diff --git a/src/Shentun.Peis.Application.Contracts/RegisterChecks/UpdateCheckResultDto.cs b/src/Shentun.Peis.Application.Contracts/RegisterChecks/UpdateCheckResultDto.cs
new file mode 100644
index 0000000..d66743e
--- /dev/null
+++ b/src/Shentun.Peis.Application.Contracts/RegisterChecks/UpdateCheckResultDto.cs
@@ -0,0 +1,87 @@
+using Shentun.Peis.RegisterCheckItems;
+using Shentun.Peis.RegisterCheckSuggestions;
+using Shentun.Peis.RegisterCheckSummarys;
+using System;
+using System.Collections.Generic;
+using System.Text;
+
+namespace Shentun.Peis.RegisterChecks
+{
+    public class UpdateCheckResultDto
+    {
+        /// 
+        /// RegisterCheck表ID
+        /// 
+        public Guid RegisterCheckId { get; set; }
+        /// 
+        /// 检查医生(内部传ID,外部医生存名字)
+        /// 
+        public string? CheckDoctorId { get; set; }
+        /// 
+        /// 检查日期(格式:2023-07-18) 空值跟null取当前日期
+        /// 
+        public string? CheckDate { get; set; }
+        public   List RegisterCheckItems { get; set; }
+        public List Summarys { get; set; } = new List();
+        public List Suggestions { get; set; } = new List();
+
+      
+    }
+
+    public class UpdateRegisterCheckItemDetail
+    {
+
+        /// 
+        /// 项目ID
+        /// 
+        public Guid ItemId { get; set; }
+
+
+
+        #region 修改内容
+        /// 
+        /// 结果
+        /// 
+        public string? Result { get; set; }
+
+        /// 
+        /// 危急值
+        /// 
+        public string? CriticalValue { get; set; }
+
+        /// 
+        /// 检查医生
+        /// 
+        public string? CheckDoctorName { get; set; }
+        /// 
+        /// 检查日期
+        /// 
+        public string? CheckDate { get; set; }
+        #endregion
+    }
+    public class UpdateRegisterCheckSummaryDetail
+    {
+        /// 
+        /// 综述
+        /// 
+        public string Summary { get; set; }
+
+        /// 
+        /// 综述标志
+        /// 
+        public char SummaryFlag { get; set; }
+    }
+
+    public class UpdateRegisterCheckSuggestionDetail
+    {
+        /// 
+        /// 综述
+        /// 
+        public string Summary { get; set; }
+
+        /// 
+        /// 综述标志
+        /// 
+        public char SummaryFlag { get; set; }
+    }
+}
diff --git a/src/Shentun.Peis.Application/RegisterCheckItems/RegisterCheckItemAppService.cs b/src/Shentun.Peis.Application/RegisterCheckItems/RegisterCheckItemAppService.cs
index 51f7745..ef9e5af 100644
--- a/src/Shentun.Peis.Application/RegisterCheckItems/RegisterCheckItemAppService.cs
+++ b/src/Shentun.Peis.Application/RegisterCheckItems/RegisterCheckItemAppService.cs
@@ -33,14 +33,15 @@ namespace Shentun.Peis.RegisterCheckItems
         private readonly IRepository _userRepository;
         private readonly RegisterCheckItemManager _registerCheckItemManager;
         private readonly ReferenceRangeManager _referenceRangeManager;
-
+        private readonly CacheService _cacheService;
         public RegisterCheckItemAppService(
             IRepository registerCheckItemRepository,
                IRepository userRepository,
                RegisterCheckItemManager registerCheckItemManager,
                ReferenceRangeManager referenceRangeManager,
                IRepository patientRegisterRepository,
-               IRepository referenceRangeRepository)
+               IRepository referenceRangeRepository,
+               CacheService cacheService)
         {
             this._registerCheckItemRepository = registerCheckItemRepository;
             this._userRepository = userRepository;
@@ -48,6 +49,7 @@ namespace Shentun.Peis.RegisterCheckItems
             this._referenceRangeManager = referenceRangeManager;
             this._patientRegisterRepository = patientRegisterRepository;
             this._referenceRangeRepository = referenceRangeRepository;
+            _cacheService = cacheService;
         }
 
