diff --git a/yudao-module-applyregistration/yudao-module-applyregistration-biz/src/main/java/cn/iocoder/yudao/module/applyregistration/controller/admin/applyform/ApplyformController.java b/yudao-module-applyregistration/yudao-module-applyregistration-biz/src/main/java/cn/iocoder/yudao/module/applyregistration/controller/admin/applyform/ApplyformController.java
index 86408c83d..93558146d 100644
--- a/yudao-module-applyregistration/yudao-module-applyregistration-biz/src/main/java/cn/iocoder/yudao/module/applyregistration/controller/admin/applyform/ApplyformController.java
+++ b/yudao-module-applyregistration/yudao-module-applyregistration-biz/src/main/java/cn/iocoder/yudao/module/applyregistration/controller/admin/applyform/ApplyformController.java
@@ -538,8 +538,12 @@ public class ApplyformController {
                     if (patientexamlistDO.getReviewDoctor() != null && !patientexamlistDO.getReviewDoctor().isEmpty()) {
                         //存放PDF
                         pdfurl.add(patientexamlistDO.getPdfurl());
-                        //存放访问地址 一次检查一个地址
-                        dcmurl.add("https://pacs.gw12320.com/viewdcm/?regid="+patientexamlistDO.getRegId()+"&orgId="+patientexamlistDO.getOrgId()+"&examid="+patientexamlistDO.getExamId());
+                        if(!patientexamlistDO.getDeviceType().equals("US"))
+                        {
+                            //存放访问地址 一次检查一个地址
+                            dcmurl.add("https://pacs.gw12320.com/viewdcm/?regid="+patientexamlistDO.getRegId()+"&orgId="+patientexamlistDO.getOrgId()+"&examid="+patientexamlistDO.getExamId());
+                        }
+
                     }
                 }
                 if(pdfurl.isEmpty())
diff --git a/yudao-module-ultrasoniccom/yudao-module-ultrasoniccom-biz/src/main/java/cn/iocoder/yudao/module/ultrasoniccom/controller/admin/ultrasonic/medicalimg/upmedicalimgVO.java b/yudao-module-ultrasoniccom/yudao-module-ultrasoniccom-biz/src/main/java/cn/iocoder/yudao/module/ultrasoniccom/controller/admin/ultrasonic/medicalimg/upmedicalimgVO.java
index 32cbe6523..b2839815e 100644
--- a/yudao-module-ultrasoniccom/yudao-module-ultrasoniccom-biz/src/main/java/cn/iocoder/yudao/module/ultrasoniccom/controller/admin/ultrasonic/medicalimg/upmedicalimgVO.java
+++ b/yudao-module-ultrasoniccom/yudao-module-ultrasoniccom-biz/src/main/java/cn/iocoder/yudao/module/ultrasoniccom/controller/admin/ultrasonic/medicalimg/upmedicalimgVO.java
@@ -6,6 +6,9 @@ import lombok.Data;
 @Data
 public class upmedicalimgVO {
 
+    @Schema(description = "患者ID", example = "26467")
+    private String regid;
+
     @Schema(description = "主键", example = "26467")
     private String id;
 
diff --git a/yudao-module-ultrasoniccom/yudao-module-ultrasoniccom-biz/src/main/java/cn/iocoder/yudao/module/ultrasoniccom/controller/admin/ultrasonic/ultrasonicController.java b/yudao-module-ultrasoniccom/yudao-module-ultrasoniccom-biz/src/main/java/cn/iocoder/yudao/module/ultrasoniccom/controller/admin/ultrasonic/ultrasonicController.java
index 91e4d03e5..b5d32bab1 100644
--- a/yudao-module-ultrasoniccom/yudao-module-ultrasoniccom-biz/src/main/java/cn/iocoder/yudao/module/ultrasoniccom/controller/admin/ultrasonic/ultrasonicController.java
+++ b/yudao-module-ultrasoniccom/yudao-module-ultrasoniccom-biz/src/main/java/cn/iocoder/yudao/module/ultrasoniccom/controller/admin/ultrasonic/ultrasonicController.java
@@ -257,14 +257,18 @@ public class ultrasonicController {
         if (!updateReqVO.isEmpty()) {
             //最终提交的数据
             List<medicalimgDO> doList = new ArrayList<>();
-
+            //更新选择时候 全部先改成0
+            List<medicalimgDO> dedoList = new ArrayList<>();
             //当前时间
             LocalDateTime dateTime = LocalDateTime.parse(LocalDateTime.now().format(DateTimeFormatter.ofPattern("yyyy-MM-dd HH:mm:ss")),
                     DateTimeFormatter.ofPattern("yyyy-MM-dd HH:mm:ss"));
+
             //循环传递进来的参数 赋值
             for (upmedicalimgVO s : updateReqVO) {
                 //新增对象
                 medicalimgDO medicalimgDO = new medicalimgDO();
+                //会多次保存 先把之前保存的图片标识全部改成0 未选择
+                medicalimgDO demedicalimgDO = new medicalimgDO();
                 medicalimgDO.setId(s.getId());
                 if (s.getIsDelete() != null && !s.getIsDelete().isEmpty()) {
                     medicalimgDO.setIsDelete(s.getIsDelete());
@@ -273,10 +277,19 @@ public class ultrasonicController {
                 }
                 if (s.getSelected() != null && !s.getSelected().isEmpty()) {
                     medicalimgDO.setSelected(s.getSelected());
+                    //如果他是选择 则先进行更新成0 在进行更新1  会存在多次保存 审核只有一次
+                    demedicalimgDO.setRegId(updateReqVO.get(0).getRegid());
+                    demedicalimgDO.setSelected("0");
                 }
+                dedoList.add(demedicalimgDO);
                 doList.add(medicalimgDO);
             }
+            //先进行更新
+            if (!dedoList.isEmpty()) {
+                medicalimgService.updateBatchById(dedoList);
+            }
             if (!doList.isEmpty()) {
+
                 boolean bol = medicalimgService.updateBatchById(doList);
                 return success(bol);
             } else {