diff --git a/openhis-server-new/openhis-application/src/main/resources/mapper/regdoctorstation/AdviceManageAppMapper.xml.bak b/openhis-server-new/openhis-application/src/main/resources/mapper/regdoctorstation/AdviceManageAppMapper.xml.bak
new file mode 100755
index 000000000..019afb542
--- /dev/null
+++ b/openhis-server-new/openhis-application/src/main/resources/mapper/regdoctorstation/AdviceManageAppMapper.xml.bak
@@ -0,0 +1,385 @@
+<?xml version="1.0" encoding="UTF-8" ?>
+<!DOCTYPE mapper
+        PUBLIC "-//mybatis.org//DTD Mapper 3.0//EN"
+        "http://mybatis.org/dtd/mybatis-3-mapper.dtd">
+<mapper namespace="com.openhis.web.regdoctorstation.mapper.AdviceManageAppMapper">
+
+    <select id="getRegPatientMainInfo" resultType="com.openhis.web.regdoctorstation.dto.RegPatientMainInfoDto">
+        SELECT DISTINCT ON (rpmi.patient_id)
+               rpmi.tenant_id,
+               rpmi.encounter_id,
+               rpmi.status_enum,
+               rpmi.bus_no,
+               rpmi.patient_bus_no,
+               rpmi.in_hospital_time,
+               rpmi.in_hospital_days,
+               rpmi.out_hospital_time,
+               rpmi.patient_id,
+               rpmi.patient_name,
+               rpmi.gender_enum,
+               rpmi.birth_date,
+               rpmi.ward_name,
+               rpmi.house_name,
+               rpmi.bed_name,
+               rpmi.in_org_time,
+               rpmi.in_hospital_org_id,
+               rpmi.in_hospital_org_name,
+               rpmi.contract_no,
+               rpmi.contract_name,
+               rpmi.reg_diagnosis_name,
+               rpmi.account_id
+        FROM (SELECT ae.tenant_id,
+                     ae.ID                                                             AS encounter_id,
+                     ae.status_enum                                                    AS status_enum,
+                     ae.bus_no                                                         AS bus_no,
+                     ap.bus_no                                                         AS patient_bus_no,
+                     ae.start_time                                                     AS in_hospital_time,
+                     (EXTRACT(DAY FROM (CURRENT_DATE - ae.start_time)) :: INTEGER + 1) AS in_hospital_days,
+                     ae.end_time                                                       AS out_hospital_time,
+                     ap.ID                                                             AS patient_id,
+                     ap.NAME                                                           AS patient_name,
+                     ap.gender_enum                                                    AS gender_enum,
+                     ap.birth_date                                                     AS birth_date,
+                     alw.NAME                                                          AS ward_name,
+                     alh.NAME                                                          AS house_name,
+                     alb.NAME                                                          AS bed_name,
+                     aelb.start_time                                                   AS in_org_time,
+                     ao.id                                                             AS in_hospital_org_id,
+                     ao.NAME                                                           AS in_hospital_org_name,
+                     aa.id                                                             AS account_id,
+                     aa.contract_no                                                    AS contract_no,
+                     fc.contract_name                                                  AS contract_name,
+                     ccd.NAME                                                          AS reg_diagnosis_name
+              FROM adm_encounter AS ae
