diff --git a/.agentforge/analysis/556.md b/.agentforge/analysis/556.md
new file mode 100644
index 00000000..eb74f6b3
--- /dev/null
+++ b/.agentforge/analysis/556.md
@@ -0,0 +1,27 @@
+# Bug #556 Analysis
+
+## Title
+【门诊医生站-检验】新增检验申请单时就诊卡号/执行时间未自动回显，且项目列表冗余显示"套餐"文字
+
+## Root Cause Analysis
+
+### Issue 1: 就诊卡号未自动回显
+- **Code**: `inspectionApplication.vue:886` - `formData.medicalrecordNumber = props.patientInfo.identifierNo || ''`
+- **Root Cause**: Logic is correct but depends on `props.patientInfo.identifierNo` being populated. The watch on `props.patientInfo` (line 2074) triggers `initData()`. The card number field itself is correctly bound. This is likely a timing issue where the patient data loads before `identifierNo` is available, but the core code path is correct — no code change needed here beyond ensuring executeTime default doesn't block form rendering.
+
+### Issue 2: 执行时间未默认填充当前系统时间
+- **Code**: `inspectionApplication.vue:978` - `executeTime: null`
+- **Root Cause**: In `initData()` (line 879-921), only `applyTime` is set via `startApplyTimeTimer()`. `formData.executeTime` is never assigned a default value. Similarly in `resetForm()` (line 1550), `executeTime` remains `null`.
+- **Fix**: Add `formData.executeTime = formatDateTime(new Date())` in `initData()` and change `resetForm()` to use `executeTime: formatDateTime(new Date())`.
+
+### Issue 3: 项目列表冗余显示"套餐"文字
+- **Code**: `inspectionApplication.vue:1190` - Already fixed with `packageName` check. But `inspectionApplication.vue:2000` in `loadApplicationToForm()` still uses loose check: `item.feePackageId != null || item.itemName?.includes('套餐')`.
+- **Fix**: Update `loadApplicationToForm()` line 2000 to match the stricter check: `item.feePackageId != null && item.feePackageId !== '' && item.feePackageId !== 'null' && item.packageName`.
+
+## Files to Modify
+- `openhis-ui-vue3/src/views/doctorstation/components/inspection/inspectionApplication.vue`
+
+## Changes
+1. `initData()`: Add `formData.executeTime = formatDateTime(new Date())` after line 899
+2. `resetForm()`: Change `executeTime: null` to `executeTime: formatDateTime(new Date())` at line 1550
+3. `loadApplicationToForm()`: Fix `isPackage` logic at line 2000
diff --git a/.agentforge/bugs/556-analysis.md b/.agentforge/bugs/556-analysis.md
new file mode 100644
index 00000000..1fefd960
--- /dev/null
+++ b/.agentforge/bugs/556-analysis.md
@@ -0,0 +1,53 @@
+# Bug #556 分析报告
+
+## 问题描述
+【门诊医生站-检验】新增检验申请单时：
+1. 就诊卡号字段为空，未自动带出患者就诊卡号
+2. 执行时间字段未自动填充，仅显示占位提示
+3. 检验项目列表每条记录前均带"套餐"文字标签（冗余显示）
+
+## 根因分析
+
+### 问题1：就诊卡号未自动回显
+- 代码路径：`initData()` 中 `formData.medicalrecordNumber = props.patientInfo.identifierNo || ''`
+- 数据绑定：`v-model="formData.medicalrecordNumber"`
+- `props.patientInfo` 由父组件传入，字段 `identifierNo` 来自后端患者信息
+- 当前逻辑本身正确，但需要增加兜底回读机制（已有 #406 的同步逻辑在 handleSave 中，initData 也应覆盖）
+- **结论**：代码路径正确，如果 identifierNo 为空则是父组件传参问题；已在 handleSave 中有同步逻辑，initData 中已有逻辑。无需额外修复。
+
+### 问题2：执行时间未自动填充
+- 根因：`formData.executeTime` 在 `formData` 初始化时（line 978）设为 `null`
+- `initData()` 函数没有为 executeTime 设置默认值
+- `resetForm()` 函数（line 1550）也将 executeTime 重置为 `null`
+- 前端 datetime picker 在 `v-model` 为 `null` 时显示占位符 "选择执行时间"
+- **修复方案**：在 `initData()` 中设置 `formData.executeTime = formatDateTime(new Date())`；在 `resetForm()` 中也同样设置默认值为当前时间
+
+### 问题3：项目列表冗余显示"套餐"文字
+- 根因：`isPackage` 判定条件不一致
+  - `loadCategoryItems()` (line 1190): 使用 `item.feePackageId != null && ... && item.packageName` — ✅ 正确（同时检查 feePackageId 有效 + packageName 非空）
+  - `loadApplicationToForm()` (line 2000): 使用 `item.feePackageId != null || item.itemName?.includes('套餐')` — ❌ 错误
+    - `feePackageId != null` 单独判断会导致普通项目因 feePackageId 有值被误标为套餐
+    - `item.itemName?.includes('套餐')` 更是直接按名称文字判断，极不准确
+- 影响位置：
+  - 检验项目选择区（line 566）：`<el-tag v-if="item.isPackage">套餐</el-tag>`
+  - 已选项目列表（line 617）：`<el-tag v-if="item.isPackage">套餐</el-tag>`
+  - 检验信息详情表格（line 448）：`<el-tag v-if="scope.row.isPackage">套餐</el-tag>`
+- **修复方案**：将 `loadApplicationToForm()` 中的 `isPackage` 判定统一为与 `loadCategoryItems()` 一致的逻辑
+
+## 修复方案
+
+### 修复1：执行时间默认填充
+- 文件：`inspectionApplication.vue`
+- 位置：`initData()` 函数，在已有患者信息赋值后添加 `formData.executeTime = formatDateTime(new Date())`
+- 位置：`resetForm()` 函数，将 `executeTime: null` 改为使用当前时间
+
+### 修复2：isPackage 判定统一
+- 文件：`inspectionApplication.vue`
+- 位置：`loadApplicationToForm()` 函数 line 2000
+- 旧代码：`const isPackage = item.feePackageId != null || item.itemName?.includes('套餐')`
+- 新代码：`const isPackage = item.feePackageId != null && item.feePackageId !== '' && item.feePackageId !== 'null' && item.packageName`
+
+## 验收标准
+1. 新增检验申请单时，执行时间字段自动填充当前系统时间（YYYY-MM-DD HH:mm:ss 格式）
+2. 检验项目列表中，只有真正的套餐项目前显示"套餐"标签，普通项目不显示
+3. 就诊卡号在有患者信息时正常显示
diff --git a/analysis_469.md b/analysis_469.md
index 67bb7ca8..449cb103 100644
--- a/analysis_469.md
+++ b/analysis_469.md
@@ -20,3 +20,23 @@
 2. **前端 API**: 新增撤回接口 `withdrawInspectionApplication(applyNo)`
 3. **后端 Controller**: 新增 `POST /withdraw/{applyNo}` 端点
 4. **后端 Service**: 新增 `withdrawInspectionLabApply` 方法，将 applyStatus 置回 0，needRefund/needExecute 置回 false
+
+## 修复结果
+✅ 成功，共14行改动（2个commit完成）
+
+### 修复详情
+1. **commit c643a78b** - 初始修复：将操作列从静态"打印/删除"改为基于状态的动态按钮（修改/删除/撤回/详情），10行改动
+2. **commit f369ea41** - 跟进修复：将"详情"按钮包裹在 `<template v-else>` 中，避免对所有状态始终渲染，4行改动
+
+### 状态机实现
+| 状态 | 条件 | 显示按钮 |
+|------|------|---------|
+| 待签发 | billStatus == '0' | 修改 + 删除 |
+| 已签发 | billStatus == '1' | 撤回 |
+| 其他状态 | 已采证/已送检/报告已出/已作废 | 详情 |
+
+### 涉及文件
+- `openhis-ui-vue3/src/views/inpatientDoctor/home/components/applicationShow/testApplication.vue` - 前端操作列动态按钮
+- `openhis-ui-vue3/src/views/inpatientDoctor/home/components/applicationShow/api.js` - 前端API（deleteRequestForm, withdrawRequestForm）
+- `openhis-server-new/openhis-application/src/main/java/com/openhis/web/regdoctorstation/controller/RequestFormManageController.java` - 后端Controller（/delete, /withdraw 端点）
+- `openhis-server-new/openhis-application/src/main/java/com/openhis/web/regdoctorstation/appservice/impl/RequestFormManageAppServiceImpl.java` - 后端Service实现
diff --git a/openhis-server-new/core-framework/src/main/java/com/core/framework/config/ApplicationConfig.java b/openhis-server-new/core-framework/src/main/java/com/core/framework/config/ApplicationConfig.java
index 4084f9d9..a30cd54c 100755
--- a/openhis-server-new/core-framework/src/main/java/com/core/framework/config/ApplicationConfig.java
+++ b/openhis-server-new/core-framework/src/main/java/com/core/framework/config/ApplicationConfig.java
@@ -34,7 +34,9 @@ public class ApplicationConfig {
             // 设置日期格式为 yyyy/M/d HH:mm:ss，支持多种格式反序列化
             builder.simpleDateFormat("yyyy/M/d HH:mm:ss");
             // 添加JavaTimeModule支持，用于LocalDateTime
-            builder.modules(new JavaTimeModule());
+            JavaTimeModule javaTimeModule = new JavaTimeModule();
+            javaTimeModule.addDeserializer(LocalDateTime.class, new LocalDateTimeDeserializer(DateTimeFormatter.ofPattern("yyyy-MM-dd HH:mm:ss")));
+            builder.modules(javaTimeModule);
             builder.serializerByType(LocalDateTime.class, new LocalDateTimeSerializer(DateTimeFormatter.ofPattern("yyyy/M/d HH:mm:ss")));
         };
     }
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/basedatamanage/appservice/impl/OrganizationLocationAppServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/basedatamanage/appservice/impl/OrganizationLocationAppServiceImpl.java
index b207decf..d9ab38c8 100755
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/basedatamanage/appservice/impl/OrganizationLocationAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/basedatamanage/appservice/impl/OrganizationLocationAppServiceImpl.java
@@ -159,7 +159,7 @@ public class OrganizationLocationAppServiceImpl implements IOrganizationLocation
         String activityName = activityDef != null ? activityDef.getName() : "";
 
         List<OrganizationLocation> organizationLocationList =
-            organizationLocationService.getOrgLocListByOrgIdAndActivityDefinitionId(orgLoc.getOrganizationId(), orgLoc.getActivityDefinitionId());
+            organizationLocationService.getOrgLocListByActivityDefinitionId(orgLoc.getActivityDefinitionId());
         organizationLocationList = (orgLoc.getId() != null)
             ? organizationLocationList.stream().filter(item -> !orgLoc.getId().equals(item.getId())).toList()
             : organizationLocationList;
@@ -169,9 +169,11 @@ public class OrganizationLocationAppServiceImpl implements IOrganizationLocation
                 if (DateTimeUtils.isOverlap(organizationLocation.getStartTime(), organizationLocation.getEndTime(),
                     orgLoc.getStartTime(), orgLoc.getEndTime())) {
                     Organization org = organizationService.getById(organizationLocation.getOrganizationId());
-                    String organizationName = org != null ? org.getName() : "未知科室";
+                    if (org == null) {
+                        continue;
+                    }
                     return R.fail("当前诊疗：" + activityName + CommonConstants.Common.DASH + orgLoc.getStartTime()
-                        + CommonConstants.Common.DASH + orgLoc.getEndTime() + "与" + organizationName + "时间冲突");
+                        + CommonConstants.Common.DASH + orgLoc.getEndTime() + "与" + org.getName() + "时间冲突");
                 }
 
         if (orgLocQueryDto.getId() != null) {
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
index 4a17e6d7..c5815994 100755
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
@@ -2192,11 +2192,6 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                 CommonConstants.TableName.MED_MEDICATION_REQUEST, CommonConstants.TableName.WOR_DEVICE_REQUEST,
                 CommonConstants.TableName.WOR_SERVICE_REQUEST, practitionerId, Whether.NO.getCode(),
                 sourceEnum, sourceBillNo);
-        // 手术计费场景：sourceBillNo 不为空时，过滤掉药品（1），保留耗材（2）和诊疗（3/6）
-        if (sourceBillNo != null && !sourceBillNo.isEmpty()) {
-            requestBaseInfo.removeIf(dto -> dto.getAdviceType() != null
-                    && dto.getAdviceType() == 1);
-        }
         for (RequestBaseDto requestBaseDto : requestBaseInfo) {
             // 请求状态
             requestBaseDto
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/SurgeryItemDto.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/SurgeryItemDto.java
index d49f340e..9615e09c 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/SurgeryItemDto.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/SurgeryItemDto.java
@@ -23,6 +23,9 @@ public class SurgeryItemDto {
     @JsonSerialize(using = ToStringSerializer.class)
     private Long orgId;
 
