diff --git a/IRaCIS.Core.Application/MassTransit/Consumer/ReadingRelationEmailConsumer.cs b/IRaCIS.Core.Application/MassTransit/Consumer/ReadingRelationEmailConsumer.cs
index 7c520dd97..f6ff6c5f8 100644
--- a/IRaCIS.Core.Application/MassTransit/Consumer/ReadingRelationEmailConsumer.cs
+++ b/IRaCIS.Core.Application/MassTransit/Consumer/ReadingRelationEmailConsumer.cs
@@ -227,11 +227,114 @@ public class UrgentIRRepliedMedicalReviewConsumer(
 /// <summary>
 /// MIM 回复医学返回通知IR
 /// </summary>
-public class UrgentMIMRepliedMedicalReviewConsumer : IConsumer<UrgentMIMRepliedMedicalReview>
+public class UrgentMIMRepliedMedicalReviewConsumer(
+      IRepository<User> _userRepository,
+       IRepository<TaskMedicalReview> _taskMedicalReviewRepository,
+      IRepository<Trial> _trialRepository,
+        IRepository<SubjectVisit> _subjectVisitRepository,
+      IRepository<ReadingQuestionCriterionTrial> _readingQuestionCriterionTrialRepository,
+      IRepository<VisitTask> _visitTaskRepository,
+         IRepository<Dictionary> _dictionaryRepository,
+      IRepository<EmailNoticeConfig> _emailNoticeConfigrepository,
+      IOptionsMonitor<SystemEmailSendConfig> systemEmailConfig) : IConsumer<UrgentMIMRepliedMedicalReview>
 {
-    public Task Consume(ConsumeContext<UrgentMIMRepliedMedicalReview> context)
+
+    private readonly SystemEmailSendConfig _systemEmailConfig = systemEmailConfig.CurrentValue;
+
+    /// <summary>
+    /// MIM 回复医学返回通知IR
+    /// </summary>
+    /// <param name="context"></param>
+    /// <returns></returns>
+    public async Task Consume(ConsumeContext<UrgentMIMRepliedMedicalReview> context)
     {
-        throw new NotImplementedException();
+        Console.WriteLine("发送(022) 【加急医学反馈】邮件！！！");
+        var isEn_US = CultureInfo.CurrentCulture.Name == StaticData.CultureInfo.en_US;
+
+        var medicalReviewId = context.Message.MedicalReviewId;
+
+        var medicalReview = await _taskMedicalReviewRepository.Where(x => x.Id == medicalReviewId).Include(x => x.VisitTask).Include(x => x.MedicalManagerUser).FirstOrDefaultAsync();
+
+
+
+        if (medicalReview.MedicalManagerUserId == null)
+        {
+            Console.WriteLine("MIMId为空 ID" + medicalReviewId);
+            return;
+        }
+        var criterion = await _readingQuestionCriterionTrialRepository.FirstOrDefaultAsync(x => x.Id == medicalReview.VisitTask.TrialReadingCriterionId);
+        var taskInfo = await _visitTaskRepository.Where(x => x.Id == medicalReview.VisitTaskId).Include(x => x.SourceSubjectVisit).Include(x => x.ReadModule).Include(x => x.Subject).FirstNotNullAsync();
+
+        var userinfo = await _userRepository.Where(x => x.Id == taskInfo.DoctorUserId).FirstOrDefaultAsync();
+
+      
+
+
+        var visitid = taskInfo.SourceSubjectVisit == null ? taskInfo.ReadModule.SubjectVisitId : taskInfo.SourceSubjectVisitId;
+
+
+        var subjectVisit = await _subjectVisitRepository.Where(x => x.Id == visitid).FirstOrDefaultAsync();
+
+
+
+        var messageToSend = new MimeMessage();
+        //发件地址
+        messageToSend.From.Add(new MailboxAddress(_systemEmailConfig.FromName, _systemEmailConfig.FromEmail));
+        messageToSend.To.Add(new MailboxAddress(String.Empty, userinfo.EMail));
+
+        var trialInfo = await _trialRepository.FirstOrDefaultAsync(t => t.Id == medicalReview.TrialId);
+        var companyName = isEn_US ? _systemEmailConfig.CompanyShortName : _systemEmailConfig.CompanyShortNameCN;
+
+
+        var dictionValue = await CommonEmailHelper.TranslationDictionary(new TranslationDictionaryDto()
+        {
+
+            DictionaryRepository = _dictionaryRepository,
+            IsEn_US = isEn_US,
+
+
+            DictionaryList = new List<DictionaryDto>()
+            {
+             new DictionaryDto (){DictionaryCode= "ReadingCategory",EnumValue=taskInfo.ReadingCategory.GetEnumInt(), },
+             new DictionaryDto (){DictionaryCode= "IsPass",EnumValue=medicalReview.IsHaveQuestion.ToString(), },// 审核结论
+             new DictionaryDto (){DictionaryCode= "AuditAdvice",EnumValue=medicalReview.AuditAdviceEnum.GetEnumInt(), },// 审核建议
+             new DictionaryDto (){DictionaryCode= "YesOrNo",EnumValue=taskInfo.IsUrgent.ToString(), }, //是否加急
+
+ 
+          
+          
+         
+            }
+        });
+
+        Func<(string topicStr, string htmlBodyStr), (string topicStr, string htmlBodyStr)> emailConfigFunc = input =>
+        {
+            var topicStr = string.Format(input.topicStr, companyName, trialInfo.ResearchProgramNo);
+            var htmlBodyStr = string.Format(
+               CommonEmailHelper.ReplaceCompanyName(_systemEmailConfig, input.htmlBodyStr),
+               userinfo.FullName,              // 用户名  {0}
+               trialInfo.ExperimentName,        // 项目   {1}
+               taskInfo.BlindSubjectCode.IsNullOrEmpty() ? taskInfo.Subject.Code : taskInfo.BlindSubjectCode, // 受试者 {2}
+               taskInfo.TaskBlindName,             // 访视  {3}
+               criterion.CriterionName,  // 阅片标准       {4}
+               dictionValue[0],      // 任务类型            {5}
+               dictionValue[1],      // 审核结论           {6}
+               dictionValue[2],     // 医学审核建议        {7}
+               dictionValue[3],    // 是否加急               {8}
+
+              _systemEmailConfig.SiteUrl              // 链接                  {9}
+                );
+
+            return (topicStr, htmlBodyStr);
+        };
+
+        await CommonEmailHelper.GetEmailSubejctAndHtmlInfoAndBuildAsync(_emailNoticeConfigrepository,
+
+          EmailBusinessScenario.ExpeditedMedicalQCToIR,
+
+            messageToSend, emailConfigFunc);
+
+        await SendEmailHelper.SendEmailAsync(messageToSend, _systemEmailConfig);
     }
 }
 
