diff --git a/src/views/Department-entry/All.vue b/src/views/Department-entry/All.vue
index 8dadb83..345bf4a 100644
--- a/src/views/Department-entry/All.vue
+++ b/src/views/Department-entry/All.vue
@@ -8,15 +8,34 @@
         <div class="image-gallery">
           <div class="image-content">
             <div
-              v-if="imageUrls.length > 0"
+              v-if="mediaFiles.length > 0"
               class="image-grid"
-              :class="{ 'single-image': imageUrls.length === 1 }"
+              :class="{ 'single-image': mediaFiles.length === 1 }"
             >
-              <div v-for="(url, index) in imageUrls" :key="index" class="image-item">
+              <div v-for="(file, index) in mediaFiles" :key="index" class="image-item">
+                <!-- PDF 预览 -->
+                <div v-if="file.type === 'pdf'" class="pdf-viewer">
+                  <!-- 内嵌 PDF 预览 -->
+                  <div class="pdf-container">
+                    <iframe
+                      :src="file.url"
+                      class="pdf-iframe"
+                      frameborder="0"
+                    ></iframe>
+                  </div>
+                  <div class="pdf-actions">
+                    <el-button type="primary" size="small" @click="openPdfInNewTab(file.url)">
+                      <el-icon><FullScreen /></el-icon>
+                      全屏查看
+                    </el-button>
+                  </div>
+                </div>
+                <!-- 图片预览 -->
                 <el-image
-                  :src="url"
+                  v-else
+                  :src="file.url"
                   :preview-src-list="imageUrls"
-                  :initial-index="index"
+                  :initial-index="getImageIndex(index)"
                   fit="contain"
                   class="medical-image"
                   @error="handleImageError"
@@ -46,7 +65,8 @@ import { PatientApi } from '@/api/inspect/inspectpatient'
 import { PatientitemsApi } from '@/api/inspect/inspectpatientitems'
 import { getUserProfile } from '@/api/system/user/profile'
 import { PacsDataApi } from '@/api/inspect/inspectpacsdata'
-import { Picture } from '@element-plus/icons-vue'
+import { Picture, Document, FullScreen } from '@element-plus/icons-vue'
+import VuePdfEmbed from 'vue-pdf-embed'
 
 // 添加props定义
 const props = defineProps({
@@ -74,18 +94,23 @@ const isImageDepartment = ref(false)
 // 添加一个变量来存储当前检查项目
 const currentItem = ref(null)
 
-// 修改获取影像图片URL的方法，根据检查类型过滤
+// 添加新的响应式引用
+const mediaFiles = ref([])
+
+// 处理 PDF 加载错误
+const handlePdfError = (error) => {
+  console.error('PDF加载失败:', error)
+  ElMessage.error('PDF加载失败')
+}
+
+// 修改获取影像数据的方法
 const getImageUrls = async () => {
   try {
-
-
-    // 检查必要参数
     if (!reportData.value.medicalSn) {
       console.warn('缺少体检编号(medicalSn)')
       return []
     }
 
-    // 获取所有PACS数据
     const response = await PacsDataApi.getPacsDataPage({
       code: reportData.value.medicalSn,
       pageNo: 1,
@@ -97,13 +122,9 @@ const getImageUrls = async () => {
     }
 
     pacsData.value = response.list
-
-    // 根据检查类型过滤图片
     let filteredData = response.list
 
-    // 根据检查类型匹配type字段
     if (props.examType) {
-      // 检查类型与API中type字段的映射关系 - 扩展匹配模式
       const typePatterns = {
         'ultrasound': ['ultrasound', 'us', '超声', '彩超', 'b超', 'doppler'],
         'ecg': ['ecg', 'ekg', '心电图', 'electrocardiogram'],
@@ -111,41 +132,100 @@ const getImageUrls = async () => {
         'urine': ['urine', 'ua', '尿常规', '尿液', 'urinalysis','RT','rt']
       }
       
-      // 获取当前检查类型对应的匹配模式
       const patterns = typePatterns[props.examType]
       
       if (patterns && patterns.length > 0) {
-        // 使用模式列表进行匹配
         filteredData = response.list.filter(item => {
           if (!item.type) return false
-          
           const itemType = item.type.toLowerCase()
           return patterns.some(pattern => itemType.includes(pattern.toLowerCase()))
         })
-        
       }
     }
 
-    // 修改：如果过滤后没有数据，直接返回空数组，显示"暂无影像资料"
     if (filteredData.length === 0) {
       return []
     }
 