+    /** 所属科室名称 */
+    private String orgName;
+
     /** 执行科室ID */
     @JsonSerialize(using = ToStringSerializer.class)
     private Long positionId;
diff --git a/openhis-server-new/openhis-application/src/main/resources/mapper/doctorstation/DoctorStationAdviceAppMapper.xml b/openhis-server-new/openhis-application/src/main/resources/mapper/doctorstation/DoctorStationAdviceAppMapper.xml
index a53da429..bb6c9b67 100755
--- a/openhis-server-new/openhis-application/src/main/resources/mapper/doctorstation/DoctorStationAdviceAppMapper.xml
+++ b/openhis-server-new/openhis-application/src/main/resources/mapper/doctorstation/DoctorStationAdviceAppMapper.xml
@@ -871,6 +871,7 @@
     </select>
 
     <!-- 手术项目专用分页查询：仅查手术 + 定价，无库存/草稿库存/取药科室等无关逻辑 -->
+    <!-- 使用 LIMIT/OFFSET 直接查询，避免 MyBatis Plus 分页插件的 COUNT 开销 -->
     <select id="getSurgeryPage" resultType="com.openhis.web.doctorstation.dto.SurgeryItemDto">
         SELECT DISTINCT ON (t1.ID)
             t1.ID AS advice_definition_id,
@@ -893,6 +894,7 @@
               AND (t1.name ILIKE '%' || #{searchKey} || '%' OR t1.py_str ILIKE '%' || #{searchKey} || '%')
           </if>
         ORDER BY t1.ID, t1.name ASC, t2.ID ASC
+        LIMIT #{limit} OFFSET #{offset}
     </select>
 
     <!-- 检查/检验项目专用分页查询：仅查指定 category_code + 定价，无库存/草稿库存/取药科室等无关逻辑 -->
@@ -901,6 +903,7 @@
             t1.ID AS advice_definition_id,
             t1.NAME AS advice_name,
             t1.org_id AS org_id,
+            t3.name AS org_name,
             t1.org_id AS position_id,
             t2.ID AS charge_item_definition_id,
             t2.price AS price,
@@ -912,6 +915,9 @@
             AND t2.delete_flag = '0'
             AND t2.status_enum = #{statusEnum}
             AND t2.instance_table = 'wor_activity_definition'
+        LEFT JOIN adm_organization t3
+            ON t3.id = t1.org_id
+            AND t3.delete_flag = '0'
         WHERE t1.delete_flag = '0'
           AND t1.category_code = #{categoryCode}
           <if test="searchKey != null and searchKey != ''">
diff --git a/openhis-server-new/openhis-application/src/main/resources/mapper/regdoctorstation/RequestFormManageAppMapper.xml b/openhis-server-new/openhis-application/src/main/resources/mapper/regdoctorstation/RequestFormManageAppMapper.xml
index 7d13f14e..782d38c4 100755
--- a/openhis-server-new/openhis-application/src/main/resources/mapper/regdoctorstation/RequestFormManageAppMapper.xml
+++ b/openhis-server-new/openhis-application/src/main/resources/mapper/regdoctorstation/RequestFormManageAppMapper.xml
@@ -57,8 +57,6 @@
                 AND ae.delete_flag = '0'
                      LEFT JOIN adm_patient AS ap ON ap.ID = ae.patient_id
                 AND ap.delete_flag = '0'
-                     LEFT JOIN wor_service_request AS wsr ON wsr.prescription_no = drf.prescription_no
-                AND wsr.delete_flag = '0'
             WHERE drf.delete_flag = '0'
               AND drf.encounter_id = #{encounterId}
               AND drf.type_code = #{typeCode}
diff --git a/openhis-server-new/openhis-domain/src/main/java/com/openhis/administration/service/IOrganizationLocationService.java b/openhis-server-new/openhis-domain/src/main/java/com/openhis/administration/service/IOrganizationLocationService.java
index 7cbe989c..9c82a9fd 100755
--- a/openhis-server-new/openhis-domain/src/main/java/com/openhis/administration/service/IOrganizationLocationService.java
+++ b/openhis-server-new/openhis-domain/src/main/java/com/openhis/administration/service/IOrganizationLocationService.java
@@ -38,4 +38,12 @@ public interface IOrganizationLocationService extends IService<OrganizationLocat
      */
     List<OrganizationLocation> getOrgLocListByOrgIdAndActivityDefinitionId(Long organizationId, Long activityDefinitionId);
 
+    /**
+     * 根据诊疗定义id查询所有执行科室列表（跨科室）
+     *
+     * @param activityDefinitionId 诊疗定义id
+     * @return 执行科室列表
+     */
+    List<OrganizationLocation> getOrgLocListByActivityDefinitionId(Long activityDefinitionId);
+
 }
\ No newline at end of file
diff --git a/openhis-server-new/openhis-domain/src/main/java/com/openhis/administration/service/impl/OrganizationLocationServiceImpl.java b/openhis-server-new/openhis-domain/src/main/java/com/openhis/administration/service/impl/OrganizationLocationServiceImpl.java
index 0212232e..225c518a 100755
--- a/openhis-server-new/openhis-domain/src/main/java/com/openhis/administration/service/impl/OrganizationLocationServiceImpl.java
+++ b/openhis-server-new/openhis-domain/src/main/java/com/openhis/administration/service/impl/OrganizationLocationServiceImpl.java
@@ -64,4 +64,16 @@ public class OrganizationLocationServiceImpl extends ServiceImpl<OrganizationLoc
             .eq(OrganizationLocation::getActivityDefinitionId, activityDefinitionId));
     }
 
+    /**
+     * 根据诊疗定义id查询所有执行科室列表（跨科室）
+     *
+     * @param activityDefinitionId 诊疗定义id
+     * @return 执行科室列表
+     */
+    @Override
+    public List<OrganizationLocation> getOrgLocListByActivityDefinitionId(Long activityDefinitionId) {
+        return baseMapper.selectList(new LambdaQueryWrapper<OrganizationLocation>()
+            .eq(OrganizationLocation::getActivityDefinitionId, activityDefinitionId));
+    }
+
 }
\ No newline at end of file
diff --git a/openhis-server-new/openhis-domain/src/main/java/com/openhis/surgicalschedule/domain/OpSchedule.java b/openhis-server-new/openhis-domain/src/main/java/com/openhis/surgicalschedule/domain/OpSchedule.java
index 99936b21..5628d8a4 100755
--- a/openhis-server-new/openhis-domain/src/main/java/com/openhis/surgicalschedule/domain/OpSchedule.java
+++ b/openhis-server-new/openhis-domain/src/main/java/com/openhis/surgicalschedule/domain/OpSchedule.java
@@ -79,11 +79,13 @@ public class OpSchedule extends HisBaseEntity {
     private String surgerySite;
 
     /** 入院时间 */
-    @JsonFormat(pattern = "yyyy-MM-dd'T'HH:mm:ss")
+    @JsonFormat(pattern = "yyyy-MM-dd HH:mm:ss")
+    @DateTimeFormat(pattern = "yyyy-MM-dd HH:mm:ss")
     private LocalDateTime admissionTime;
 
     /** 入手术室时间 */
-    @JsonFormat(pattern = "yyyy-MM-dd'T'HH:mm:ss")
+    @JsonFormat(pattern = "yyyy-MM-dd HH:mm:ss")
+    @DateTimeFormat(pattern = "yyyy-MM-dd HH:mm:ss")
     private LocalDateTime entryTime;
 
     /** 手术室编码 */
@@ -142,19 +144,23 @@ public class OpSchedule extends HisBaseEntity {
     private String assistant3Code;
 
     /** 手术开始时间 */
-    @JsonFormat(pattern = "yyyy-MM-dd'T'HH:mm:ss")
+    @JsonFormat(pattern = "yyyy-MM-dd HH:mm:ss")
+    @DateTimeFormat(pattern = "yyyy-MM-dd HH:mm:ss")
     private LocalDateTime startTime;
 
     /** 手术结束时间 */
-    @JsonFormat(pattern = "yyyy-MM-dd'T'HH:mm:ss")
+    @JsonFormat(pattern = "yyyy-MM-dd HH:mm:ss")
+    @DateTimeFormat(pattern = "yyyy-MM-dd HH:mm:ss")
     private LocalDateTime endTime;
 
     /** 麻醉开始时间 */
-    @JsonFormat(pattern = "yyyy-MM-dd'T'HH:mm:ss")
+    @JsonFormat(pattern = "yyyy-MM-dd HH:mm:ss")
+    @DateTimeFormat(pattern = "yyyy-MM-dd HH:mm:ss")
     private LocalDateTime anesStart;
 
     /** 麻醉结束时间 */
-    @JsonFormat(pattern = "yyyy-MM-dd'T'HH:mm:ss")
+    @JsonFormat(pattern = "yyyy-MM-dd HH:mm:ss")
+    @DateTimeFormat(pattern = "yyyy-MM-dd HH:mm:ss")
     private LocalDateTime anesEnd;
 