+                       LEFT JOIN adm_patient AS ap ON ap.ID = ae.patient_id
+                  AND ap.delete_flag = '0'
+                       LEFT JOIN adm_organization AS ao ON ao.ID = ae.organization_id
+                  AND ao.delete_flag = '0'
+                       LEFT JOIN adm_encounter_location AS aelw ON aelw.encounter_id = ae.ID
+                  AND aelw.delete_flag = '0'
+                  AND aelw.form_enum = #{wardEnum}
+                  AND aelw.status_enum = #{encounterActivityStatus}
+                       LEFT JOIN adm_location AS alw ON alw.ID = aelw.location_id
+                  AND alw.delete_flag = '0'
+                       LEFT JOIN adm_encounter_location AS aelh ON aelh.encounter_id = ae.ID
+                  AND aelh.delete_flag = '0'
+                  AND aelh.form_enum = #{houseEnum}
+                  AND aelh.status_enum = #{encounterActivityStatus}
+                       LEFT JOIN adm_location AS alh ON alh.ID = aelh.location_id
+                  AND alh.delete_flag = '0'
+                       LEFT JOIN adm_encounter_location AS aelb ON aelb.encounter_id = ae.ID
+                  AND aelb.delete_flag = '0'
+                  AND aelb.form_enum = #{bedEnum}
+                  AND aelb.status_enum = #{encounterActivityStatus}
+                       LEFT JOIN adm_location AS alb ON alb.ID = aelb.location_id
+                  AND alb.delete_flag = '0'
+                       INNER JOIN adm_account AS aa ON aa.encounter_id = ae.ID
+                  AND aa.delete_flag = '0'
+                  AND aa.encounter_flag = 1
+                       LEFT JOIN fin_contract AS fc ON fc.bus_no = aa.contract_no
+                  AND fc.delete_flag = '0'
+                       LEFT JOIN adm_encounter_diagnosis AS aed ON aed.encounter_id = ae.ID
+                  AND aed.delete_flag = '0'
+                  AND aed.maindise_flag = #{maindiseFlag}
+                       LEFT JOIN cli_condition AS cc ON cc.ID = aed.condition_id
+                  AND cc.delete_flag = '0'
+                       LEFT JOIN cli_condition_definition AS ccd ON ccd.ID = cc.definition_id
+                  AND ccd.delete_flag = '0'
+              WHERE ae.delete_flag = '0'
+                AND ae.class_enum = #{classEnum}
+                AND ae.status_enum != #{toBeRegistered}
+                AND ae.status_enum != #{alreadySettled}
+                AND ae.status_enum != #{registered}
+                AND EXISTS(
+                  SELECT 1
+                  FROM adm_practitioner_role
+                  WHERE delete_flag = '0'
+                    AND practitioner_id = #{practitionerId}
+                    AND org_id = ae.organization_id
+              )) AS rpmi
+        <if test="ew != null and ew.sqlSegment != null and ew.sqlSegment != ''">
+            WHERE ${ew.sqlSegment}
+        </if>
+        ORDER BY rpmi.patient_id, rpmi.encounter_id DESC
+    </select>
+
+    <!-- 用于分页的COUNT查询，与主查询保持一致的去重逻辑 -->
+    <select id="getRegPatientMainInfoCount" resultType="java.lang.Long">
+        SELECT COUNT(*) FROM (
+            SELECT DISTINCT ON (rpmi.patient_id)
+                   rpmi.patient_id
+            FROM (SELECT ae.tenant_id,
+                         ae.ID                                                             AS encounter_id,
+                         ae.status_enum                                                    AS status_enum,
+                         ae.bus_no                                                         AS bus_no,
+                         ap.bus_no                                                         AS patient_bus_no,
+                         ae.start_time                                                     AS in_hospital_time,
+                         (EXTRACT(DAY FROM (CURRENT_DATE - ae.start_time)) :: INTEGER + 1) AS in_hospital_days,
+                         ae.end_time                                                       AS out_hospital_time,
