diff --git a/src/Shentun.Peis.Application/PatientRegisters/PatientRegisterAppService.cs b/src/Shentun.Peis.Application/PatientRegisters/PatientRegisterAppService.cs
index 39a6611..d4128d6 100644
--- a/src/Shentun.Peis.Application/PatientRegisters/PatientRegisterAppService.cs
+++ b/src/Shentun.Peis.Application/PatientRegisters/PatientRegisterAppService.cs
@@ -2791,7 +2791,17 @@ namespace Shentun.Peis.PatientRegisters
                 }
 
 
-                patientRegisterList.ForEach(f => f.CompleteFlag = input.CompleteFlag.Value);
+                patientRegisterList.ForEach(f => 
+                    {
+                        if(f.CompleteFlag == PatientRegisterCompleteFlag.PreRegistration 
+                        && input.CompleteFlag == PatientRegisterCompleteFlag.Registration)
+                        {
+                            f.MedicalStartDate = DateTime.Now;
+                            f.IsMedicalStart = 'Y';
+                        }
+                        f.CompleteFlag = input.CompleteFlag.Value;
+                    }
+                );
 
 
                 if (!string.IsNullOrEmpty(input.MedicalStartDate))
@@ -2799,12 +2809,7 @@ namespace Shentun.Peis.PatientRegisters
                     patientRegisterList.ForEach(f => f.MedicalStartDate = PageHelper.ConvertDatetimeV(input.MedicalStartDate));
 
                 }
-                patientRegisterList.ForEach(f =>
-                {
-                    f.IsMedicalStart = 'Y';
-                    f.MedicalStartDate = DateTime.Now;
-                }
-                );
+               
 
                 await _repository.UpdateManyAsync(patientRegisterList);
 
diff --git a/src/Shentun.Peis.Application/PrintReports/PrintReportAppService.cs b/src/Shentun.Peis.Application/PrintReports/PrintReportAppService.cs
index a0705c5..52b9aae 100644
--- a/src/Shentun.Peis.Application/PrintReports/PrintReportAppService.cs
+++ b/src/Shentun.Peis.Application/PrintReports/PrintReportAppService.cs
@@ -722,7 +722,9 @@ namespace Shentun.Peis.PrintReports
                 //    Summary = o.registerCheckSummaryHaveEmpty.Summary,
                 //    DisplayOrder = o.registerCheckSummaryHaveEmpty.DisplayOrder
                 //}).OrderBy(o => o.DisplayOrder).Distinct().ToList();
-                medicalReportRegisterCheckDto.Summarys = registerCheckRows.GroupBy(g => g.registerCheckSummaryHaveEmpty.Id).Select(o => new MedicalReportCheckAsbitemSummaryDto()
+                medicalReportRegisterCheckDto.Summarys = registerCheckRows.Where(o=>o.registerCheckSummaryHaveEmpty!=null)
+                    .GroupBy(g => g.registerCheckSummaryHaveEmpty.Id)
+                    .Select(o => new MedicalReportCheckAsbitemSummaryDto()
                 {
                     Summary = o.FirstOrDefault().registerCheckSummaryHaveEmpty.Summary,
                     DisplayOrder = o.FirstOrDefault().registerCheckSummaryHaveEmpty.DisplayOrder
diff --git a/src/Shentun.Peis.HttpApi.Host/PeisHttpApiHostModule.cs b/src/Shentun.Peis.HttpApi.Host/PeisHttpApiHostModule.cs
index 1413fd2..c37a4d7 100644
--- a/src/Shentun.Peis.HttpApi.Host/PeisHttpApiHostModule.cs
+++ b/src/Shentun.Peis.HttpApi.Host/PeisHttpApiHostModule.cs
@@ -117,8 +117,13 @@ public class PeisHttpApiHostModule : AbpModule
         ConfigureCors(context, configuration);
         ConfigureSwaggerServices(context, configuration);
 