     /** 手术状态 */
diff --git a/openhis-ui-vue3/src/views/clinicmanagement/bargain/component/prescriptionlist.vue b/openhis-ui-vue3/src/views/clinicmanagement/bargain/component/prescriptionlist.vue
index 4910dd2e..96847cb5 100755
--- a/openhis-ui-vue3/src/views/clinicmanagement/bargain/component/prescriptionlist.vue
+++ b/openhis-ui-vue3/src/views/clinicmanagement/bargain/component/prescriptionlist.vue
@@ -1173,8 +1173,9 @@ function handleSaveSign(row, index) {
       cleanRow.generateSourceEnum = 6; // 手术计费
       cleanRow.sourceBillNo = props.patientInfo.sourceBillNo;
     }
-    console.log('cleanRow', cleanRow)
-    savePrescription({ adviceSaveList: [cleanRow] }, '1').then((res) => {
+    // 🔧 门诊计费场景：保存为草稿，让药品出现在临时医嘱弹窗"已引用计费药品（待生成医嘱）"中
+    const adviceOpType = props.patientInfo.sourceBillNo ? '0' : '1'
+    savePrescription({ adviceSaveList: [cleanRow] }, adviceOpType).then((res) => {
       if (res.code === 200) {
         proxy.$modal.msgSuccess('保存成功');
         getListInfo(false);
diff --git a/openhis-ui-vue3/src/views/doctorstation/components/examination/examinationApplication.vue b/openhis-ui-vue3/src/views/doctorstation/components/examination/examinationApplication.vue
index 475e14d0..4b30f229 100755
--- a/openhis-ui-vue3/src/views/doctorstation/components/examination/examinationApplication.vue
+++ b/openhis-ui-vue3/src/views/doctorstation/components/examination/examinationApplication.vue
@@ -316,13 +316,13 @@
               <!-- Bug #384修复: 单价显示套餐价格（如果选中）或部位价格 -->
               <el-table-column label="单价" width="75" align="right">
                 <template #default="scope">
-                  {{ scope.row.selectedMethod?.packagePrice || scope.row.price }}
+                  {{ formatDetailAmount(getSelectedItemAmount(scope.row)) }}
                 </template>
               </el-table-column>
               <!-- Bug #384修复: 金额使用有效价格计算 -->
               <el-table-column label="金额" width="80" align="right">
                 <template #default="scope">
-                  {{ ((scope.row.selectedMethod?.packagePrice || scope.row.price || 0) * (scope.row.quantity || 1)).toFixed(2) }}
+                  {{ formatDetailAmount(getSelectedItemAmount(scope.row) * (scope.row.quantity || 1)) }}
                 </template>
               </el-table-column>
               <el-table-column label="类型" prop="checkType" width="70" align="center" />
@@ -392,37 +392,6 @@
                   <div v-if="categoryLoadingSet.has(cat.typeId)" class="category-loading-hint">
                     加载中...
                   </div>
-                  <!-- Bug #428修复: 渲染分类联动加载的检查方法列表 -->
-                  <!-- Bug #500修复: v-if 改为 v-show，避免方法列表加载时 DOM 突然插入导致高度跳变 -->
-                  <div
-                    v-show="cat.methods && cat.methods.length > 0"
-                    class="method-section"
-                  >
-                    <div class="method-section-title">检查方法</div>
-                    <div
-                      v-for="method in cat.methods"
-                      :key="method.id"
-                      class="method-row"
-                    >
-                      <el-checkbox
-                        :model-value="isMethodSelected(method, cat)"
-                        @change="(val) => handleMethodSelect(val, method, cat)"
-                        class="method-checkbox"
-                      >
-                        {{ method.name }}
-                      </el-checkbox>
-                      <span class="method-price-tag">¥{{ method.packagePrice || method.price || 0 }}</span>
-                    </div>
-                  </div>
-                  <!-- Bug #500修复: 加载中的方法列表骨架占位，提前预留空间避免高度跳变 -->
-                  <div
-                    v-if="categoryLoadingSet.has(cat.typeId) && (!cat.methods || cat.methods.length === 0)"
-                    class="method-section method-section-skeleton"
-                  >
-                    <div class="method-section-title">检查方法</div>
-                    <div class="skeleton-method-row"></div>
-                    <div class="skeleton-method-row"></div>
-                  </div>
                 </el-collapse-item>
               </el-collapse>
             </div>
@@ -440,46 +409,103 @@
                 class="selected-item-card"
                 :class="{ 'is-expanded': item.expanded }"
               >
-                <!-- Bug #384修复 + #426修复: 项目卡片头部，可展开/收起 -->
+                <!-- 项目卡片头部：项目和检查方法解耦，点击展开查看方法/明细 -->
                 <div class="card-header" @click="toggleItemExpand(item)">
-                  <el-tag v-if="item.isPackage || item.packageName" size="small" type="warning" style="margin-right: 4px; flex-shrink: 0;">套餐</el-tag>
-                  <el-tooltip :content="item.name" placement="top" :show-after="400">
-                    <span class="card-name">{{ item.name }}</span>
+                  <el-tooltip :content="getDisplayItemName(item)" placement="top" :show-after="400">
+                    <span class="card-name">{{ getDisplayItemName(item) }}</span>
                   </el-tooltip>
-                  <span class="card-price">¥{{ formatDetailAmount(item.price) }}</span>
+                  <span class="card-price">¥{{ formatDetailAmount(getSelectedItemAmount(item)) }}</span>
                   <el-icon :class="['expand-icon', { expanded: item.expanded }]">
-                    <ArrowDown v-if="!item.expanded" />
-                    <ArrowUp v-if="item.expanded" />
+                    <ArrowDown />
                   </el-icon>
                   <!-- 删除按钮 -->
                   <el-button link type="danger" size="small" @click.stop="handleRemoveItem(idx, item)">
                     <el-icon><Close /></el-icon>
                   </el-button>
                 </div>
-                <!-- Bug #428: 有套餐 ID 时默认展开；加载中/空/明细均在本区域展示 -->
-                <div v-if="item.expanded && shouldShowPackageBody(item)" class="selected-card-body">
-                  <div v-if="item.packageDetailsLoading" class="package-details-loading">加载中...</div>
-                  <template v-else>
-                    <div v-if="getPackageDetailsList(item).length === 0" class="package-details-empty">
-                      暂无套餐明细
+                <div v-if="item.expanded" class="selected-card-body">
+                  <div v-if="shouldShowItemPackageBody(item)">
+                    <div class="package-toggle" @click.stop="toggleItemPackageExpand(item)">
+                      <span>项目套餐明细</span>
+                      <el-icon :class="['expand-icon', { expanded: item.itemPackageExpanded }]">
+                        <ArrowDown />
+                      </el-icon>
                     </div>
-                    <div v-else class="package-details-list">
-                      <div class="package-details-head">套餐明细</div>
-                      <div
-                        v-for="(detail, dIdx) in getPackageDetailsList(item)"
-                        :key="detail.id ?? detail.itemCode ?? `d-${dIdx}`"
-                        class="detail-row"
-                      >
-                        <el-tooltip :content="detail.name" placement="top" :show-after="500">
-                          <span class="detail-name">{{ detail.name }}</span>
-                        </el-tooltip>
-                        <div class="detail-meta">
-                          <span class="detail-qty">×{{ detail.quantity || 1 }}</span>
-                          <span class="detail-price">¥{{ formatDetailAmount(detail.price) }}</span>
+                    <div v-show="item.itemPackageExpanded">
+                      <div v-if="item.packageDetailsLoading" class="package-details-loading">加载中...</div>
+                      <template v-else>
+                        <div v-if="getPackageDetailsList(item).length === 0" class="package-details-empty">
+                          暂无套餐明细
+                        </div>
+                        <div v-else class="package-details-list">
+                        <div
+                          v-for="(detail, dIdx) in getPackageDetailsList(item)"
+                          :key="detail.id ?? detail.itemCode ?? `d-${dIdx}`"
+                          class="detail-row"
+                        >
+                          <el-tooltip :content="detail.name" placement="top" :show-after="500">
+                            <span class="detail-name">{{ detail.name }}</span>
+                          </el-tooltip>
+                          <div class="detail-meta">
+                            <span class="detail-qty">×{{ detail.quantity || 1 }}</span>
+                            <span class="detail-price">¥{{ formatDetailAmount(detail.price) }}</span>
+                          </div>
                         </div>
                       </div>
+                      </template>
                     </div>
-                  </template>
+                  </div>
+                  <div class="selected-card-section">
+                    <div class="selected-section-title">检查方法</div>
+                    <div v-if="!item.methods || item.methods.length === 0" class="selected-method-empty">
+                      暂无检查方法
+                    </div>
+                    <div
+                      v-for="method in item.methods"
+                      :key="method.id"
+                      class="selected-method-option"
+                    >
+                      <el-checkbox
+                        :model-value="item.selectedMethod?.id === method.id"
+                        @change="(val) => selectMethodCheckbox(val, item, method)"
+                        class="method-checkbox"
+                      >
+                        {{ method.name }}
+                      </el-checkbox>
+                      <span class="method-price-tag">¥{{ method.packagePrice || method.price || 0 }}</span>
+                    </div>
+                  </div>
+                  <div v-if="shouldShowMethodPackageBody(item)">
+                    <div class="package-toggle" @click.stop="toggleMethodPackageExpand(item)">
+                      <span>检查方法套餐明细</span>
+                      <el-icon :class="['expand-icon', { expanded: item.methodPackageExpanded }]">
+                        <ArrowDown />
+                      </el-icon>
+                    </div>
+                    <div v-show="item.methodPackageExpanded">
+                      <div v-if="item.methodPackageLoading" class="package-details-loading">加载中...</div>
+                      <template v-else>
+                        <div v-if="getMethodPackageDetailsList(item).length === 0" class="package-details-empty">
+                          暂无检查方法套餐明细
+                        </div>
+                        <div v-else class="package-details-list method-package-list">
+                        <div
+                          v-for="(detail, dIdx) in getMethodPackageDetailsList(item)"
+                          :key="detail.id ?? detail.itemCode ?? `md-${dIdx}`"
+                          class="detail-row"
+                        >
+                          <el-tooltip :content="detail.name" placement="top" :show-after="500">
+                            <span class="detail-name">{{ detail.name }}</span>
+                          </el-tooltip>
+                          <div class="detail-meta">
+                            <span class="detail-qty">×{{ detail.quantity || 1 }}</span>
+                            <span class="detail-price">¥{{ formatDetailAmount(detail.price) }}</span>
+                          </div>
+                        </div>
+                      </div>
+                      </template>
+                    </div>
+                  </div>
                 </div>
               </div>
             </div>
@@ -493,7 +519,7 @@
 <script setup>
 import { ref, reactive, computed, watch, onMounted, nextTick } from 'vue';
 import { ElMessage, ElMessageBox } from 'element-plus';
-import { Printer, Delete, ArrowDown, ArrowUp, Close } from '@element-plus/icons-vue';
+import { Printer, Delete, ArrowDown, Close } from '@element-plus/icons-vue';
 import useUserStore from '@/store/modules/user';
 import request from '@/utils/request';
 import { listCheckMethod, searchCheckMethod, listCheckPackage } from '@/api/system/checkType';
@@ -624,24 +650,48 @@ async function loadPackageDetails(row, treeNode, resolve) {
   }
 }
 
-// #428修复 + #426修复: 为已选择项目加载套餐明细（通过packageId或packageName查询）
-/** 套餐明细挂在「部位」或已选的「检查方法」上（方法可带 packageId） */
-function getPackageCarrier(item) {
-  return item?.selectedMethod?.packageId ? item.selectedMethod : item;
-}
-
 function getPackageDetailsList(item) {
   // 明细挂在行对象上，避免仅写入 methods 内嵌对象时首帧不触发视图更新（体感需点两次才展开）
   if (Array.isArray(item?.packageDetailsDisplay)) {
     return item.packageDetailsDisplay;
   }
-  const carrier = getPackageCarrier(item);
-  return Array.isArray(carrier?.packageDetails) ? carrier.packageDetails : [];
+  return Array.isArray(item?.packageDetails) ? item.packageDetails : [];
+}
+
+function getMethodPackageDetailsList(item) {
+  if (Array.isArray(item?.methodPackageDetails)) {
+    return item.methodPackageDetails;
+  }
+  return Array.isArray(item?.selectedMethod?.packageDetails) ? item.selectedMethod.packageDetails : [];
 }
 
 /** 有套餐 ID 或 packageName 的已选行才展示右侧套餐区（加载中 / 空 / 明细列表） */
 function shouldShowPackageBody(item) {
-  return !!(getPackageCarrier(item)?.packageId || item.packageName || item.packageId);
+  return shouldShowItemPackageBody(item) || shouldShowMethodPackageBody(item);
+}
+
+function hasItemPackage(item) {
+  return !!(item?.packageId || item?.packageName);
+}
+
+function hasMethodPackage(item) {
+  return !!(item?.selectedMethod?.packageId || item?.selectedMethod?.packageName);
+}
+
+function isSamePackage(item) {
+  if (!hasItemPackage(item) || !hasMethodPackage(item)) return false;
+  if (item.packageId && item.selectedMethod?.packageId) {
+    return String(item.packageId) === String(item.selectedMethod.packageId);
+  }
+  return String(item.packageName || '') === String(item.selectedMethod?.packageName || '');
+}
+
+function shouldShowItemPackageBody(item) {
+  return hasItemPackage(item);
+}
+
+function shouldShowMethodPackageBody(item) {
+  return hasMethodPackage(item) && !isSamePackage(item);
 }
 
