1Point1 && criterionConfig.IsAdditionalAssessment)
         {
             // PM申请 SPM / CPM审批
-            if (requestReReadingType == RequestReReadingType.TrialGroupApply)
-            {
-                filterExpression = filterExpression.And(t => t.TrialReadingCriterionId == origenalTask.TrialReadingCriterionId || t.TrialReadingCriterion.CriterionType == CriterionType.RECIST1Pointt1_MB);
-            }
+            //if (requestReReadingType == RequestReReadingType.TrialGroupApply)
+            //{
+            //    filterExpression = filterExpression.And(t => t.TrialReadingCriterionId == origenalTask.TrialReadingCriterionId || t.TrialReadingCriterion.CriterionType == CriterionType.RECIST1Pointt1_MB);
+            //}
             //IR 申请  PM审批
-            else
+            if (requestReReadingType != RequestReReadingType.TrialGroupApply)
             {
 
                 // 1.1 基线任务影响BM任务
@@ -1741,8 +1741,11 @@ public class VisitTaskService(IRepository<VisitTask> _visitTaskRepository,
         }
         else
         {
-            //默认影响的都是该标准的任务
-            filterExpression = filterExpression.And(t => t.TrialReadingCriterionId == origenalTask.TrialReadingCriterionId);
+            if (requestReReadingType != RequestReReadingType.TrialGroupApply)
+            {
+                //默认影响的都是该标准的任务
+                filterExpression = filterExpression.And(t => t.TrialReadingCriterionId == origenalTask.TrialReadingCriterionId);
+            }
         }
 
         //PM申请   SPM / CPM审批   回退访视，因此这里不生成访视任务  影响多个标准的任务
@@ -2643,7 +2646,7 @@ public class VisitTaskService(IRepository<VisitTask> _visitTaskRepository,
     /// <param name="applyId"> 申请记录的Id</param>
     /// <returns></returns>
     [HttpGet("{taskId:guid}/{isReReading:bool}")]
-    public async Task<(List<InfluenceTaskInfo>, object)> GetReReadingOrBackInfluenceTaskList(Guid taskId, bool isReReading, Guid? applyId)
+    public async Task<IResponseOutput<List<InfluenceTaskInfo>>> GetReReadingOrBackInfluenceTaskList(Guid taskId, bool isReReading, Guid? applyId)
     {
         var isIRAppyTaskInfluenced = false;
 
@@ -2661,13 +2664,16 @@ public class VisitTaskService(IRepository<VisitTask> _visitTaskRepository,
         //IR 申请1.1 基线重阅，影响附加评估所有的任务
         var isIR1Point1AdditionalAssessmentBaseline = false;
 
+        //是IR 申请 PM 审批流程
+        var isIRApplyPMApprovalProcess = (IsPMOrAPm() && applyId != null && await _visitTaskReReadingRepository.AnyAsync(t => t.Id == applyId && t.CreateUserRole.UserTypeEnum == UserTypeEnum.IndependentReviewer))
+            || (_userInfo.UserTypeEnumInt == (int)UserTypeEnum.IndependentReviewer && applyId == null);
+
         //附加评估  IR  和PM 看到的影响列表不一样
         if (criterionConfig.CriterionType == CriterionType.RECIST1Point1 && criterionConfig.IsAdditionalAssessment)
         {
 
             //  IR 申请  PM 同意  
-            if (((IsPMOrAPm() && applyId != null && await _visitTaskReReadingRepository.AnyAsync(t => t.Id == applyId && t.CreateUserRole.UserTypeEnum == UserTypeEnum.IndependentReviewer))
-                || (_userInfo.UserTypeEnumInt == (int)UserTypeEnum.IndependentReviewer && applyId == null)))
+            if (isIRApplyPMApprovalProcess)
             {
 
                 // 1.1 基线任务影响BM任务
@@ -2686,18 +2692,20 @@ public class VisitTaskService(IRepository<VisitTask> _visitTaskRepository,
                 }
 