-    // 直接使用data字段作为图片URL，过滤掉空值
-    const urls = filteredData.map((item) => item.data).filter((url) => url)
+    // 处理文件类型
+    mediaFiles.value = filteredData.map(item => {
+      const url = item.data
+      if (!url) return null
 
-    return urls
+      // 检查文件类型
+      const isPDF = url.toLowerCase().endsWith('.pdf') || 
+                   url.toLowerCase().includes('application/pdf') ||
+                   item.type?.toLowerCase().includes('pdf')
+
+      return {
+        url,
+        type: isPDF ? 'pdf' : 'image'
+      }
+    }).filter(item => item)
+
+    console.log('处理后的媒体文件:', mediaFiles.value) // 添加调试日志
+
+    // 只收集图片URL用于预览
+    imageUrls.value = mediaFiles.value
+      .filter(file => file.type === 'image')
+      .map(file => file.url)
+
+    return imageUrls.value
   } catch (error) {
+    console.error('获取影像数据失败:', error)
     ElMessage.error('获取影像数据失败，请联系管理员')
     return []
   }
 }
 
+// 获取图片在预览列表中的索引
+const getImageIndex = (currentIndex) => {
+  let imageIndex = 0
+  for (let i = 0; i < currentIndex; i++) {
+    if (mediaFiles.value[i].type === 'image') {
+      imageIndex++
+    }
+  }
+  return imageIndex
+}
+
+// 下载PDF文件
+const downloadFile = (url) => {
+  window.open(url, '_blank')
+}
+
 // 处理图片加载错误
 const handleImageError = (e) => {
   e.target.src = 'https://via.placeholder.com/500x400?text=Image+Not+Found'
 }
 
+// 简化后的新窗口打开PDF方法
+const openPdfInNewTab = (url) => {
+  const win = window.open('', '_blank')
+  win.document.write(`
+    <html>
+      <head>
+        <title>PDF查看器</title>
+        <style>
+          body { 
+            margin: 0; 
+            padding: 0; 
+            background: #525659;
+          }
+          iframe {
+            width: 100vw;
+            height: 100vh;
+            border: none;
+          }
+        </style>
+      </head>
+      <body>
+        <iframe src="${url}"></iframe>
+      </body>
+    </html>
+  `)
+}
+
 // 年龄计算属性
 const age = computed(() => {
   if (!reportData.value.birthday) return ''
@@ -392,35 +472,22 @@ const getExamTypeTitle = () => {
 
 .image-grid {
   display: grid;
-  grid-template-columns: repeat(auto-fit, minmax(400px, 1fr));
-  gap: 10px;
-  height: 100%;
-  place-items: center;
+  grid-template-columns: repeat(auto-fit, minmax(300px, 1fr));
+  gap: 20px;
+  padding: 20px;
 }
 
 .image-item {
   width: 100%;
-  height: 100%;
-  max-width: 600px;
-  max-height: 450px;
-  aspect-ratio: 4/3;
-  border-radius: 4px;
-  overflow: hidden;
-  transition: transform 0.3s;
-}
-
-.image-item:hover {
-  transform: scale(1.02);
-}
-
-.single-image {
+  height: 400px;
   display: flex;
-  justify-content: center;
+  flex-direction: column;
+  align-items: center;
 }
 
 .single-image .image-item {
-  width: 90%;
-  height: 90%;
+  max-width: 800px;
+  margin: 0 auto;
 }
 