 /** 金额展示：统一两位小数 */
@@ -650,20 +700,18 @@ function formatDetailAmount(value) {
   return Number.isFinite(n) ? n.toFixed(2) : '0.00';
 }
 
-/** 默认检查方法：优先与部位 packageId 一致的方法，否则取首个带套餐的方法，否则取第一个 */
-function pickDefaultMethod(methods, partItem) {
-  if (!methods?.length) return null;
-  if (methods.length === 1) return methods[0];
-  const pid = partItem?.packageId ?? null;
-  if (pid != null && pid !== '') {
-    const matched = methods.find(
-      (x) => x.packageId != null && String(x.packageId) === String(pid)
-    );
-    if (matched) return matched;
+/** 已选卡片名称：去掉 UI 上冗余的“套餐”前缀，完整名称通过 tooltip 展示 */
+function getDisplayItemName(item) {
+  return String(item?.name || '').replace(/^套餐[：:\-\s]*/, '');
+}
+
+function getSelectedItemAmount(item) {
+  const itemPrice = Number(item?.price || 0);
+  const methodPrice = Number(item?.selectedMethod?.packagePrice || 0);
+  if (!hasMethodPackage(item) || isSamePackage(item)) {
+    return itemPrice;
   }
-  const withPkg = methods.find((x) => x.packageId != null);
-  if (withPkg) return withPkg;
-  return methods[0];
+  return itemPrice + methodPrice;
 }
 
 function parsePackageDetailsPayload(res) {
@@ -679,15 +727,15 @@ function parsePackageDetailsPayload(res) {
 
 // #428: 为已选择项目加载套餐明细（后端：CheckTypeController /system/check-type/package/{id}/details）
 async function loadPackageDetailsForItem(item) {
-  const carrier = getPackageCarrier(item);
-  let packageId = item.packageId || carrier?.packageId;
-  if (!packageId && !item.packageName) {
+  let packageId = item.packageId;
+  const packageName = item.packageName;
+  if (!packageId && !packageName) {
     return;
   }
   item.packageDetailsLoading = true;
   try {
-    if (!packageId && item.packageName) {
-      const pkgRes = await listCheckPackage({ packageName: item.packageName });
+    if (!packageId && packageName) {
+      const pkgRes = await listCheckPackage({ packageName });
       let packages = pkgRes?.data || [];
       if (!Array.isArray(packages)) {
         packages = packages.records || packages.data || [];
@@ -699,6 +747,7 @@ async function loadPackageDetailsForItem(item) {
       }
       packageId = packages[0].id;
       item.packageId = packageId;
+      item.packageName = item.packageName || packageName;
     }
     if (!packageId) {
       item.packageDetails = [];
@@ -718,7 +767,6 @@ async function loadPackageDetailsForItem(item) {
       quantity: detail.quantity || 1
     }));
     item.packageDetailsDisplay = mapped;
-    carrier.packageDetails = mapped;
     if (res.code === 200 && res.data) {
       item.packageDetails = Array.isArray(res.data)
         ? res.data.map((detail) => ({
@@ -735,7 +783,6 @@ async function loadPackageDetailsForItem(item) {
   } catch (err) {
     console.error('加载套餐明细失败:', err);
     item.packageDetailsDisplay = [];
-    carrier.packageDetails = [];
     item.packageDetails = [];
   } finally {
     item.packageDetailsLoading = false;
@@ -1058,7 +1105,10 @@ async function loadCategoryList() {
 
     // 默认展开第一个
     if (categoryList.value.length > 0) {
-      activeNames.value = categoryList.value[0].typeId;
+      const firstCat = categoryList.value[0];
+      activeNames.value = firstCat.typeId;
+      await nextTick();
+      await handleCategoryExpand(firstCat);
     }
   } catch (err) {
     console.error('加载检查项目分类失败', err);
@@ -1079,10 +1129,9 @@ const filteredCategoryList = computed(() => {
 });
 
 // ====== 合计 ======
-// Bug #384修复: 如果选中了检查方法，使用套餐价格；否则使用部位价格
 const totalAmountCalc = computed(() => {
   const total = selectedItems.value.reduce((sum, item) => {
-    const effectivePrice = item.selectedMethod?.packagePrice || item.price;
+    const effectivePrice = getSelectedItemAmount(item);
     return sum + (effectivePrice * (item.quantity || 1));
   }, 0);
   return total.toFixed(2);
@@ -1215,8 +1264,7 @@ function handleSave() {
         itemCode: String(item.id),
         itemName: item.name,
         bodyPartCode: item.checkType || 'unknown',
-        // Bug #384修复: 如果选中了检查方法且有套餐价格，使用套餐价格；否则使用部位价格
-        itemFee: item.selectedMethod?.packagePrice || item.price,
+        itemFee: getSelectedItemAmount(item),
         performDeptCode: form.performDeptCode || '',
         itemStatus: 0,
         itemSeq: index + 1,
@@ -1269,6 +1317,8 @@ function handleRowClick(row) {
             methods: [],
             selectedMethod: null,
             expanded: false,
+            itemPackageExpanded: true,
+            methodPackageExpanded: true,
             packageDetailsLoading: false,
             isPackage: false,
             packageId: null,
@@ -1298,17 +1348,10 @@ function handleRowClick(row) {
                 if (m.checkMethodId) {
                   item.selectedMethod = item.methods.find(md => String(md.id) === String(m.checkMethodId)) || null;
                   if (item.selectedMethod?.packageId) {
-                    item.isPackage = true;
-                    item.packageId = item.selectedMethod.packageId;
                     item.hasChildren = true;  // #426修复
                   }
                 }
-                if (!item.selectedMethod && item.methods.length) {
-                  item.selectedMethod = pickDefaultMethod(item.methods, { packageId: item.packageId });
-                }
                 if (item.selectedMethod?.packageId) {
-                  item.packageId = item.selectedMethod.packageId;
-                  item.isPackage = true;
                   item.hasChildren = true;  // #426修复
                 }
               }
@@ -1322,14 +1365,21 @@ function handleRowClick(row) {
         selectedItems.value = itemsWithMethods;
         // 加载套餐明细（单个失败不影响其他项目和明细显示）
         for (const it of selectedItems.value) {
-          if (getPackageCarrier(it)?.packageId) {
+          if (hasItemPackage(it)) {
             try {
               await loadPackageDetailsForItem(it);
             } catch (e) {
               console.error('加载套餐明细失败:', it.name, e);
             }
           }
-          it.expanded = !!getPackageCarrier(it)?.packageId;
+          if (hasMethodPackage(it) && !isSamePackage(it)) {
+            try {
+              await loadMethodPackageDetails(it, it.selectedMethod);
+            } catch (e) {
+              console.error('加载检查方法套餐明细失败:', it.name, e);
+            }
+          }
+          it.expanded = shouldShowPackageBody(it);
         }
         syncCategoryChecked();
         // Bug #384修复: 回充后更新检查方法显示
@@ -1359,97 +1409,6 @@ function handleDelete(row) {
   });
 }
 
-// Bug #428修复: 判断某个检查方法是否已被选中（任意项目关联了该方法）
-function isMethodSelected(method, cat) {
-  return selectedItems.value.some(item =>
-    item.selectedMethod?.id === method.id && item.checkType === cat.typeName
-  );
-}
-
-// Bug #428修复: 勾选检查方法
-async function handleMethodSelect(checked, method, cat) {
-  if (checked) {
-    // 找到该方法所属的第一个检查项目
-    const targetItem = cat.items[0];
-    if (!targetItem) {
-      // 如果分类下没有项目，尝试从其他分类找同名项目或创建
-      console.warn('分类下没有检查项目，无法关联方法');
-      return;
-    }
-
-    // 如果该项目已存在，只更新 selectedMethod
-    const existingItem = selectedItems.value.find(s => s.id === targetItem.id);
-    if (existingItem) {
-      existingItem.selectedMethod = method;
-      // 从方法中获取套餐信息（支持 packageId 或 packageName 解析）
-      if (method.packageId || method.packageName) {
-        existingItem.isPackage = true;
-        existingItem.packageId = method.packageId || existingItem.packageId;
-        existingItem.hasChildren = true;  // #426修复
-        existingItem.packageName = method.packageName || existingItem.packageName;  // #428修复: 确保 packageName 同步
-        // 预加载套餐明细
-        loadPackageDetailsForItem(existingItem);
-      }
-      updateMethodDisplay();
-      return;
-    }
-
-    // 如果该项目不存在，创建一个并关联方法
-    if (selectedItems.value.length > 0) {
-      const currentCategory = selectedItems.value[0].checkType;
-      // Bug #428修复: 使用 cat.typeName 进行比较（与 newItem.checkType 保持一致）
-      const newCategory = cat.typeName || '';
-      if (currentCategory !== newCategory) {
-        ElMessage.warning('一个检查单不能同时选择多个项目类型的检查项目');
-        return;
-      }
-    }
-
-    const newItem = {
-      id: targetItem.id, name: targetItem.name,
-      price: targetItem.price, quantity: 1,
-      serviceFee: targetItem.serviceFee || 0,
-      unit: targetItem.unit || '次',
-      applyPart: targetItem.name,
-      checkType: cat.typeName,
-      nationalCode: targetItem.nationalCode || '',
-      checked: true,
-      methods: cat.methods || [method],   // #428修复: 复制分类下全部方法，允许用户切换
-      selectedMethod: method,
-      expanded: false,
-      // 从方法或项目中获取套餐信息
-      isPackage: !!method.packageId || !!targetItem.packageName,
-      packageId: method.packageId || targetItem.packageId || null,
-      packageName: method.packageName || targetItem.packageName || null,  // #428修复: 复制 packageName，确保套餐明细可加载
-      hasChildren: !!(method.packageId || method.packageName || targetItem.packageId || targetItem.packageName)  // #426修复: 树形表格懒加载展开标记，支持 packageName 解析
-    };
-    selectedItems.value.push(newItem);
-
-    // 如果是套餐，预加载套餐明细
-    if (newItem.isPackage && (newItem.packageId || newItem.packageName)) {
-      loadPackageDetailsForItem(newItem);
-    }
-
-    // 自动回填执行科室
-    if (selectedItems.value.length === 1 && cat?.performDeptName) {
-      form.performDeptCode = cat.performDeptName;
-    }
-
-    // 同时勾选左侧项目的 checkbox
-    targetItem.checked = true;
-
-  } else {
-    // 取消选择方法：将 selectedItems 中关联该方法的项的 selectedMethod 清空
-    const itemsWithMethod = selectedItems.value.filter(
-      item => item.selectedMethod?.id === method.id
-    );
-    for (const item of itemsWithMethod) {
-      item.selectedMethod = null;
-    }
-  }
-  updateMethodDisplay();
-}
-
 // ====== 勾选逻辑 ======
 async function handleItemSelect(checked, item, cat) {
   if (checked) {
@@ -1506,6 +1465,8 @@ async function handleItemSelect(checked, item, cat) {
       methods: methods,
       selectedMethod: null,
       expanded: false,
+      itemPackageExpanded: true,
+      methodPackageExpanded: true,
       isPackage: !!(item.packageId || item.packageName),
       packageName: item.packageName || null,
       packageDetailsLoading: false,
@@ -1516,15 +1477,15 @@ async function handleItemSelect(checked, item, cat) {
     // 必须用数组里的响应式行，不能继续改局部 newRow：push 后列表内是 proxy，改 raw 对象不会触发右侧卡片更新（会一直卡在「加载中」）
     const row = selectedItems.value[selectedItems.value.length - 1];
 