         /// 
@@ -59,7 +61,7 @@ namespace Shentun.Peis.RegisterCheckItems
         {
 
 
-            var entlist = (await _registerCheckItemRepository.GetDbSetAsync())
+            var entlist = (await _registerCheckItemRepository.GetQueryableAsync())
                 .Include(x => x.Item)
                 .Include(x => x.Item.ItemResultTemplates)
                 .Include(x => x.Item.ItemType)
@@ -109,7 +111,7 @@ namespace Shentun.Peis.RegisterCheckItems
 
 
 
-            var userList = await _userRepository.GetListAsync();
+           
             var entdto = entlist.Select(s => new RegisterCheckItemOrItemOrItemResultTemplateDto
             {
 
@@ -141,8 +143,8 @@ namespace Shentun.Peis.RegisterCheckItems
                 CreatorId = s.CreatorId,
                 LastModificationTime = s.LastModificationTime,
                 LastModifierId = s.LastModifierId,
-                CreatorName = EntityHelper.GetUserNameNoSql(userList, s.CreatorId),
-                LastModifierName = EntityHelper.GetUserNameNoSql(userList, s.LastModifierId),
+                CreatorName = _cacheService.GetUserNameAsync(s.CreatorId).Result,
+                LastModifierName = _cacheService.GetUserNameAsync(s.LastModifierId).Result,
                 InputCheck = s.Item.InputCheck
             }).ToList();
 
diff --git a/src/Shentun.Peis.Application/RegisterChecks/RegisterCheckAppService.cs b/src/Shentun.Peis.Application/RegisterChecks/RegisterCheckAppService.cs
index 4efe2c9..8e6ff4f 100644
--- a/src/Shentun.Peis.Application/RegisterChecks/RegisterCheckAppService.cs
+++ b/src/Shentun.Peis.Application/RegisterChecks/RegisterCheckAppService.cs
@@ -137,6 +137,13 @@ namespace Shentun.Peis.RegisterChecks
             return entdto;
         }
 
+        public async Task UpdateCheckResult(UpdateCheckResultDto input)
+        {
+            if(input == null)
+            {
+                throw new UserFriendlyException("input参数不能为空");
+            }
+        }
         ///// 
         ///// 弃检跟恢复操作   0(为未检), 1(已检), 2(弃检)
         ///// 
diff --git a/src/Shentun.Peis.Domain/Suggestions/Suggestion.cs b/src/Shentun.Peis.Domain/Suggestions/Suggestion.cs
index dd3b4d8..2b01633 100644
--- a/src/Shentun.Peis.Domain/Suggestions/Suggestion.cs
+++ b/src/Shentun.Peis.Domain/Suggestions/Suggestion.cs
@@ -22,6 +22,12 @@ namespace Shentun.Peis.Models
         //[StringLength(8)]
         public Guid DiagnosisId { get; set; }
         /// 
+        /// 建议类别
+        /// 
+        [Column("suggestion_type")]
+        [StringLength(1)]
+        public char SuggestionType { get; set; }
+        /// 
         /// 建议内容
         /// 
         [Column("suggestion_content")]
diff --git a/src/Shentun.Peis.Domain/SumSuggestionContents/SumSuggestionContent.cs b/src/Shentun.Peis.Domain/SumSuggestionContents/SumSuggestionContent.cs
index d5079ab..8c506e6 100644
--- a/src/Shentun.Peis.Domain/SumSuggestionContents/SumSuggestionContent.cs
+++ b/src/Shentun.Peis.Domain/SumSuggestionContents/SumSuggestionContent.cs
@@ -19,6 +19,10 @@ namespace Shentun.Peis.Models
          /// 
         [Column("sum_suggestion_header_id")]
         public Guid SumSuggestionHeaderId { get; set; }
+        [Column("suggestion_type")]
+        [StringLength(1)]
+        public string SuggestionType { get; set; }
+        
         /// 
         /// 建议内容
         /// 
diff --git a/src/Shentun.Peis.EntityFrameworkCore/DbMapping/Suggestions/SuggestionDbMapping.cs b/src/Shentun.Peis.EntityFrameworkCore/DbMapping/Suggestions/SuggestionDbMapping.cs
index b8cb4e4..d027e3e 100644
--- a/src/Shentun.Peis.EntityFrameworkCore/DbMapping/Suggestions/SuggestionDbMapping.cs
+++ b/src/Shentun.Peis.EntityFrameworkCore/DbMapping/Suggestions/SuggestionDbMapping.cs
@@ -16,6 +16,7 @@ namespace Shentun.Peis.DbMapping
         {
             entity.HasComment("建议设置");
             entity.Property(t => t.DiagnosisId).HasComment("诊断ID").IsRequired().IsFixedLength();
+            entity.Property(t => t.SuggestionType).HasComment("建议类别").IsRequired();
             entity.Property(t => t.SuggestionContent).HasComment("建议内容").IsRequired();
 
