diff --git a/yudao-module-system/yudao-module-system-biz/pom.xml b/yudao-module-system/yudao-module-system-biz/pom.xml
index 096a3c03c..a9da986ed 100644
--- a/yudao-module-system/yudao-module-system-biz/pom.xml
+++ b/yudao-module-system/yudao-module-system-biz/pom.xml
@@ -128,6 +128,18 @@
             <version>4.4.0</version>
         </dependency>
 
+        <!--itextpdf-->
+        <dependency>
+            <groupId>com.itextpdf</groupId>
+            <artifactId>itextpdf</artifactId>
+            <version>5.5.13.4</version>
+        </dependency>
+        <dependency>
+            <groupId>com.itextpdf</groupId>
+            <artifactId>itext-asian</artifactId>
+            <version>5.2.0</version>
+        </dependency>
+
     </dependencies>
 
 </project>
diff --git a/yudao-module-tblist/yudao-module-tblist-biz/src/main/java/cn/iocoder/yudao/module/tblist/controller/admin/patientexamlist/PatientexamlistController.java b/yudao-module-tblist/yudao-module-tblist-biz/src/main/java/cn/iocoder/yudao/module/tblist/controller/admin/patientexamlist/PatientexamlistController.java
index 4ab9f8534..63d7944ce 100644
--- a/yudao-module-tblist/yudao-module-tblist-biz/src/main/java/cn/iocoder/yudao/module/tblist/controller/admin/patientexamlist/PatientexamlistController.java
+++ b/yudao-module-tblist/yudao-module-tblist-biz/src/main/java/cn/iocoder/yudao/module/tblist/controller/admin/patientexamlist/PatientexamlistController.java
@@ -11,6 +11,7 @@ import cn.iocoder.yudao.module.system.service.user.AdminUserService;
 import cn.iocoder.yudao.module.tblist.dal.mysql.patientexamlist.PatientexamlistMapper;
 import cn.iocoder.yudao.module.tblist.service.patientexamlist.org.OrgService;
 
+import com.alibaba.fastjson.JSONObject;
 import com.google.gson.Gson;
 import com.google.gson.GsonBuilder;
 import com.mzt.logapi.starter.annotation.LogRecord;
@@ -486,6 +487,20 @@ public class PatientexamlistController {
         return success(msg);
     }
 
+    @PostMapping("/generatePdf_ct")
+    @Operation(summary = "生成pdf进行上传(ct)")
+    public CommonResult<Map<String, Object>> generatePdf_ct(@RequestBody JSONObject params) {
+        Map<String, Object> out = patientexamlistService.generatePdf_ct(params);
+        return success(out);
+    }
+
+    @PostMapping("/generatePdf_us")
+    @Operation(summary = "生成pdf进行上传(us)")
+    public CommonResult<Map<String, Object>> generatePdf_us(@RequestBody JSONObject params) {
+        Map<String, Object> out = patientexamlistService.generatePdf_us(params);
+        return success(out);
+    }
+
     @PostMapping("/ftppdf")
     @Operation(summary = "获取pdf上传ftp")
     public void FtpPdf(@RequestBody inspdfscreenshotVO insimagescreenshotVO) {
diff --git a/yudao-module-tblist/yudao-module-tblist-biz/src/main/java/cn/iocoder/yudao/module/tblist/service/patientexamlist/PatientexamlistService.java b/yudao-module-tblist/yudao-module-tblist-biz/src/main/java/cn/iocoder/yudao/module/tblist/service/patientexamlist/PatientexamlistService.java
index cc32c042a..fa9042cd0 100644
--- a/yudao-module-tblist/yudao-module-tblist-biz/src/main/java/cn/iocoder/yudao/module/tblist/service/patientexamlist/PatientexamlistService.java
+++ b/yudao-module-tblist/yudao-module-tblist-biz/src/main/java/cn/iocoder/yudao/module/tblist/service/patientexamlist/PatientexamlistService.java
@@ -5,6 +5,7 @@ import java.util.*;
 import cn.iocoder.yudao.module.tblist.controller.admin.patientexamlist.vo.*;
 import cn.iocoder.yudao.module.tblist.dal.dataobject.patientexamlist.PatientexamlistDO;
 import cn.iocoder.yudao.framework.common.pojo.PageResult;
+import com.alibaba.fastjson.JSONObject;
 import com.baomidou.mybatisplus.extension.service.IService;
 