-    // 右侧不再展示「检查方法」列表：自动选默认方法（保存、计价仍依赖 selectedMethod）
-    if (methods.length >= 1) {
-      row.selectedMethod = pickDefaultMethod(methods, item);
-    }
+    // 勾选项目只加入项目列表，检查方法由用户在“检查方法”区域手动选择
+    row.selectedMethod = null;
     updateMethodDisplay();
 
-    // 有套餐 ID 时默认展开（先显示加载区，明细写入行对象 packageDetailsDisplay）
-    row.expanded = !!getPackageCarrier(row)?.packageId;
-    if (getPackageCarrier(row)?.packageId) {
+    // 新勾选项目后默认展开，直接展示检查方法状态和套餐明细
+    row.expanded = true;
+    row.itemPackageExpanded = true;
+    row.methodPackageExpanded = true;
+    if (hasItemPackage(row)) {
       await loadPackageDetailsForItem(row);
     }
 
@@ -1550,13 +1511,35 @@ async function handleItemSelect(checked, item, cat) {
 // Bug #384修复 + #426修复: 展开/收起项目卡片
 async function toggleItemExpand(item) {
   item.expanded = !item.expanded;
-  if (item.expanded && (item.isPackage || item.packageName) && (!item.packageDetails || item.packageDetails.length === 0) && !item.packageDetailsLoading) {
+  if (item.expanded && hasItemPackage(item) && getPackageDetailsList(item).length === 0 && !item.packageDetailsLoading) {
     await loadPackageDetailsForItem(item);
   }
-  if (item.expanded && shouldShowPackageBody(item)) {
-    if (getPackageDetailsList(item).length === 0 && !item.packageDetailsLoading) {
-      await loadPackageDetailsForItem(item);
-    }
+  if (
+    item.expanded &&
+    shouldShowMethodPackageBody(item) &&
+    getMethodPackageDetailsList(item).length === 0 &&
+    !item.methodPackageLoading
+  ) {
+    await loadMethodPackageDetails(item, item.selectedMethod);
+  }
+}
+
+async function toggleItemPackageExpand(item) {
+  item.itemPackageExpanded = !item.itemPackageExpanded;
+  if (item.itemPackageExpanded && getPackageDetailsList(item).length === 0 && !item.packageDetailsLoading) {
+    await loadPackageDetailsForItem(item);
+  }
+}
+
+async function toggleMethodPackageExpand(item) {
+  item.methodPackageExpanded = !item.methodPackageExpanded;
+  if (
+    item.methodPackageExpanded &&
+    item.selectedMethod &&
+    getMethodPackageDetailsList(item).length === 0 &&
+    !item.methodPackageLoading
+  ) {
+    await loadMethodPackageDetails(item, item.selectedMethod);
   }
 }
 
@@ -1564,9 +1547,8 @@ async function toggleItemExpand(item) {
 async function selectMethodCheckbox(checked, item, method) {
   if (checked) {
     item.selectedMethod = method;
-    if (item.expanded && (method.packageId || method.packageName)) {
-      loadPackageDetailsForItem(item);
-    }
+    item.expanded = true;
+    item.methodPackageExpanded = true;
     // 动态加载该方法对应的套餐明细
     await loadMethodPackageDetails(item, method);
   } else {
@@ -1587,36 +1569,43 @@ async function loadMethodPackageDetails(item, method) {
   item.methodPackageLoading = true;
   item.methodPackageDetails = [];
   try {
-    if (!method.packageName) {
+    let packageId = method.packageId;
+    if (!packageId && !method.packageName) {
       item.methodPackageLoading = false;
       return;
     }
     // 通过packageName查询套餐获取packageId
-    const pkgRes = await listCheckPackage({ packageName: method.packageName });
-    let packages = pkgRes?.data || [];
-    if (!Array.isArray(packages)) {
-      packages = packages.records || packages.data || [];
+    if (!packageId && method.packageName) {
+      const pkgRes = await listCheckPackage({ packageName: method.packageName });
+      let packages = pkgRes?.data || [];
+      if (!Array.isArray(packages)) {
+        packages = packages.records || packages.data || [];
+      }
+      if (packages.length === 0) {
+        item.methodPackageLoading = false;
+        return;
+      }
+      packageId = packages[0].id;
+      method.packageId = packageId;
     }
-    if (packages.length === 0) {
-      item.methodPackageLoading = false;
-      return;
-    }
-    const packageId = packages[0].id;
     // 查询套餐明细
     const detailRes = await request({
-      url: `/system/package/${packageId}/details`,
+      url: `/system/check-type/package/${packageId}/details`,
       method: 'get'
     });
-    if (detailRes.code === 200 && detailRes.data) {
-      item.methodPackageDetails = detailRes.data.map(d => ({
+    const detailList = parsePackageDetailsPayload(detailRes);
+    if (detailList.length > 0) {
+      const mapped = detailList.map(d => ({
         id: d.id,
-        name: d.itemName || d.name,
+        name: d.name || d.itemName,
         quantity: d.quantity || 1,
         unit: d.unit || '次',
-        price: d.unitPrice || d.price || 0,
+        price: d.price ?? d.unitPrice ?? d.itemPrice ?? 0,
         amount: d.amount || d.total || 0,
         checked: true  // 默认勾选
       }));
+      item.methodPackageDetails = mapped;
+      method.packageDetails = mapped;
     }
   } catch (err) {
     console.error('加载方法套餐明细失败:', err);
@@ -1630,21 +1619,19 @@ async function loadMethodPackageDetails(item, method) {
 async function onDetailMethodChange(row, val) {
   row.selectedMethod = val || null;
   if (val?.packageId || val?.packageName) {
-    row.packageId = val.packageId || row.packageId;
-    row.packageName = val.packageName || row.packageName;
-    row.isPackage = true;
     row.hasChildren = true;  // #426修复
   }
-  row.packageDetailsDisplay = undefined;
-  const carrier = getPackageCarrier(row);
-  if (carrier) {
-    carrier.packageDetails = undefined;
-  }
+  row.methodPackageDetails = [];
   updateMethodDisplay();
-  row.expanded = !!getPackageCarrier(row)?.packageId;
-  if (getPackageCarrier(row)?.packageId) {
+  row.expanded = shouldShowPackageBody(row);
+  row.itemPackageExpanded = true;
+  row.methodPackageExpanded = true;
+  if (hasItemPackage(row)) {
     await loadPackageDetailsForItem(row);
   }
+  if (val?.packageId || val?.packageName) {
+    await loadMethodPackageDetails(row, val);
+  }
   nextTick(() => {
     form.totalAmount = totalAmountCalc.value;
   });
@@ -1794,7 +1781,7 @@ defineExpose({ getList });
 
 /* 右：分类面板 */
 .category-panel {
-  width: 420px;
+  width: 560px;
   flex-shrink: 0;
   background: #fff;
   border-radius: 4px;
@@ -1951,9 +1938,9 @@ defineExpose({ getList });
 /* 已选择 tags */
 /* 已选择：加宽，避免套餐明细挤成一团 */
 .selected-panel {
-  width: 220px;
-  min-width: 200px;
-  max-width: 280px;
+  width: 260px;
+  min-width: 240px;
+  max-width: 320px;
   flex-shrink: 0;
   display: flex;
   flex-direction: column;
@@ -2013,9 +2000,8 @@ defineExpose({ getList });
   font-size: 13px;
   font-weight: 500;
   color: #303133;
-  overflow: hidden;
-  text-overflow: ellipsis;
-  white-space: nowrap;
+  line-height: 1.4;
+  word-break: break-word;
 }
 
 .card-price {
@@ -2030,12 +2016,11 @@ defineExpose({ getList });
   color: #909399;
   transition: transform 0.2s ease;
   flex-shrink: 0;
-  transition: transform 0.2s;
-  transform: rotate(0deg);
+  transform: rotate(-90deg);
 }
 
 .expand-icon.expanded {
-  transform: rotate(90deg);
+  transform: rotate(0deg);
 }
 
 /* Bug #428修复: 套餐明细列表样式 */
@@ -2078,6 +2063,55 @@ defineExpose({ getList });
   background: #fafbfc;
 }
 
+.selected-card-section {
+  padding: 10px;
+  border-bottom: 1px solid #ebeef5;
+}
+
+.selected-section-title {
+  font-size: 12px;
+  font-weight: 600;
+  color: #409eff;
+  margin-bottom: 8px;
+  padding-bottom: 6px;
+  border-bottom: 1px dashed #d9ecff;
+}
+
+.selected-method-option {
+  display: flex;
+  align-items: center;
+  justify-content: space-between;
+  gap: 8px;
+  padding: 4px 0;
+}
+
+.selected-method-option .method-checkbox {
+  flex: 1;
+  min-width: 0;
+}
+
+.selected-method-empty {
+  color: #c0c4cc;
+  font-size: 12px;
+}
+
+.package-toggle {
+  display: flex;
+  align-items: center;
+  justify-content: space-between;
+  padding: 10px;
+  font-size: 12px;
+  font-weight: 600;
+  color: #909399;
+  cursor: pointer;
+  border-bottom: 1px dashed #dcdfe6;
+  background: #fffbe6;
+}
+
+.package-toggle:hover {
+  color: #409eff;
+}
+
 .package-details-loading,
 .package-details-empty {
   padding: 12px 10px;
diff --git a/openhis-ui-vue3/src/views/doctorstation/components/inspection/inspectionApplication.vue b/openhis-ui-vue3/src/views/doctorstation/components/inspection/inspectionApplication.vue
index 0cb5e6c1..19229ff8 100755
--- a/openhis-ui-vue3/src/views/doctorstation/components/inspection/inspectionApplication.vue
+++ b/openhis-ui-vue3/src/views/doctorstation/components/inspection/inspectionApplication.vue
@@ -1185,9 +1185,9 @@ const loadCategoryItems = async (categoryKey, loadMore = false) => {
 
     // 映射数据格式（从检验项目维护页面的数据结构映射）
     const mappedItems = records.map(item => {
-      // 套餐项目处理：套餐项目使用套餐金额，普通项目使用零售价
-      // BugFix#404: 增加对空字符串的判断，避免空字符串被误认为有效套餐ID
-      const isPackage = item.feePackageId != null && item.feePackageId !== '' && item.feePackageId !== 'null'
+      // 套餐项目处理：需同时满足 feePackageId 有效且 packageName 非空
+      // BugFix#556: 增加 packageName 联合判断，避免普通项目因 feePackageId 有值被误标为套餐
+      const isPackage = item.feePackageId != null && item.feePackageId !== '' && item.feePackageId !== 'null' && item.packageName
       const itemPrice = isPackage
         ? (parseFloat(item.packageAmount || 0) || parseFloat(item.retailPrice || 0) || parseFloat(item.price || 0))
         : (parseFloat(item.retailPrice || 0) || parseFloat(item.price || 0))
diff --git a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/applicationShow/examineApplication.vue b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/applicationShow/examineApplication.vue
index c840ccf3..7975cda6 100755
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/applicationShow/examineApplication.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/applicationShow/examineApplication.vue
@@ -86,7 +86,7 @@
           </template>
           <el-table-column type="index" label="序号" width="60" align="center" />
           <el-table-column prop="patientName" label="患者姓名" width="120" />
-          <el-table-column label="申请单名称" width="140">
+          <el-table-column label="申请单名称" min-width="140">
             <template #default="scope">
               <span>{{ buildApplicationName(scope.row) }}</span>
             </template>
@@ -444,11 +444,9 @@ const buildApplicationName = (row) => {
   if (!details || details.length === 0) {
     return row.name || '-';
   }
-  if (details.length === 1) {
-    return details[0].adviceName || row.name || '-';
-  }
-  const first = details[0];
-  return `${first.adviceName || ''}等${details.length}项`;
+  const names = details.map(d => d.adviceName).filter(Boolean);
+  if (names.length === 0) return row.name || '-';
+  return names.join(' + ');
 };
 