 .medical-image {
@@ -547,4 +614,69 @@ const getExamTypeTitle = () => {
   background: #f8f9fa;
   color: #909399;
 }
+
+/* 更新 PDF 查看器样式 */
+.pdf-viewer {
+  width: 100%;
+  height: 100%;
+  display: flex;
+  flex-direction: column;
+  background: #f8f9fa;
+  border-radius: 4px;
+  position: relative;
+  overflow: hidden;
+}
+
+.pdf-container {
+  flex: 1;
+  width: 100%;
+  height: calc(100% - 40px); /* 减去按钮区域的高度 */
+  position: relative;
+  background: #525659;
+}
+
+.pdf-iframe {
+  width: 100%;
+  height: 100%;
+  border: none;
+  background: #fff;
+}
+
+.pdf-actions {
+  height: 40px;
+  display: flex;
+  align-items: center;
+  justify-content: center;
+  padding: 0 10px;
+  background: #fff;
+  border-top: 1px solid #dcdfe6;
+}
+
+.pdf-actions .el-button {
+  display: flex;
+  align-items: center;
+  gap: 5px;
+}
+
+/* 确保图片网格布局合适 */
+.image-grid {
+  display: grid;
+  grid-template-columns: repeat(auto-fit, minmax(300px, 1fr));
+  gap: 20px;
+  padding: 20px;
+}
+
+.image-item {
+  width: 100%;
+  height: 400px;
+  display: flex;
+  flex-direction: column;
+  align-items: center;
+}
+
+/* 单个文件时的样式 */
+.single-image .image-item {
+  max-width: 800px;
+  margin: 0 auto;
+}
 </style>
diff --git a/src/views/Department-entry/Medical-examination-vehicle.vue b/src/views/Department-entry/Medical-examination-vehicle.vue
index a087adc..699fbec 100644
--- a/src/views/Department-entry/Medical-examination-vehicle.vue
+++ b/src/views/Department-entry/Medical-examination-vehicle.vue
@@ -1275,59 +1275,58 @@ const handleRefresh = async () => {
       text: '刷新中...',
       background: 'rgba(255, 255, 255, 0.7)'
     })
-    
-    // 重置日期相关状态
-    selectedPeriod.value = 'reset'
+
+    // 重置所有状态
+    selectedPeriod.value = 'today'
     showDatePicker.value = false
-    customDateRange.value = []
-    
-    // 重置搜索条件
     searchQuery.value = ''
-    
-    // 调用同步接口前先检查是否有新患者需要同步
-    try {
-      // 获取当前所有患者的体检编号
-      const existingPatients = await PatientApi.getPatientPage({
-        pageNo: 1,
-        pageSize: 100,
-        examDate: formatDate(new Date())
-      })
-      
-      const existingMedicalSns = new Set()
-      if (existingPatients.list && existingPatients.list.length > 0) {
-        existingPatients.list.forEach(patient => {
-          if (patient.medicalSn) {
-            existingMedicalSns.add(patient.medicalSn)
-          }
-        })
-      }
-      
-      // 如果没有患者或者患者数量很少，才调用全量同步
-      if (existingMedicalSns.size < 5) {
-        // 修改：传递空对象而不是空参数，避免后端解析错误
-        await PatientitemsApi.createPatientapiInfo({})
-      } else {
-        ElMessage.info('已有足够的患者数据，跳过全量同步')
-      }
-    } catch (syncError) {
-      console.error('同步数据失败:', syncError)
-      // 同步失败不阻止后续操作
-    }
-    
-    // 重置选中状态
     selectedPatient.value = null
-    
-    // 重置页码
     pageNo.value = 1
-    
-    // 重新获取患者列表
-    await getPatientList()
-    
-    loading.close()
-    ElMessage.success('刷新成功')
+
+    // 设置今日日期范围
+    const today = new Date()
+    const todayStart = new Date(today.setHours(0, 0, 0, 0))
+    const todayEnd = new Date(today.setHours(23, 59, 59, 999))
+    customDateRange.value = [todayStart, todayEnd]
+
+    try {
+      // 1. 先调用同步接口
+      await PatientitemsApi.createPatientapiInfo({})
+      
+      // 2. 等待一小段时间确保后端数据同步完成
+      await new Promise(resolve => setTimeout(resolve, 1000))
+      
+      // 3. 获取最新的患者列表
+      const params = {
+        pageNo: pageNo.value,
+        pageSize: pageSize.value,
+        medicalDateTime: [
+          `${formatDate(todayStart)} 00:00:00`,
+          `${formatDate(todayEnd)} 23:59:59`
+        ]
+      }
+      
+      const res = await PatientApi.getPatientPage(params)
+      
+      // 更新列表数据
+      patients.value = res.list
+      originalPatients.value = res.list
+      filteredPatients.value = res.list
+      total.value = res.total
+
+      // 清除缓存
+      patientDataCache.value.clear()
+      
+      loading.close()
+      ElMessage.success('刷新成功')
+    } catch (error) {
+      loading.close()
+      console.error('同步数据失败:', error)
+      ElMessage.error('同步数据失败，请稍后重试')
+    }
   } catch (error) {
     console.error('刷新失败:', error)
-    ElMessage.error('刷新失败')
+    ElMessage.error('刷新失败，请稍后重试')
   }
 }
 
@@ -1771,6 +1770,11 @@ const refreshExamData = async () => {
 const inspectDoctor = ref('')
 const inspectTime = ref('')
 
+// 添加特殊检查类型的计算属性
+const isSpecialExam = computed(() => {
+  return ['ultrasound', 'ecg', 'blood', 'urine'].includes(currentTab.value)
+})
+
 </script>
 
 <style scoped>