 import javax.validation.Valid;
@@ -147,4 +148,14 @@ public interface PatientexamlistService extends IService<PatientexamlistDO> {
     Map<String, Object> getCheckRecord(String regId, String orgId);
 
     List<PatientexamlistDO> selectMp(Map<String, Object> columnMap);
+
+    /**
+     * 生成pdf进行上传(ct报告)
+     */
+    Map<String, Object> generatePdf_ct(JSONObject params);
+
+    /**
+     * 生成pdf进行上传(us报告)
+     */
+    Map<String, Object> generatePdf_us(JSONObject params);
 }
\ No newline at end of file
diff --git a/yudao-module-tblist/yudao-module-tblist-biz/src/main/java/cn/iocoder/yudao/module/tblist/service/patientexamlist/PatientexamlistServiceImpl.java b/yudao-module-tblist/yudao-module-tblist-biz/src/main/java/cn/iocoder/yudao/module/tblist/service/patientexamlist/PatientexamlistServiceImpl.java
index 0b4c2875e..d6978e15f 100644
--- a/yudao-module-tblist/yudao-module-tblist-biz/src/main/java/cn/iocoder/yudao/module/tblist/service/patientexamlist/PatientexamlistServiceImpl.java
+++ b/yudao-module-tblist/yudao-module-tblist-biz/src/main/java/cn/iocoder/yudao/module/tblist/service/patientexamlist/PatientexamlistServiceImpl.java
@@ -1,17 +1,32 @@
 package cn.iocoder.yudao.module.tblist.service.patientexamlist;
 
 import cn.iocoder.yudao.framework.common.exception.ErrorCode;
+import cn.iocoder.yudao.framework.common.util.io.FileUtils;
+import cn.iocoder.yudao.module.infra.dal.dataobject.config.ConfigDO;
+import cn.iocoder.yudao.module.infra.service.config.ConfigService;
 import cn.iocoder.yudao.module.system.dal.dataobject.dicomworklist.*;
 import cn.iocoder.yudao.module.system.dal.dataobject.user.AdminUserDO;
 import cn.iocoder.yudao.module.system.dal.mysql.dicomworklist.DicomworklistMapper;
 import cn.iocoder.yudao.module.system.service.user.AdminUserService;
 import cn.iocoder.yudao.module.tblist.dal.mysql.ecganalysisparas.EcganalysisparasMapper;
 import cn.iocoder.yudao.module.tblist.dal.mysql.positivestatistics.PositivestatisticsMapper;
+import com.alibaba.fastjson.JSONObject;
 import com.baomidou.mybatisplus.extension.service.impl.ServiceImpl;
+import com.itextpdf.text.Image;
+import com.itextpdf.text.Rectangle;
+import com.itextpdf.text.pdf.*;
+import org.springframework.boot.system.ApplicationHome;
 import org.springframework.stereotype.Service;
 
 import org.springframework.validation.annotation.Validated;
 
+import java.io.ByteArrayOutputStream;
+import java.io.IOException;
+import java.net.URL;
+import java.nio.file.Files;
+import java.nio.file.Path;
+import java.nio.file.Paths;
+import java.nio.file.StandardOpenOption;
 import java.time.LocalDateTime;
 import java.time.ZoneOffset;
 import java.time.format.DateTimeFormatter;
@@ -39,6 +54,9 @@ import static cn.iocoder.yudao.framework.security.core.util.SecurityFrameworkUti
 @Validated
 public class PatientexamlistServiceImpl extends ServiceImpl<PatientexamlistMapper, PatientexamlistDO> implements PatientexamlistService {
 