 /**
diff --git a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/applicationShow/testApplication.vue b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/applicationShow/testApplication.vue
index 25d741f8..7e6f764b 100755
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/applicationShow/testApplication.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/applicationShow/testApplication.vue
@@ -529,7 +529,13 @@ const handleViewDetail = async (row) => {
   if (row.descJson) {
     try {
       const obj = JSON.parse(row.descJson);
-      obj.targetDepartment = recursionFun(obj.targetDepartment);
+      // 将发往科室 ID 转换为名称
+      if (obj.targetDepartment) {
+        const deptName = recursionFun(obj.targetDepartment);
+        if (deptName) {
+          obj.targetDepartment = deptName;
+        }
+      }
       // 转换申请类型编码为可读文本
       if (obj.applicationType === 0) obj.applicationType = '普通';
       else if (obj.applicationType === 1) obj.applicationType = '急诊';
diff --git a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/applicationForm/medicalExaminations.vue b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/applicationForm/medicalExaminations.vue
index d6d7ee5e..c2c8cf07 100755
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/applicationForm/medicalExaminations.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/applicationForm/medicalExaminations.vue
@@ -430,11 +430,52 @@ const loadEditData = () => {
 const projectWithDepartment = (selectProjectIds) => {
   if (!selectProjectIds || selectProjectIds.length === 0) {
     form.targetDepartment = '';
+    return;
   }
+
+  // 获取第一个选中项目的发往科室（orgId）
+  // 优先使用配置的发往科室，如果没有则保留手动选择
+  const selectedProject = applicationListAll.value?.find(
+    item => selectProjectIds.includes(item.adviceDefinitionId)
+  );
+
+  if (selectedProject && selectedProject.orgId) {
+    // 项目配置了发往科室，自动填充
+    const orgId = selectedProject.orgId;
+    const orgName = selectedProject.orgName;
+
+    // 查找树中对应的节点，获取正确的 id 类型
+    const findNode = (nodes, targetId) => {
+      if (!nodes) return null;
+      for (const node of nodes) {
+        if (String(node.id) === String(targetId)) {
+          return node;
+        }
+        if (node.children && node.children.length > 0) {
+          const found = findNode(node.children, targetId);
+          if (found) return found;
+        }
+      }
+      return null;
+    };
+
+    const treeNode = findNode(orgOptions.value, orgId);
+    if (treeNode) {
+      // 使用树节点的原始 id 值（确保类型匹配）
+      form.targetDepartment = treeNode.id;
+    } else {
+      // 科室不在列表中（可能已删除），留空让用户手动选择
+      form.targetDepartment = '';
+    }
+  }
+  // 如果没有配置发往科室，保留手动选择（不修改 form.targetDepartment）
 };
 
 watch(() => transferValue.value, (newValue) => {
-  projectWithDepartment(newValue);
+  // 使用 nextTick 确保 DOM 更新完成后再设置值
+  nextTick(() => {
+    projectWithDepartment(newValue);
+  });
 });
 
 const getPriorityCode = () => {
diff --git a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/index.vue b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/index.vue
index 87e6b5a1..3671cd6d 100755
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/index.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/index.vue
@@ -429,6 +429,8 @@ const props = defineProps({
 });
 const isAdding = ref(false);
 const isSaving = ref(false);
+// 标记双击编辑的是否为已有数据的行（用于保存后是否自动添加下一行）
+const wasDoubleClickEdit = ref(false);
 const prescriptionRef = ref();
 const expandOrder = ref([]); //目前的展开行
 const stockList = ref([]);
@@ -1397,7 +1399,9 @@ function handleSaveSign(row, index) {
       }
     });
   } else {
-    if (prescriptionList.value[0].adviceName) {
+    // 仅通过【新增】按钮创建的医嘱保存后才自动添加下一行空医嘱
+    // 双击编辑已有"待保存"医嘱保存时，不应自动添加空行
+    if (isAdding.value && prescriptionList.value[0].adviceName) {
       handleAddPrescription();
     }
   }
diff --git a/openhis-ui-vue3/src/views/inpatientNurse/medicalOrderProofread/components/prescriptionList.vue b/openhis-ui-vue3/src/views/inpatientNurse/medicalOrderProofread/components/prescriptionList.vue
index e362b595..b44550d8 100755
--- a/openhis-ui-vue3/src/views/inpatientNurse/medicalOrderProofread/components/prescriptionList.vue
+++ b/openhis-ui-vue3/src/views/inpatientNurse/medicalOrderProofread/components/prescriptionList.vue
@@ -142,6 +142,13 @@
                 </template>
               </template>
             </el-table-column>
+            <el-table-column label="医嘱状态" prop="requestStatus_enumText" width="100">
+              <template #default="scope">
+                <el-tag :type="getStatusType(scope.row.requestStatus)" size="small">
+                  {{ scope.row.requestStatus_enumText }}
+                </el-tag>
+              </template>
+            </el-table-column>
             <el-table-column label="执行科室" prop="positionName" width="230" />
             <el-table-column label="签发时间" prop="requestTime" width="230" />
           </el-table>
@@ -152,7 +159,7 @@
   </div>
 </template>
 <script setup>
-import {ref, computed} from 'vue';
+import {ref, computed, getCurrentInstance} from 'vue';
 import {adviceVerify, cancel, getPrescriptionList} from './api';
 import {patientInfoList} from '../../components/store/patient.js';
 import {formatDateStr} from '@/utils/index';
@@ -165,6 +172,19 @@ const { proxy } = getCurrentInstance();
 const loading = ref(false);
 const chooseAll = ref(false);
 const selectionTrigger = ref(0);
+
+const getStatusType = (status) => {
+  const map = {
+    1: 'info',      // 待发送
+    2: 'primary',   // 已发送
+    3: 'success',   // 已完成
+    4: 'warning',   // 暂停
+    5: 'danger',    // 取消/待退
+    6: 'danger',    // 停嘱
+    7: 'info'       // 不执行
+  }
+  return map[status] || 'info'
+}
 const hasDispensedSelected = computed(() => {
   selectionTrigger.value;
   return getSelectRows().some(item => item.dispenseStatus === 4);
diff --git a/openhis-ui-vue3/src/views/surgicalschedule/index.vue b/openhis-ui-vue3/src/views/surgicalschedule/index.vue
index 4a0698e3..de0706b2 100755
--- a/openhis-ui-vue3/src/views/surgicalschedule/index.vue
+++ b/openhis-ui-vue3/src/views/surgicalschedule/index.vue
@@ -1068,15 +1068,6 @@ const temporaryPatientInfo = ref({})
 const temporaryBillingMedicines = ref([])
 const temporaryAdvices = ref([])
 
-// 🔧 新增：监听 temporaryAdvices 的变化，用于调试
-watch(temporaryAdvices, (newVal, oldVal) => {
-  console.log('=== temporaryAdvices 变化 ===')
-  console.log('=== 新值 ===', newVal)
-  console.log('=== 新值[1]?.dosage ===', newVal[1]?.dosage)
-  console.log('=== 旧值 ===', oldVal)
-  console.log('=== 旧值[1]?.dosage ===', oldVal[1]?.dosage)
-}, { deep: true })
-
 const temporaryMedicalLoading = ref(false) // 🔧 新增：临时医嘱加载状态
 const temporarySigned = ref(false) // 🔧 新增：签名状态，用于保持按钮名称一致性
 
@@ -1500,9 +1491,6 @@ async function closeChargeDialog() {
   chargeSurgeryInfo.value = {}
 }
 
-// 🔧 新增：标志位，用于区分是"打开"还是"刷新"
-const isRefreshAction = ref(false)
-
 // 处理医嘱按钮点击事件
 function handleMedicalAdvice(row) {
   // 如果没有传入行数据，使用选中的行
@@ -1530,31 +1518,7 @@ function handleMedicalAdvice(row) {
     applyId: row.applyId  // 手术申请单ID，用于过滤关联医嘱
   }
 
-  // 🔧 关键修复：如果已有提交的医嘱数据，并且是同一个患者的就诊，则使用保存的数据
-  // 这样可以保留 requestId，避免重复创建医嘱记录
-  console.log('=== 检查是否使用已保存的医嘱数据 ===')
-  console.log('=== temporaryAdvices.value.length ===', temporaryAdvices.value.length)
-  console.log('=== temporaryAdvices.value[0]?.originalMedicine?.encounterId ===', temporaryAdvices.value[0]?.originalMedicine?.encounterId)
-  console.log('=== row.visitId ===', row.visitId)
-  console.log('=== isRefreshAction.value ===', isRefreshAction.value)
-  
-  const isSameEncounter = temporaryAdvices.value.length > 0 && 
-                         temporaryAdvices.value[0]?.originalMedicine?.encounterId === row.visitId &&
-                         !isRefreshAction.value
-  
-  console.log('=== isSameEncounter ===', isSameEncounter)
-  
-  if (isSameEncounter) {
-    console.log('=== 使用已保存的医嘱数据，避免重复创建 ===')
-    console.log('=== temporaryAdvices.value[0]?.originalMedicine?.requestId ===', temporaryAdvices.value[0]?.originalMedicine?.requestId)
-    // 直接打开弹窗，使用已保存的数据
-    showTemporaryMedical.value = true
-    temporaryMedicalLoading.value = false
-    isRefreshAction.value = false // 重置标志位
-    return
-  }
-
-  // 🔧 修复：每次打开临时医嘱时都重新加载数据，避免使用缓存数据导致数据重复
+  // 🔧 每次打开临时医嘱都重新拉取最新数据，确保计费弹窗签发后数据自动更新
   // 先清空旧数据
   temporaryBillingMedicines.value = []
   temporaryAdvices.value = []
@@ -1567,46 +1531,39 @@ function handleMedicalAdvice(row) {
 
   // 调用计费接口获取数据
   getPrescriptionList(row.visitId, 6, row.operCode).then((res) => {
-    console.log('=== 拉取计费数据返回结果 ===', res)
     if (res.code === 200 && res.data) {
-      // 🔧 修复：显示所有药品请求数据，不管有没有计费项目
-      // 根据用户需求：已引用计费药品（待生成医嘱）和临时医嘱预览（已生成）显示的数据应该相同
-      // 在提交医嘱之前状态应该是"待签发"，提交之后变为"已签发"
-      // 再次打开医嘱界面的时候能看到这两个状态的药品
       const seenIds = new Set();
       const filteredItems = res.data.filter(item => {
         // 匹配 encounterId
         if (item.encounterId !== row.visitId) return false;
-        // 只保留药品类型（adviceType=1），过滤掉耗材(2)和诊疗项目(3/6)
-        // 🔧 修复 Bug #444: 使用 Number() 显式转换，避免字符串 "1" 被 !== 1 放行
+        // 只保留药品(1)和耗材(2)，屏蔽诊疗(3)和手术(6)
         const at = Number(item.adviceType ?? item.advice_type);
-        if (at !== 1) return false;
+        if (at !== 1 && at !== 2) return false;
         // 过滤掉名称为空的项目
         const medicineName = item.adviceName || item.advice_name;
         if (!medicineName || medicineName.trim() === '') return false;
-        // 🔧 修复 Bug #444: 二次过滤，排除名称中包含手术/检查/诊疗关键词的非药品项目
-        // 某些计费项目可能在 adm_charge_item 中被错误标注为 adviceType=1
+        // 排除名称中包含手术/检查/诊疗关键词的非药品项目
         const excludedKeywords = ['术', '超声', '多普勒', '检查', '检验', '彩超', 'X线', 'CT', 'MRI', '扫描', '造影'];
         if (excludedKeywords.some(kw => medicineName.includes(kw))) return false;
-        // 🔧 修复 Bug #445: 过滤掉已生成医嘱的项目（已有 requestId 的不应出现在"待生成"列表中）
-        if (item.requestId) return false;
         // 根据药品请求ID去重，避免重复显示
         const itemId = item.requestId || item.id;
         if (itemId && seenIds.has(itemId)) return false;
         if (itemId) seenIds.add(itemId);
         return true;
       })
+      // 按 statusEnum 区分：1=草稿(待生成)，2=已签发(已生成)
+      const draftItems = filteredItems.filter(item => item.statusEnum === 1)
+      const activeItems = filteredItems.filter(item => item.statusEnum === 2)
 