-        ConfigureJsonOptions();  //全局配置api返回值中的日期默认格式
+        //ConfigureJsonOptions();  //全局配置api返回值中的日期默认格式
+        context.Services.AddControllers().AddJsonOptions(configure =>
+        {
+            configure.JsonSerializerOptions.Converters.Add(new DateTimeJsonConverter());
+            configure.JsonSerializerOptions.PropertyNameCaseInsensitive = true;
 
+        });
         //密码策略配置
         context.Services.Configure<IdentityOptions>(opt =>
         {
diff --git a/src/Shentun.Utilities/DateTimeJsonConverter.cs b/src/Shentun.Utilities/DateTimeJsonConverter.cs
index 0246048..a33a4ab 100644
--- a/src/Shentun.Utilities/DateTimeJsonConverter.cs
+++ b/src/Shentun.Utilities/DateTimeJsonConverter.cs
@@ -13,7 +13,13 @@ namespace Shentun.Utilities
        
         public override DateTime Read(ref Utf8JsonReader reader, Type typeToConvert, JsonSerializerOptions options)
         {
-            return DateTime.Parse(reader.GetString());
+            if (reader.TokenType == JsonTokenType.String)
+            {
+                if (DateTime.TryParse(reader.GetString(), out DateTime date))
+                    return date;
+            }
+            return reader.GetDateTime();
+
         }
 
        
diff --git a/test/Shentun.Peis.Application.Tests/DiagnosisFunctionAppServiceTest.cs b/test/Shentun.Peis.Application.Tests/DiagnosisFunctionAppServiceTest.cs
index e7ba3da..fbde665 100644
--- a/test/Shentun.Peis.Application.Tests/DiagnosisFunctionAppServiceTest.cs
+++ b/test/Shentun.Peis.Application.Tests/DiagnosisFunctionAppServiceTest.cs
@@ -35,20 +35,20 @@ namespace Shentun.Peis
             {
                 var getDiagnosisResultRequestDto = new GetDiagnosisResultRequestDto()
                 {
-                    RegisterCheckId = new Guid("3a123c55-07ad-f46e-8f6a-4c3b8c8a78de"),
+                    RegisterCheckId = new Guid("3a1272f5-689f-f6ea-3ab7-65e75e94b058"),
                     Items = new List<GetDiagnosisResultRequest_Item>
                     {
                         new GetDiagnosisResultRequest_Item()
                         {
-                            ItemId = new Guid("3a1203c2-6bcd-5490-19af-4663293fddd8"),
-                            Result = "未见异常"
+                            ItemId = new Guid("3a126b34-dd13-c067-7b10-56cbd5fefedb"),
+                            Result = "50.1"
                         },
 
-                           new GetDiagnosisResultRequest_Item()
-                        {
-                            ItemId = new Guid("3a1203c2-6c55-b07a-79cd-bec4e231390b"),
-                            Result = "未见异常"
-                        }
+                        //   new GetDiagnosisResultRequest_Item()
+                        //{
+                        //    ItemId = new Guid("3a1203c2-6c55-b07a-79cd-bec4e231390b"),
+                        //    Result = "未见异常"
+                        //}
                     }
                 };
                 var result = await _appService.GetDoctorCheckDiagnosisResultAsync(getDiagnosisResultRequestDto);
diff --git a/test/Shentun.Peis.Application.Tests/PrintReportAppServiceTest.cs b/test/Shentun.Peis.Application.Tests/PrintReportAppServiceTest.cs
index 696894c..15055d3 100644
--- a/test/Shentun.Peis.Application.Tests/PrintReportAppServiceTest.cs
+++ b/test/Shentun.Peis.Application.Tests/PrintReportAppServiceTest.cs
@@ -52,7 +52,7 @@ namespace Shentun.Peis
             {
                 var medicalReportDto = await _appService.GetMedicalReportAsync(new PatientRegisterIdInputDto()
                 {
-                    PatientRegisterId = new Guid("3a11ee70-02cb-c5e6-a087-79ecdd0356b6")
+                    PatientRegisterId = new Guid("3a126ce3-a20e-73ef-2671-815fa576b55f")
                 });
                 _output.WriteLine(medicalReportDto.PatientName);
                 foreach (var medicalReportType in medicalReportDto.MedicalReportTypes)