+    @Resource
+    private ConfigService configService;
+
     @Resource
     private PatientexamlistMapper patientexamlistMapper;
 
@@ -397,4 +415,243 @@ public class PatientexamlistServiceImpl extends ServiceImpl<PatientexamlistMappe
     {
         return patientexamlistMapper.selectByMap(columnMap);
     }
+
+    @Override
+    public Map<String, Object> generatePdf_ct(JSONObject params) {
+        Map<String, Object> out = new HashMap<>();
+        if (params != null && !params.isEmpty()) {
+            if (safeString(params.get("model")).equals("0")) {
+                //普通文件模式
+                ConfigDO configInfo_basePath = configService.getConfigByKey("printTemplate.basePath");
+                ConfigDO configInfo_CTTemplate = configService.getConfigByKey("printTemplate.CTTemplate");
+                String templateFile = configInfo_basePath.getValue() + "\\" + configInfo_CTTemplate.getValue();
+                PdfReader reader = null;
+                PdfStamper stamper = null;
+                ByteArrayOutputStream bos = null;
+                try {
+                    reader = new PdfReader(templateFile);
+                    bos = new ByteArrayOutputStream();
+                    stamper = new PdfStamper(reader, bos);
+                    AcroFields form = stamper.getAcroFields();
+
+                    //BaseFont font = BaseFont.createFont("STSong-Light", "UniGB-UCS2-H", BaseFont.NOT_EMBEDDED);
+                    //form.addSubstitutionFont(font);
+                    form.setField("regid",safeString(params.get("regid")));
+                    form.setField("examid",safeString(params.get("examid")));
+                    form.setField("name",safeString(params.get("name")));
+                    form.setField("gender",safeString(params.get("gender")));
+                    form.setField("age",safeString(params.get("age")));
+                    form.setField("deviceName",safeString(params.get("deviceName")));
+                    form.setField("Department",safeString(params.get("Department")));
+                    form.setField("examItemName",safeString(params.get("examItemName")));
+                    form.setField("examDescription",safeString(params.get("examDescription")));
+                    form.setField("diagResults",safeString(params.get("diagResults")));
+                    form.setField("hsname",safeString(params.get("hsname")));
+                    form.setField("diagDoctor",safeString(params.get("diagDoctor")));
+                    form.setField("diagDate",safeString(params.get("diagDate")));
+                    form.setField("reviewDoctor",safeString(params.get("reviewDoctor")));
+                    form.setField("reviewDate", safeString(params.get("reviewDate")));
+
+                    stamper.setFormFlattening(true);
+                    stamper.close();
+                    String fileName = System.currentTimeMillis() + ".pdf";
+                    writeAttachment(bos.toByteArray(), safeString(params.get("folderPath")), fileName.split("\\.")[0], "pdf");
+                    out.put("code", 200);
+                    out.put("msg", "文件上传成功");
+
+                    if (!safeString(params.get("id")).equals("")) {
+                        ConfigDO config = configService.getConfigByKey("url.ftpurl");
+                        PatientexamlistSaveReqVO updateReqVO = new PatientexamlistSaveReqVO();
+                        updateReqVO.setId(safeString(params.get("id")));
+                        updateReqVO.setPdfurl(config.getValue() + "/" + safeString(params.get("id")) + "/" + fileName);
+                        updatePatientexamlist(updateReqVO);
+                    }
+                } catch (Exception ex) {
+                    System.out.println("文件上传失败" + ex.getMessage());
+                    out.put("code", -200);
+                    out.put("msg", "文件上传失败");
+                } finally {
+                    try {
+                        if (bos != null) {
+                            bos.close();
+                        }
+                        if (reader != null) {
+                            reader.close();
+                        }
+                    } catch (Exception ex) {
+                    }
+                }
+            } else {
+                //ftp模式
+                out.put("code", -200);
+                out.put("msg", "ftp模式禁用");
+            }
+        } else {
+            out.put("code", -200);
+            out.put("msg", "参数不能为空");