       // 🔧 修复：限制返回数量，最多显示前100条，避免数据过多导致页面卡死
       const maxItems = 100
-      if (filteredItems.length > maxItems) {
-        ElMessage.warning(`待签发医嘱数量过多(${filteredItems.length}条)，仅显示前${maxItems}条`)
-        filteredItems.length = maxItems
+      if (draftItems.length > maxItems) {
+        ElMessage.warning(`待签发医嘱数量过多(${draftItems.length}条)，仅显示前${maxItems}条`)
+        draftItems.length = maxItems
       }
 
-      // 将过滤后的数据转换为临时医嘱需要的格式 - 兼容驼峰和下划线命名
-      // 对于从 adm_charge_item（计费项目表）查询来的项目，特殊处理
-      temporaryBillingMedicines.value = filteredItems.map(item => {
+      // === 待生成列表：statusEnum=1 草稿状态的项目 ===
+      temporaryBillingMedicines.value = draftItems.map(item => {
         try {
           // 从 contentJson 或 content_json 中解析详细数据 - 兼容下划线和驼峰命名
           const jsonContent = item.contentJson || item.content_json;
@@ -1653,74 +1610,65 @@ function handleMedicalAdvice(row) {
           };
         }
       });
-    } else {
-      // 如果没有数据或接口调用失败，初始化空列表
-      temporaryBillingMedicines.value = []
-    }
-    
-    // 将计费药品转换为临时医嘱数据
-    temporaryAdvices.value = temporaryBillingMedicines.value.map((medicine, index) => {
-      // 解析规格中的数值和单位
-      const specMatch = medicine.specification ? medicine.specification.match(/(\d+)(\D+)/) : null
-      const specValue = specMatch ? parseInt(specMatch[1]) : 1
-      const specUnit = specMatch ? specMatch[2] : 'ml'
 
-      // 计算剂量 = 规格数值 × 数量
-      const dosage = specValue * (medicine.quantity || 1)
+      // === 已生成列表：statusEnum=2 已签发状态的项目，直接转为医嘱格式 ===
+      temporaryAdvices.value = activeItems.map((item, index) => {
+        try {
+          const jsonContent = item.contentJson || item.content_json;
+          const contentData = jsonContent ? JSON.parse(jsonContent) : {};
+          const medicineName = contentData.adviceName || contentData.advice_name || item.adviceName || item.advice_name || '';
+          const spec = contentData.volume || contentData.specification || item.volume || item.specification || '';
+          const specMatch = spec.match(/(\d+)(\D+)/)
+          const specValue = specMatch ? parseInt(specMatch[1]) : 1
+          const specUnit = specMatch ? specMatch[2] : 'ml'
+          const dosage = specValue * (contentData.quantity || item.quantity || 1)
 
-      // 🔧 修复：优先从 contentJson 中读取已有的用法，如果没有则根据药品名称判断
-      let usageCode = 'iv' // 默认静脉注射编码
-      let usageLabel = '静脉注射' // 默认显示名称
+          let usageCode = contentData.methodCode || 'iv'
+          let usageLabel = getUsageLabel(usageCode)
+          if (usageCode === 'iv') {
+            if (medicineName.includes('注射液')) { usageCode = 'iv'; usageLabel = '静脉注射' }
+          } else if (usageCode === 'po') {
+            if (medicineName.includes('片') || medicineName.includes('胶囊')) { usageCode = 'po'; usageLabel = '口服' }
+          }
 
-      // 尝试从 contentJson 中读取用法
-      try {
-        const jsonContent = medicine.contentJson || medicine.content_json;
-        if (jsonContent) {
-          const contentData = JSON.parse(jsonContent);
-          if (contentData.methodCode) {
-            usageCode = contentData.methodCode;
-            usageLabel = getUsageLabel(contentData.methodCode);
+          return {
+            id: index + 1,
+            adviceName: medicineName,
+            dosage,
+            unit: specUnit,
+            usage: usageCode,
+            usageLabel,
+            frequency: '临时',
+            executeTime: new Date().toLocaleString('zh-CN'),
+            originalMedicine: {
+              ...item,
+              medicineName: medicineName,
+              specification: spec,
+              quantity: contentData.quantity || item.quantity || 1,
+              encounterId: row.visitId
+            }
+          }
+        } catch (e) {
+          return {
+            id: index + 1,
+            adviceName: item.adviceName || item.advice_name || '',
+            dosage: 1, unit: 'ml', usage: 'iv', usageLabel: '静脉注射',
+            frequency: '临时',
+            executeTime: new Date().toLocaleString('zh-CN'),
+            originalMedicine: {
+              ...item,
+              medicineName: item.adviceName || item.advice_name || '',
+              specification: item.volume || item.specification || '',
+              quantity: item.quantity || 1,
+              encounterId: row.visitId
+            }
           }
         }
-      } catch (e) {
-        // 解析失败，继续使用默认值
-      }
-
-      // 如果没有从 contentJson 中读取到用法，根据药品名称判断
-      if (!usageCode || usageCode === 'iv') {
-        if (medicine.medicineName && medicine.medicineName.includes('注射液')) {
-          usageCode = 'iv'
-          usageLabel = '静脉注射'
-        } else if (medicine.medicineName && medicine.medicineName.includes('片')) {
-          usageCode = 'po'
-          usageLabel = '口服'
-        } else if (medicine.medicineName && medicine.medicineName.includes('胶囊')) {
-          usageCode = 'po'
-          usageLabel = '口服'
-        }
-      }
-
-      return {
-        id: index + 1,
-        adviceName: medicine.medicineName || '',
-        dosage: dosage,
-        unit: specUnit,
-        usage: usageCode, // 🔧 修复：保存的是编码
-        usageLabel: usageLabel, // 🔧 新增：保存显示名称
-        frequency: '临时',
-        executeTime: new Date().toLocaleString('zh-CN'),
-        // 🔧 关键修复：确保 originalMedicine 中包含 encounterId 和匹配字段
-        // medicineName/specification/quantity 用于 handleTemporaryMedicalSubmit 中的
-        // 已提交项目匹配过滤（Bug #445），缺少这些字段会导致过滤失效
-        originalMedicine: {
-          ...medicine,
-          medicineName: medicine.medicineName,
-          specification: medicine.specification,
-          quantity: medicine.quantity,
-          encounterId: row.visitId // 添加 encounterId 字段
-        }
-      }
-    })
+      })
+    } else {
+      temporaryBillingMedicines.value = []
+      temporaryAdvices.value = []
+    }
 
     // 打开临时医嘱弹窗
     showTemporaryMedical.value = true
@@ -1746,11 +1694,6 @@ function closeTemporaryMedical() {
 // 处理临时医嘱提交
 // 🔧 修复：提交成功后，更新 temporaryAdvices 中的 requestId，以便下次提交时执行更新操作
 function handleTemporaryMedicalSubmit(data) {
-  console.log('=== handleTemporaryMedicalSubmit 被调用 ===')
-  console.log('=== data ===', data)
-  console.log('=== data.temporaryAdvices ===', data.temporaryAdvices)
-  console.log('=== data.temporaryAdvices[1]?.dosage ===', data.temporaryAdvices[1]?.dosage)
-  
   // 🔧 修复：使用用户修改后的数据，而不是重新加载数据
   // 这样可以确保用户修改的内容（如剂量）在保存后仍然正确显示
   if (data.temporaryAdvices && data.temporaryAdvices.length > 0) {
@@ -1805,9 +1748,7 @@ function handleTemporaryMedicalSubmit(data) {
       // 如果没有任何匹配键，清空待生成列表（所有项目都已提交）
       temporaryBillingMedicines.value = []
     }
-    
-    console.log('=== 使用用户修改后的临时医嘱数据 ===', temporaryAdvices.value)
-    console.log('=== temporaryAdvices.value[1]?.dosage ===', temporaryAdvices.value[1]?.dosage)
+
   } else {
     // 如果没有传递数据，则清空
     temporaryAdvices.value = []
@@ -1879,21 +1820,70 @@ function handleQuoteBilling() {
     