+                         ap.ID                                                             AS patient_id,
+                         ap.NAME                                                           AS patient_name,
+                         ap.gender_enum                                                    AS gender_enum,
+                         ap.birth_date                                                     AS birth_date,
+                         alw.NAME                                                          AS ward_name,
+                         alh.NAME                                                          AS house_name,
+                         alb.NAME                                                          AS bed_name,
+                         aelb.start_time                                                   AS in_org_time,
+                         ao.id                                                             AS in_hospital_org_id,
+                         ao.NAME                                                           AS in_hospital_org_name,
+                         aa.id                                                             AS account_id,
+                         aa.contract_no                                                    AS contract_no,
+                         fc.contract_name                                                  AS contract_name,
+                         ccd.NAME                                                          AS reg_diagnosis_name
+                  FROM adm_encounter AS ae
+                           LEFT JOIN adm_patient AS ap ON ap.ID = ae.patient_id
+                      AND ap.delete_flag = '0'
+                           LEFT JOIN adm_organization AS ao ON ao.ID = ae.organization_id
+                      AND ao.delete_flag = '0'
+                           LEFT JOIN adm_encounter_location AS aelw ON aelw.encounter_id = ae.ID
+                      AND aelw.delete_flag = '0'
+                      AND aelw.form_enum = #{wardEnum}
+                      AND aelw.status_enum = #{encounterActivityStatus}
+                           LEFT JOIN adm_location AS alw ON alw.ID = aelw.location_id
+                      AND alw.delete_flag = '0'
+                           LEFT JOIN adm_encounter_location AS aelh ON aelh.encounter_id = ae.ID
+                      AND aelh.delete_flag = '0'
+                      AND aelh.form_enum = #{houseEnum}
+                      AND aelh.status_enum = #{encounterActivityStatus}
+                           LEFT JOIN adm_location AS alh ON alh.ID = aelh.location_id
+                      AND alh.delete_flag = '0'
+                           LEFT JOIN adm_encounter_location AS aelb ON aelb.encounter_id = ae.ID
+                      AND aelb.delete_flag = '0'
+                      AND aelb.form_enum = #{bedEnum}
+                      AND aelb.status_enum = #{encounterActivityStatus}
+                           LEFT JOIN adm_location AS alb ON alb.ID = aelb.location_id
+                      AND alb.delete_flag = '0'
+                           INNER JOIN adm_account AS aa ON aa.encounter_id = ae.ID
+                      AND aa.delete_flag = '0'
+                      AND aa.encounter_flag = 1
+                           LEFT JOIN fin_contract AS fc ON fc.bus_no = aa.contract_no
+                      AND fc.delete_flag = '0'
+                           LEFT JOIN adm_encounter_diagnosis AS aed ON aed.encounter_id = ae.ID
+                      AND aed.delete_flag = '0'
+                      AND aed.maindise_flag = #{maindiseFlag}
+                           LEFT JOIN cli_condition AS cc ON cc.ID = aed.condition_id
+                      AND cc.delete_flag = '0'
+                           LEFT JOIN cli_condition_definition AS ccd ON ccd.ID = cc.definition_id
+                      AND ccd.delete_flag = '0'