+        }
+        return out;
+    }
+
+    @Override
+    public Map<String, Object> generatePdf_us(JSONObject params) {
+        Map<String, Object> out = new HashMap<>();
+        if (params != null && !params.isEmpty()) {
+            if (safeString(params.get("model")).equals("0")) {
+                //普通文件模式
+                ConfigDO configInfo_basePath = configService.getConfigByKey("printTemplate.basePath");
+                ConfigDO configInfo_USTemplate = configService.getConfigByKey("printTemplate.USTemplate");
+                String templateFile = configInfo_basePath.getValue() + "\\" + configInfo_USTemplate.getValue();
+                PdfReader reader = null;
+                PdfStamper stamper = null;
+                ByteArrayOutputStream bos = null;
+                try {
+                    reader = new PdfReader(templateFile);
+                    bos = new ByteArrayOutputStream();
+                    stamper = new PdfStamper(reader, bos);
+                    AcroFields form = stamper.getAcroFields();
+
+                    //BaseFont font = BaseFont.createFont("STSong-Light", "UniGB-UCS2-H", BaseFont.NOT_EMBEDDED);
+                    //form.addSubstitutionFont(font);
+                    form.setField("regid",safeString(params.get("regid")));
+                    form.setField("examid",safeString(params.get("examid")));
+                    form.setField("name",safeString(params.get("name")));
+                    form.setField("gender",safeString(params.get("gender")));
+                    form.setField("age",safeString(params.get("age")));
+                    form.setField("deviceName",safeString(params.get("deviceName")));
+                    form.setField("Department",safeString(params.get("Department")));
+                    form.setField("examItemName",safeString(params.get("examItemName")));
+                    form.setField("examDescription",safeString(params.get("examDescription")));
+                    form.setField("diagResults",safeString(params.get("diagResults")));
+                    form.setField("hsname",safeString(params.get("hsname")));
+                    form.setField("diagDoctor",safeString(params.get("diagDoctor")));
+                    form.setField("diagDate",safeString(params.get("diagDate")));
+                    form.setField("reviewDoctor",safeString(params.get("reviewDoctor")));
+                    form.setField("reviewDate", safeString(params.get("reviewDate")));
+                    Image image = null;
+                    int pageNo = 0;
+                    PdfContentByte under = null;
+                    Rectangle signRect = null;
+                    try {
+                        //image1_af_image
+                        image = getAcroField_Image(safeString(params.get("image1")));
+                        pageNo = form.getFieldPositions("image1_af_image").get(0).page;
+                        if (image != null && pageNo >= 1) {
+                            under = stamper.getOverContent(pageNo);
+                            signRect = form.getFieldPositions("image1_af_image").get(0).position;
+                            if (signRect != null) {
+                                image.scaleToFit(signRect.getWidth(), signRect.getHeight());
+                                image.setAbsolutePosition(signRect.getLeft(), signRect.getBottom() +
+                                        ((signRect.getHeight() - image.getScaledHeight() - 4 > 0) ? signRect.getHeight() - image.getScaledHeight() - 4 : 0));
+                                under.addImage(image);
+                            }
+                        }
+                        //image2_af_image
+                        image = getAcroField_Image(safeString(params.get("image2")));
+                        pageNo = form.getFieldPositions("image2_af_image").get(0).page;
+                        if (image != null && pageNo >= 1) {
+                            under = stamper.getOverContent(pageNo);
+                            signRect = form.getFieldPositions("image2_af_image").get(0).position;
+                            if (signRect != null) {
+                                image.scaleToFit(signRect.getWidth(), signRect.getHeight());
+                                image.setAbsolutePosition(signRect.getLeft(), signRect.getBottom() +
+                                        ((signRect.getHeight() - image.getScaledHeight() - 4 > 0) ? signRect.getHeight() - image.getScaledHeight() - 4 : 0));