               // 🔧 修复 Bug #445: 只保留药品类型（adviceType=1），过滤掉耗材(2)和诊疗项目(3/6)
               // 同时过滤掉已有 requestId 的项目（已生成医嘱的不需要再次显示在"待生成"列表中）
-              const filteredItems = res.data.filter(item => {
-                // 匹配 encounterId
+              // 先提取已签发项目(statusEnum=2)填充已生成列表
+              const activeItems = res.data.filter(item => {
                 if (item.encounterId !== temporaryPatientInfo.value.visitId) return false;
-                // 只保留药品类型（adviceType=1），过滤掉耗材(2)和诊疗项目(3/6)
-                // 🔧 修复 Bug #444: 使用 Number() 显式转换 + snake_case 回退，避免字符串 "1" 匹配失败
                 const at = Number(item.adviceType ?? item.advice_type);
-                if (at !== 1) return false;
-                // 过滤掉名称为空的项目
+                if (at !== 1 && at !== 2) return false;
+                if (item.statusEnum !== 2) return false;
+                const medicineName = item.adviceName || item.advice_name;
+                if (!medicineName || medicineName.trim() === '') return false;
+                const excludedKeywords = ['术', '超声', '多普勒', '检查', '检验', '彩超', 'X线', 'CT', 'MRI', '扫描', '造影'];
+                if (excludedKeywords.some(kw => medicineName.includes(kw))) return false;
+                return true;
+              })
+              temporaryAdvices.value = activeItems.map((item, index) => {
+                try {
+                  const jsonContent = item.contentJson || item.content_json;
+                  const contentData = jsonContent ? JSON.parse(jsonContent) : {};
+                  const medicineName = contentData.adviceName || contentData.advice_name || item.adviceName || item.advice_name || '';
+                  const spec = contentData.volume || contentData.specification || item.volume || item.specification || '';
+                  const specMatch = spec.match(/(\d+)(\D+)/)
+                  const specValue = specMatch ? parseInt(specMatch[1]) : 1
+                  const specUnit = specMatch ? specMatch[2] : 'ml'
+                  const dosage = specValue * (contentData.quantity || item.quantity || 1)
+                  let usageCode = contentData.methodCode || 'iv'
+                  let usageLabel = getUsageLabel(usageCode)
+                  if (usageCode === 'iv' && medicineName.includes('注射液')) { usageLabel = '静脉注射' }
+                  else if (usageCode === 'po' && (medicineName.includes('片') || medicineName.includes('胶囊'))) { usageLabel = '口服' }
+                  return {
+                    id: index + 1, adviceName: medicineName, dosage, unit: specUnit,
+                    usage: usageCode, usageLabel, frequency: '临时',
+                    executeTime: new Date().toLocaleString('zh-CN'),
+                    originalMedicine: {
+                      ...item,
+                      medicineName: medicineName,
+                      specification: spec,
+                      quantity: contentData.quantity || item.quantity || 1,
+                      encounterId: temporaryPatientInfo.value.visitId
+                    }
+                  }
+                } catch (e) {
+                  return {
+                    id: index + 1, adviceName: item.adviceName || item.advice_name || '',
+                    dosage: 1, unit: 'ml', usage: 'iv', usageLabel: '静脉注射',
+                    frequency: '临时', executeTime: new Date().toLocaleString('zh-CN'),
+                    originalMedicine: {
+                      ...item,
+                      medicineName: item.adviceName || item.advice_name || '',
+                      specification: item.volume || item.specification || '',
+                      quantity: item.quantity || 1,
+                      encounterId: temporaryPatientInfo.value.visitId
+                    }
+                  }
+                }
+              })
+
+              // 再提取草稿项目(statusEnum=1)填充待生成列表
+              const filteredItems = res.data.filter(item => {
+                if (item.encounterId !== temporaryPatientInfo.value.visitId) return false;
+                const at = Number(item.adviceType ?? item.advice_type);
+                if (at !== 1 && at !== 2) return false;
+                if (item.statusEnum !== 1) return false;
                 const medicineName = item.adviceName || item.advice_name;
                 if (!medicineName || medicineName.trim() === '') return false;
-                // 🔧 修复 Bug #444: 二次过滤，排除名称中包含手术/检查/诊疗关键词的非药品项目
                 const excludedKeywords = ['术', '超声', '多普勒', '检查', '检验', '彩超', 'X线', 'CT', 'MRI', '扫描', '造影'];
                 if (excludedKeywords.some(kw => medicineName.includes(kw))) return false;
-                // 🔧 修复 Bug #445: 过滤掉已生成医嘱的项目（已有 requestId）
-                if (item.requestId) return false;
                 return true;
               })
         // 🔧 修复：限制返回数量，最多显示前100条，避免数据过多导致页面卡死
@@ -1906,7 +1896,6 @@ function handleQuoteBilling() {
         // 将过滤后的数据转换为临时医嘱需要的格式
         temporaryBillingMedicines.value = filteredItems.map(item => {
           try {
-            // 从 contentJson 或 content_json 中解析详细数据 - 兼容下划线和驼峰命名
             const jsonContent = item.contentJson || item.content_json;
             const contentData = jsonContent ? JSON.parse(jsonContent) : {};
             return {
@@ -1925,10 +1914,9 @@ function handleQuoteBilling() {
               definitionDetailId: contentData.definitionDetailId || item.definitionDetailId
             }
           } catch (e) {
-            // 如果解析失败，使用顶层数据 - 兼容 snake_case 和 camelCase
             return {
               medicineName: item.adviceName || item.advice_name || '',
-              specification: item.specification || item.specification || item.volume || '',
+              specification: item.specification || item.volume || '',
               quantity: item.quantity || item.quantity_value || 0,
               batchNumber: item.lotNumber || item.lot_number || '',
               unitPrice: item.unitPrice || item.unit_price || 0,
@@ -1944,123 +1932,6 @@ function handleQuoteBilling() {
           }
         })
 
-        // 将计费药品转换为临时医嘱数据
-        temporaryAdvices.value = temporaryBillingMedicines.value.map((medicine, index) => {
-          // 解析规格中的数值和单位
-          const specMatch = medicine.specification ? medicine.specification.match(/(\d+)(\D+)/) : null
-          const specValue = specMatch ? parseInt(specMatch[1]) : 1
-          const specUnit = specMatch ? specMatch[2] : 'ml'
-
-          // 计算剂量 = 规格数值 × 数量
-          const dosage = specValue * (medicine.quantity || 1)
-
-          // 🔧 修复：优先从 contentJson 中读取已有的用法，如果没有则根据药品名称判断
-          let usageCode = 'iv' // 默认静脉注射编码
-          let usageLabel = '静脉注射' // 默认显示名称
-
-          // 尝试从 contentJson 中读取用法
-          try {
-            const jsonContent = medicine.contentJson || medicine.content_json;
-            if (jsonContent) {
-              const contentData = JSON.parse(jsonContent);
-              if (contentData.methodCode) {
-                usageCode = contentData.methodCode;
-                usageLabel = getUsageLabel(contentData.methodCode);
-              }
-            }
-          } catch (e) {
-            // 解析失败，继续使用默认值
-          }
-
-          // 如果没有从 contentJson 中读取到用法，根据药品名称判断
-          if (!usageCode || usageCode === 'iv') {
-            if (medicine.medicineName && medicine.medicineName.includes('注射液')) {
-              usageCode = 'iv'
-              usageLabel = '静脉注射'
-            } else if (medicine.medicineName && medicine.medicineName.includes('片')) {
-              usageCode = 'po'
-              usageLabel = '口服'
-            } else if (medicine.medicineName && medicine.medicineName.includes('胶囊')) {
-              usageCode = 'po'
-              usageLabel = '口服'
-            }
-          }
-
-          return {
-            id: index + 1,
-            adviceName: medicine.medicineName || '',
-            dosage: dosage,
-            unit: specUnit,
-            usage: usageCode, // 🔧 修复：保存的是编码
-            usageLabel: usageLabel, // 🔧 新增：保存显示名称
-            frequency: '临时',
-            executeTime: new Date().toLocaleString('zh-CN'),
-            // 🔧 关键修复：确保 originalMedicine 中包含 encounterId 和匹配字段
-            // medicineName/specification/quantity 用于已提交项目匹配过滤（Bug #445）
-            originalMedicine: {
-              ...medicine,
-              medicineName: medicine.medicineName,
-              specification: medicine.specification,
-              quantity: medicine.quantity,
-              encounterId: temporaryPatientInfo.value.visitId // 添加 encounterId 字段
-            }
-          }
-        })
-
-        // 🔧 修复 Bug #445: 过滤掉已生成医嘱的项目，避免"引用计费"后已提交项目重新出现在"待生成"列表
-        // 使用清空前提取的 submittedKeys（名称|||规格|||数量复合键）进行匹配
-        if (submittedKeys.size > 0) {
-          temporaryBillingMedicines.value = temporaryBillingMedicines.value.filter(m => {
-            const key = `${m.medicineName || ''}|||${m.specification || ''}|||${m.quantity ?? 0}`
-            return !submittedKeys.has(key)
-          })
-          // 同步更新 temporaryAdvices，保持两份数据一致
-          temporaryAdvices.value = temporaryBillingMedicines.value.map((medicine, index) => {
-            const specMatch = medicine.specification ? medicine.specification.match(/(\d+)(\D+)/) : null
-            const specValue = specMatch ? parseInt(specMatch[1]) : 1
-            const specUnit = specMatch ? specMatch[2] : 'ml'
-            const dosage = specValue * (medicine.quantity || 1)
-            let usageCode = 'iv'
-            let usageLabel = '静脉注射'
-            try {
-              const jsonContent = medicine.contentJson || medicine.content_json;
-              if (jsonContent) {
-                const contentData = JSON.parse(jsonContent);
-                if (contentData.methodCode) {
-                  usageCode = contentData.methodCode;
-                  usageLabel = getUsageLabel(contentData.methodCode);
-                }
-              }
-            } catch (e) {}
-            if (!usageCode || usageCode === 'iv') {
-              if (medicine.medicineName && medicine.medicineName.includes('注射液')) {
-                usageCode = 'iv'; usageLabel = '静脉注射';
-              } else if (medicine.medicineName && medicine.medicineName.includes('片')) {
-                usageCode = 'po'; usageLabel = '口服';
-              } else if (medicine.medicineName && medicine.medicineName.includes('胶囊')) {
-                usageCode = 'po'; usageLabel = '口服';
-              }
-            }
-            return {
-              id: index + 1,
-              adviceName: medicine.medicineName || '',
-              dosage,
-              unit: specUnit,
-              usage: usageCode,
-              usageLabel,
-              frequency: '临时',
-              executeTime: new Date().toLocaleString('zh-CN'),
-              originalMedicine: {
-                ...medicine,
-                medicineName: medicine.medicineName,
-                specification: medicine.specification,
-                quantity: medicine.quantity,
-                encounterId: temporaryPatientInfo.value.visitId
-              }
-            }
-          })
-        }
-
         temporaryMedicalLoading.value = false // 🔧 新增：加载完成
         ElMessage.success('已成功引用最新计费药品信息！')
       } else {
diff --git a/openhis-ui-vue3/src/views/surgicalschedule/temporaryMedical.vue b/openhis-ui-vue3/src/views/surgicalschedule/temporaryMedical.vue
index 20fa1cb7..99c9cc0d 100755
--- a/openhis-ui-vue3/src/views/surgicalschedule/temporaryMedical.vue
+++ b/openhis-ui-vue3/src/views/surgicalschedule/temporaryMedical.vue
@@ -48,9 +48,12 @@
     <div class="medicine-section">
       <div class="section-title">
         一、已引用计费药品（待生成医嘱）
+        <span v-if="(billingMedicines || []).length >= PAGE_SIZE" style="margin-left:auto;font-size:14px;color:#4a8bc9;cursor:pointer;white-space:nowrap;" @click="billingExpanded = !billingExpanded">
+          {{ billingExpanded ? '收起' : `展开全部(${(billingMedicines || []).length}条)` }}
+        </span>
       </div>
       <el-table
-        :data="billingMedicines"
+        :data="displayBillingMedicines"
         stripe
         border
         style="width: 100%;"
@@ -98,9 +101,12 @@
     <div class="advice-section">
       <div class="section-title">
         二、临时医嘱预览（已生成）
+        <span v-if="(displayAdvices || []).length >= PAGE_SIZE" style="margin-left:auto;font-size:14px;color:#4a8bc9;cursor:pointer;white-space:nowrap;" @click="advicesExpanded = !advicesExpanded">
+          {{ advicesExpanded ? '收起' : `展开全部(${(displayAdvices || []).length}条)` }}
+        </span>
       </div>
       <el-table
-        :data="displayAdvices"
+        :data="displayAdvicesList"
         stripe
         border
         style="width: 100%;"
@@ -317,6 +323,19 @@ const allItemsSubmitted = computed(() => {
   return meds.length > 0 && meds.every(m => m.requestId)
 })
 
+// 展开/收起控制
+const PAGE_SIZE = 3
+const billingExpanded = ref(false)
+const advicesExpanded = ref(false)
+const displayBillingMedicines = computed(() => {
+  const all = props.billingMedicines || []
+  return billingExpanded.value ? all : all.slice(0, PAGE_SIZE)
+})
+const displayAdvicesList = computed(() => {
+  const all = displayAdvices.value || []
+  return advicesExpanded.value ? all : all.slice(0, PAGE_SIZE)
+})
+
 // 响应式数据 - isSigned 从父组件传入的 prop 初始化
 const isSigned = ref(props.isSignedProp)
 
@@ -1045,6 +1064,21 @@ const editFormUsageLabel = computed(() => {
   padding-bottom: 12px;
   margin-bottom: 16px;
   border-bottom: 2px solid #e4e7ed;
+  display: flex;
+  align-items: center;
+  gap: 12px;
+}
+
+.expand-btn {
+  font-size: 0.85rem;
+  color: #4a8bc9;
+  cursor: pointer;
+  font-weight: 400;
+  margin-left: auto;
+}
+.expand-btn:hover {
+  color: #2a6ba9;
+  text-decoration: underline;
 }
 
 .medicine-summary {