+                  WHERE ae.delete_flag = '0'
+                    AND ae.class_enum = #{classEnum}
+                    AND ae.status_enum != #{toBeRegistered}
+                    AND ae.status_enum != #{alreadySettled}
+                    AND ae.status_enum != #{registered}
+                    AND EXISTS(
+                      SELECT 1
+                      FROM adm_practitioner_role
+                      WHERE delete_flag = '0'
+                        AND practitioner_id = #{practitionerId}
+                        AND org_id = ae.organization_id
+                  )) AS rpmi
+            <if test="ew != null and ew.sqlSegment != null and ew.sqlSegment != ''">
+                WHERE ${ew.sqlSegment}
+            </if>
+            ORDER BY rpmi.patient_id, rpmi.encounter_id DESC
+        ) AS distinct_patients
+    </select>
+
+    <select id="getRegRequestBaseInfo" resultType="com.openhis.web.regdoctorstation.dto.RegRequestBaseDto">
+        (SELECT 1 AS advice_type,
+        T1.id AS request_id,
+        T1.id || '-1' AS unique_key,
+        T1.practitioner_id AS requester_id,
+        T1.create_time AS request_time,
+        CASE WHEN T1.practitioner_id = #{practitionerId} THEN '1' ELSE '0' END AS biz_request_flag,
+        T1.content_json AS content_json,
+        T1.skin_test_flag AS skin_test_flag,
+        T1.infusion_flag AS inject_flag,
+        T1.group_id AS group_id,
+        T2.NAME AS advice_name,
+        T3.total_volume AS volume,
+        T1.lot_number AS lot_number,
+        T1.quantity AS quantity,
+        T1.unit_code AS unit_code,
+        T1.status_enum AS status_enum,
+        T1.method_code AS method_code,
+        T1.rate_code AS rate_code,
+        T1.dose AS dose,
+        T1.dose_unit_code AS dose_unit_code,
+        T4.id AS charge_item_id,
+        T4.unit_price AS unit_price,
+        T4.total_price AS total_price,
+        T4.status_enum AS charge_status,
+        al.id AS position_id,
+        al.name AS position_name,
+        T1.dispense_per_duration AS dispense_per_duration,
+        T2.part_percent AS part_percent,
+        ccd.name AS condition_definition_name,
+        T1.effective_dose_start AS start_time,
+        T1.therapy_enum AS therapyEnum,
+        T1.sort_number AS sort_number,
+        T1.based_on_id AS based_on_id,
+        T1.medication_id AS advice_definition_id,
+        T1.effective_dose_end AS stop_time,
+        T1.update_by AS stop_user_name
+        FROM med_medication_request AS T1
+        LEFT JOIN med_medication_definition AS T2 ON T2.ID = T1.medication_id
+        AND T2.delete_flag = '0'
+        LEFT JOIN med_medication AS T3 ON T3.medication_def_id = T2.ID
+        AND T3.delete_flag = '0'
+        LEFT JOIN adm_charge_item AS T4 ON T4.service_id = T1.ID AND T4.delete_flag = '0' AND
+        T4.service_table = #{MED_MEDICATION_REQUEST}
+        LEFT JOIN adm_location AS al ON al.ID = T1.perform_location AND al.delete_flag = '0'
+        LEFT JOIN cli_condition AS cc ON cc.id = T1.condition_id AND cc.delete_flag = '0'
+        LEFT JOIN cli_condition_definition AS ccd ON ccd.id = cc.definition_id
+        WHERE T1.delete_flag = '0' AND T1.tcm_flag = 0 AND T1.generate_source_enum = #{generateSourceEnum}
+        <if test="historyFlag == '0'.toString()">
+            AND T1.encounter_id = #{encounterId}
+        </if>
+        <if test="historyFlag == '1'.toString()">
+            AND T1.patient_id = #{patientId} AND T1.encounter_id != #{encounterId}
+        </if>
+        AND T1.refund_medicine_id IS NULL
+        ORDER BY T1.status_enum,T1.sort_number,T1.group_id)
+        UNION ALL
+        (SELECT 2 AS advice_type,
+        T1.id AS request_id,
+        T1.id || '-2' AS unique_key,
+        T1.requester_id AS requester_id,
+        T1.create_time AS request_time,
+        CASE WHEN T1.requester_id = #{practitionerId} THEN '1' ELSE '0' END AS biz_request_flag,
+        T1.content_json AS content_json,