diff --git a/IRaCIS.Core.Domain/Allocation/TaskMedicalReview.cs b/IRaCIS.Core.Domain/Allocation/TaskMedicalReview.cs
index d2950a0f7..b2c80102e 100644
--- a/IRaCIS.Core.Domain/Allocation/TaskMedicalReview.cs
+++ b/IRaCIS.Core.Domain/Allocation/TaskMedicalReview.cs
@@ -76,6 +76,9 @@ public class TaskMedicalReview : BaseFullAuditEntity
     public Guid VisitTaskId { get; set; }
     public Guid TrialId { get; set; }
 
+    /// <summary>
+    /// 审核结论  false 为通过 true 为不通过
+    /// </summary>
     [Comment("是否有问题")]
     public bool IsHaveQuestion { get; set; } = false;
 
diff --git a/IRaCIS.Core.Domain/_DomainEvent/ReadingEnrollOrPDRelationEvent.cs b/IRaCIS.Core.Domain/_DomainEvent/ReadingEnrollOrPDRelationEvent.cs
index 170809f01..0c210c440 100644
--- a/IRaCIS.Core.Domain/_DomainEvent/ReadingEnrollOrPDRelationEvent.cs
+++ b/IRaCIS.Core.Domain/_DomainEvent/ReadingEnrollOrPDRelationEvent.cs
@@ -37,6 +37,8 @@ public class UrgentIRRepliedMedicalReview : DomainEvent
 public class UrgentMIMRepliedMedicalReview : DomainEvent
 {
     public Guid ReadingMedicalReviewDialogId { get; set; }
+
+    public Guid MedicalReviewId { get; set; }
 }
 
 
diff --git a/IRaCIS.Core.Infra.EFCore/Interceptor/AddDomainExt.cs b/IRaCIS.Core.Infra.EFCore/Interceptor/AddDomainExt.cs
index 0135866e8..7d26f4e2c 100644
--- a/IRaCIS.Core.Infra.EFCore/Interceptor/AddDomainExt.cs
+++ b/IRaCIS.Core.Infra.EFCore/Interceptor/AddDomainExt.cs
@@ -216,7 +216,7 @@ public static class DBContext_Ext
             {
                 if (entry.State == EntityState.Added && readingMedicalReviewDialog.UserTypeEnumInt == (int)UserTypeEnum.MIM)
                 {
-                    readingMedicalReviewDialog.AddDomainEvent(new UrgentMIMRepliedMedicalReview() { ReadingMedicalReviewDialogId = readingMedicalReviewDialog.Id });
+                    readingMedicalReviewDialog.AddDomainEvent(new UrgentMIMRepliedMedicalReview() { MedicalReviewId = readingMedicalReviewDialog.TaskMedicalReviewId, ReadingMedicalReviewDialogId = readingMedicalReviewDialog.Id });
                 }
                 else if (entry.State == EntityState.Added && readingMedicalReviewDialog.UserTypeEnumInt == (int)UserTypeEnum.IndependentReviewer)
                 {