             entity.Property(e => e.Id).IsFixedLength();
diff --git a/src/Shentun.Peis.EntityFrameworkCore/DbMapping/SumSuggestionContents/SumSuggestionContentDbMapping.cs b/src/Shentun.Peis.EntityFrameworkCore/DbMapping/SumSuggestionContents/SumSuggestionContentDbMapping.cs
index e7e2e4d..eb5ed03 100644
--- a/src/Shentun.Peis.EntityFrameworkCore/DbMapping/SumSuggestionContents/SumSuggestionContentDbMapping.cs
+++ b/src/Shentun.Peis.EntityFrameworkCore/DbMapping/SumSuggestionContents/SumSuggestionContentDbMapping.cs
@@ -16,6 +16,7 @@ namespace Shentun.Peis.DbMapping
         {
             entity.HasComment("总检建议内容");
             entity.Property(t => t.SumSuggestionHeaderId).HasComment("建议头ID").IsRequired();
+            entity.Property(t => t.SuggestionType).HasComment("建议类型").IsRequired();
             entity.Property(t => t.SuggestionContent).HasComment("建议内容").IsRequired();
 
             entity.Property(e => e.Id).ValueGeneratedNever().IsRequired();
diff --git a/test/Shentun.Peis.Application.Tests/DiagnosisFunctionAppServiceTest.cs b/test/Shentun.Peis.Application.Tests/DiagnosisFunctionAppServiceTest.cs
index b202b81..2a21ce7 100644
--- a/test/Shentun.Peis.Application.Tests/DiagnosisFunctionAppServiceTest.cs
+++ b/test/Shentun.Peis.Application.Tests/DiagnosisFunctionAppServiceTest.cs
@@ -427,6 +427,85 @@ namespace Shentun.Peis
             return result;
         }
 
+
+        [Fact]
+        public void GetItemDiagnosisResultTzzsTest()
+        {
+            PatientItemDiagnosisInput patient = new PatientItemDiagnosisInput();
+            patient.SexName = "男";
+            patient.Age = 30;
+            patient.Item = new ItemResultInput()
+            {
+                ItemId = Guid.NewGuid(),
+                ItemName = "体重指数",
+                Result = "25"
+            };
+            var result = GetItemDiagnosisResultTzzs(patient);
+            _output.WriteLine("结果:" + result);
+            string code = @"
+                     string result = """";
+            decimal tzzsDecimal = 0;
+         
+            var itemResult = patient.Item.Result;
+            if (string.IsNullOrWhiteSpace(itemResult))
+            {
+                return null;
+            }
+         
+         
+            if (!decimal.TryParse(itemResult, out tzzsDecimal))
+            {
+                return null;
+            }
+
+         
+            if (tzzsDecimal > 24 )
+            {
+                return ""超重"";
+            }
+            if (tzzsDecimal < 18)
+            {
+                return ""营养不良"";
+            }
+            return result;;
+                      ";
+
+
+            DiagnosisBuilder diagnosisBuilder = new DiagnosisBuilder();
+            result = diagnosisBuilder.GetItemDiagnosisResult(patient, code);
+            _output.WriteLine("动态结果:" + result);
+
+
+        }
+
+        public string GetItemDiagnosisResultTzzs(PatientItemDiagnosisInput patient)
+        {
+            string result = "";
+            decimal tzzsDecimal = 0;
+         
+            var itemResult = patient.Item.Result;
+            if (string.IsNullOrWhiteSpace(itemResult))
+            {
+                return null;
+            }
+         
+         
+            if (!decimal.TryParse(itemResult, out tzzsDecimal))
+            {
+                return null;
+            }
+
+         
+            if (tzzsDecimal > 24 )
+            {
+                return "超重";
+            }
+            if (tzzsDecimal < 18)
+            {
+                return "营养不良";
+            }
+            return result;
+        }
         /// 
         /// 乙肝五项
         ///