+        null AS skin_test_flag,
+        null AS inject_flag,
+        null AS group_id,
+        T2.NAME AS advice_name,
+        T2.SIZE AS volume,
+        T1.lot_number AS lot_number,
+        T1.quantity AS quantity,
+        T1.unit_code AS unit_code,
+        T1.status_enum AS status_enum,
+        '' AS method_code,
+        T1.rate_code AS rate_code,
+        NULL AS dose,
+        '' AS dose_unit_code,
+        T3.id AS charge_item_id,
+        T3.unit_price AS unit_price,
+        T3.total_price AS total_price,
+        T3.status_enum AS charge_status,
+        al.id AS position_id,
+        al.name AS position_name,
+        null AS dispense_per_duration,
+        T2.part_percent AS part_percent,
+        '' AS condition_definition_name,
+        2 AS therapyEnum,
+        99 AS sort_number,
+        T1.req_authored_time AS start_time,
+        T1.based_on_id AS based_on_id,
+        T1.device_def_id AS advice_definition_id,
+        NULL::timestamp AS stop_time,
+        '' AS stop_user_name
+        FROM wor_device_request AS T1
+        LEFT JOIN adm_device_definition AS T2 ON T2.ID = T1.device_def_id
+        AND T2.delete_flag = '0'
+        LEFT JOIN adm_charge_item AS T3
+        ON T3.service_id = T1.ID AND T3.delete_flag = '0' AND
+        T3.service_table = #{WOR_DEVICE_REQUEST}
+        LEFT JOIN adm_location AS al ON al.ID = T1.perform_location AND al.delete_flag = '0'
+        WHERE T1.delete_flag = '0' AND T1.generate_source_enum = #{generateSourceEnum}
+        <if test="historyFlag == '0'.toString()">
+            AND T1.encounter_id = #{encounterId}
+        </if>
+        <if test="historyFlag == '1'.toString()">
+            AND T1.patient_id = #{patientId} AND T1.encounter_id != #{encounterId}
+        </if>
+        AND T1.refund_device_id IS NULL
+        ORDER BY T1.status_enum)
+        UNION ALL
+        (SELECT CASE WHEN T1.category_enum IN (4, 24) THEN 6 ELSE 3 END AS advice_type,
+        T1.id AS request_id,
+        T1.id || '-3' AS unique_key,
+        T1.requester_id AS requester_id,
+        T1.create_time AS request_time,
+        CASE WHEN T1.requester_id = #{practitionerId} THEN '1' ELSE '0' END AS biz_request_flag,
+        T1.content_json AS content_json,
+        null AS skin_test_flag,
+        null AS inject_flag,
+        null AS group_id,
+        COALESCE(T2.NAME, T1.content_json::jsonb->>'surgeryName') AS advice_name,
+        '' AS volume,
+        '' AS lot_number,
+        T1.quantity AS quantity,
+        T1.unit_code AS unit_code,
+        T1.status_enum AS status_enum,
+        '' AS method_code,
+        '' AS rate_code,
+        NULL AS dose,
+        '' AS dose_unit_code,
+        T3.id AS charge_item_id,
+        T3.unit_price AS unit_price,
+        T3.total_price AS total_price,
+        T3.status_enum AS charge_status,
+        ao.id AS position_id,
+        ao.name AS position_name,
+        null AS dispense_per_duration,
+        1 AS part_percent,
+        '' AS condition_definition_name,
+        COALESCE(T1.therapy_enum, 2) AS therapyEnum,
+        99 AS sort_number,
+        T1.occurrence_start_time AS start_time,
+        T1.based_on_id AS based_on_id,
+        T1.activity_id AS advice_definition_id,
+        T1.occurrence_end_time AS stop_time,
+        T1.update_by AS stop_user_name
+        FROM wor_service_request AS T1
+        LEFT JOIN wor_activity_definition AS T2
+        ON T2.ID = T1.activity_id
+        AND T2.delete_flag = '0'
+        LEFT JOIN adm_charge_item AS T3 ON T3.service_id = T1.ID AND T3.delete_flag = '0' AND
+        T3.service_table = #{WOR_SERVICE_REQUEST}
+        LEFT JOIN adm_organization AS ao ON ao.ID = T1.org_id AND ao.delete_flag = '0'
+        WHERE T1.delete_flag = '0' AND T1.generate_source_enum = #{generateSourceEnum}
+        AND T1.parent_id IS NULL
+        <if test="historyFlag == '0'.toString()">
+            AND T1.encounter_id = #{encounterId}