             }
-            //（1、PM回退，PM申请重阅，SPM同意回退）
-            else
-            {
-                filterExpression = filterExpression.And(t => t.TrialReadingCriterionId == filterObj.TrialReadingCriterionId || t.TrialReadingCriterion.CriterionType == CriterionType.RECIST1Pointt1_MB);
+            //（1、PM回退，PM申请重阅，SPM同意回退）--20250804-感觉这里没用，不用限制
+            //else
+            //{
+            //    filterExpression = filterExpression.And(t => t.TrialReadingCriterionId == filterObj.TrialReadingCriterionId || t.TrialReadingCriterion.CriterionType == CriterionType.RECIST1Pointt1_MB);
 
-            }
+            //}
         }
         else
         {
-            //默认影响的都是该标准的任务
-            filterExpression = filterExpression.And(t => t.TrialReadingCriterionId == filterObj.TrialReadingCriterionId);
-
+            if (isReReading == true && isIRApplyPMApprovalProcess)
+            {
+                //默认影响的都是该标准的任务
+                filterExpression = filterExpression.And(t => t.TrialReadingCriterionId == filterObj.TrialReadingCriterionId);
+            }
         }
 
 
@@ -2938,8 +2946,8 @@ public class VisitTaskService(IRepository<VisitTask> _visitTaskRepository,
         }
         #endregion
 
-
-        return (list, new { IsIRAppyTaskInfluenced = isIRAppyTaskInfluenced });
+        //IsIRAppyTaskInfluenced 列表中存在IR已申请重阅的任务！
+        return ResponseOutput.Ok(list, new { IsIRAppyTaskInfluenced = isIRAppyTaskInfluenced });
 
     }
 
diff --git a/IRaCIS.Core.Application/Service/Common/ExcelExportService.cs b/IRaCIS.Core.Application/Service/Common/ExcelExportService.cs
index f0f4370d7..92ce94fec 100644
--- a/IRaCIS.Core.Application/Service/Common/ExcelExportService.cs
+++ b/IRaCIS.Core.Application/Service/Common/ExcelExportService.cs
@@ -88,7 +88,7 @@ namespace IRaCIS.Core.Application.Service.Common
 
 
             var query = from qa in _trialQCQuestionAnswerRepository.Where(t => t.SubjectVisit.TrialId == trialId &&
-               (t.SubjectVisit.AuditState == AuditStateEnum.QCPassed ||
+               (t.SubjectVisit.AuditState == AuditStateEnum.QCPassed && t.SecondReviewTime == null ||
                (t.SubjectVisit.SecondReviewState == SecondReviewState.AuditPassed && t.SecondReviewTime <= t.SubjectVisit.Trial.QCQuestionConfirmedTime) ||
                (t.SubjectVisit.SecondReviewState == SecondReviewState.WaitAudit && t.SecondReviewTime < t.SubjectVisit.Trial.QCQuestionConfirmedTime)))
                         join u in _userRoleRepository.AsQueryable() on qa.UpdateUserId equals u.Id
diff --git a/IRaCIS.Core.Application/TestService.cs b/IRaCIS.Core.Application/TestService.cs
index 82afeaeff..57c3ad1a3 100644
--- a/IRaCIS.Core.Application/TestService.cs
+++ b/IRaCIS.Core.Application/TestService.cs
@@ -130,6 +130,35 @@ namespace IRaCIS.Core.Application.Service
             return ResponseOutput.Ok();
         }
 
+        //添加医学审核问题
+        [AllowAnonymous]
+        public async Task<IResponseOutput> AddReadingMedicineSystemQuestion([FromServices] IRepository<ReadingMedicineSystemQuestion> _readingMedicineSystemQuestion)
+        {
+            if (!_readingMedicineSystemQuestion.Any(t => t.CriterionTypeEnum == CriterionType.mRECISTHCC))
+            {
+                var list = _readingMedicineSystemQuestion.Where(t => t.CriterionTypeEnum == CriterionType.RECIST1Point1).ToList();
+
+                var initOrder = 500;
+                foreach (var item in list)
+                {
+                    item.Id = NewId.NextSequentialGuid();
+
+                    item.CriterionTypeEnum = CriterionType.mRECISTHCC;
+
+                    item.CreateTime = DateTime.Now;
+                    item.ShowOrder = initOrder;
+
+                    initOrder = initOrder + 1;
+                }
+
+                await _readingMedicineSystemQuestion.AddRangeAsync(list,true);
+            }
+
+           
+
+            return ResponseOutput.Ok();
+        }
+
         /// <summary>
         /// IQC 回退到影像上传
         /// </summary>