+                                under.addImage(image);
+                            }
+                        }
+                        //image3_af_image
+                        image = getAcroField_Image(safeString(params.get("image3")));
+                        pageNo = form.getFieldPositions("image3_af_image").get(0).page;
+                        if (image != null && pageNo >= 1) {
+                            under = stamper.getOverContent(pageNo);
+                            signRect = form.getFieldPositions("image3_af_image").get(0).position;
+                            if (signRect != null) {
+                                image.scaleToFit(signRect.getWidth(), signRect.getHeight());
+                                image.setAbsolutePosition(signRect.getLeft(), signRect.getBottom() +
+                                        ((signRect.getHeight() - image.getScaledHeight() - 4 > 0) ? signRect.getHeight() - image.getScaledHeight() - 4 : 0));
+                                under.addImage(image);
+                            }
+                        }
+                    } catch (Exception ex) {
+                        System.out.println("[image_af_image]生成失败");
+                    }
+
+                    stamper.setFormFlattening(true);
+                    stamper.close();
+                    String fileName = System.currentTimeMillis() + ".pdf";
+                    writeAttachment(bos.toByteArray(), safeString(params.get("folderPath")), fileName.split("\\.")[0], "pdf");
+                    out.put("code", 200);
+                    out.put("msg", "文件上传成功");
+
+                    if (!safeString(params.get("id")).equals("")) {
+                        ConfigDO config = configService.getConfigByKey("url.ftpurl");
+                        PatientexamlistSaveReqVO updateReqVO = new PatientexamlistSaveReqVO();
+                        updateReqVO.setId(safeString(params.get("id")));
+                        updateReqVO.setPdfurl(config.getValue() + "/" + safeString(params.get("id")) + "/" + fileName);
+                        updatePatientexamlist(updateReqVO);
+                    }
+                } catch (Exception ex) {
+                    System.out.println("文件上传失败" + ex.getMessage());
+                    out.put("code", -200);
+                    out.put("msg", "文件上传失败");
+                } finally {
+                    try {
+                        if (bos != null) {
+                            bos.close();
+                        }
+                        if (reader != null) {
+                            reader.close();
+                        }
+                    } catch (Exception ex) {
+                    }
+                }
+            } else {
+                //ftp模式
+                out.put("code", -200);
+                out.put("msg", "ftp模式禁用");
+            }
+        } else {
+            out.put("code", -200);
+            out.put("msg", "参数不能为空");
+        }
+        return out;
+    }
+
+    private Image getAcroField_Image(String url) {
+        Image out = null;
+        try {
+            URL urlObj = new URL(safeString(url));
+            if (urlObj != null)
+                out = Image.getInstance(urlObj);
+        } catch (Exception ex) {
+            out = null;
+        }
+        return out;
+    }
+
+    private String safeString(Object value) {
+        String out = (value == null) ? "" : value.toString().trim();
+        return out.trim();
+    }
+
+    private void writeAttachment(byte[] decodedBytes, String folderPath, String fileName, String extension) throws Exception {
+        // 检查文件名是否有效
+        if (fileName.contains("..") || fileName.contains("/") || fileName.contains("\\")) {
+            throw new IllegalArgumentException("Invalid file name.");
+        }
+        // 创建文件的路径
+        Path folder = Paths.get(folderPath);
+        if (!Files.exists(folder)) {
+            // 如果文件夹不存在，则创建它
+            Files.createDirectories(folder);
+        }
+        // 构建完整的文件名（包括扩展名）
+        Path filePath = folder.resolve(fileName + "." + extension);
+        // 使用Files.newOutputStream创建OutputStream，并设置为追加模式
+        try (java.io.OutputStream outputStream = Files.newOutputStream(filePath, StandardOpenOption.CREATE, StandardOpenOption.WRITE)) {
+            outputStream.write(decodedBytes);
+        } catch (IOException ex) {
+            throw ex;
+        }
+    }
 }
\ No newline at end of file