+        </if>
+        <if test="historyFlag == '1'.toString()">
+            AND T1.patient_id = #{patientId} AND T1.encounter_id != #{encounterId}
+        </if>
+        ORDER BY T1.status_enum)
+    </select>
+
+    <select id="getAmount" resultType="com.openhis.web.inhospitalnursestation.dto.EncounterAccountDto">
+        SELECT final_res.id,
+               final_res.insutype,
+               final_res.encounter_id,
+               final_res.advance_amount,
+               final_res.total_amount,
+               final_res.balance_amount
+        FROM (SELECT aa.tenant_id,
+                     aa.id,
+                     aa.insutype,
+                     aa.encounter_id,
+                     aa.balance_amount AS advance_amount,
+                     COALESCE(
+                             SUM(CASE WHEN aci.status_enum IN (#{billed}, #{billable}) THEN aci.total_price ELSE 0 END),
+                             0)        AS total_amount,
+                     (
+                         aa.balance_amount
+                             - COALESCE(SUM(CASE
+                                                WHEN aci.status_enum IN (#{billed}, #{billable}) THEN aci.total_price
+                                                ELSE 0 END), 0)
+                             + COALESCE(SUM(CASE WHEN aci.status_enum = #{refunded} THEN aci.total_price ELSE 0 END), 0)
+                         )             AS balance_amount
+              FROM adm_account aa
+                       LEFT JOIN adm_charge_item aci
+                                 ON aa.encounter_id = aci.encounter_id
+                                     AND aci.delete_flag = '0'
+              WHERE aa.type_code = #{personalCashAccount}
+                AND aa.delete_flag = '0'
+              GROUP BY aa.tenant_id, aa.id, aa.insutype, aa.encounter_id, aa.balance_amount) AS final_res
+        <if test="ew != null and ew.sqlSegment != null and ew.sqlSegment != ''">
+            WHERE ${ew.sqlSegment}
+        </if>
+    </select>
+
+</mapper>
diff --git a/openhis-server-new/openhis-domain/src/main/resources/mapper/administration/EncounterDiagnosisMapper.xml b/openhis-server-new/openhis-domain/src/main/resources/mapper/administration/EncounterDiagnosisMapper.xml
index 59e8ac007..a297876df 100755
--- a/openhis-server-new/openhis-domain/src/main/resources/mapper/administration/EncounterDiagnosisMapper.xml
+++ b/openhis-server-new/openhis-domain/src/main/resources/mapper/administration/EncounterDiagnosisMapper.xml
@@ -27,6 +27,7 @@
           AND T1.delete_flag = '0'
           AND T2.delete_flag = '0'
           AND T1.tenant_id = #{tenantId}
+        LIMIT 1
     </select>
 
 </mapper>
\ No newline at end of file
diff --git a/sql/迁移记录-DB变更记录/20260529_fix_BUG#613_add_column_back_reason.sql b/sql/迁移记录-DB变更记录/20260529_fix_BUG#613_add_column_back_reason.sql
index 08f941cd5..e50ff420f 100644
--- a/sql/迁移记录-DB变更记录/20260529_fix_BUG#613_add_column_back_reason.sql
+++ b/sql/迁移记录-DB变更记录/20260529_fix_BUG#613_add_column_back_reason.sql
@@ -1,13 +1,17 @@
 -- Bug #613: 医嘱退回流程 — med_medication_request 表缺少退回原因字段
--- 执行前检查：如果列已存在则跳过
+-- 退回原因必填（NOT NULL），前端弹窗 + 后端都做校验
 DO $$
 BEGIN
     IF NOT EXISTS (
         SELECT 1 FROM information_schema.columns 
         WHERE table_name = 'med_medication_request' AND column_name = 'back_reason'
     ) THEN
-        ALTER TABLE med_medication_request ADD COLUMN back_reason VARCHAR(500) DEFAULT NULL;
-        COMMENT ON COLUMN med_medication_request.back_reason IS '退回原因';
+        ALTER TABLE med_medication_request ADD COLUMN back_reason VARCHAR(500) NOT NULL DEFAULT '';
+        COMMENT ON COLUMN med_medication_request.back_reason IS '退回原因（必填）';
+    ELSE
+        -- 列已存在，确保 NOT NULL
+        ALTER TABLE med_medication_request ALTER COLUMN back_reason SET NOT NULL;
+        ALTER TABLE med_medication_request ALTER COLUMN back_reason SET DEFAULT '';
     END IF;
 END
 $$;