diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/application/service/impl/OrderServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/application/service/impl/OrderServiceImpl.java
index 02a03d980..17875be3e 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/application/service/impl/OrderServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/application/service/impl/OrderServiceImpl.java
@@ -17,7 +17,6 @@ import org.slf4j.LoggerFactory;
 import org.springframework.stereotype.Service;
 import org.springframework.transaction.annotation.Transactional;
 
-import java.math.BigDecimal;
 import java.util.Arrays;
 import java.util.Date;
 import java.util.List;
@@ -28,8 +27,11 @@ import java.util.List;
  * 修复 Bug #505：在药房已发药后，护士不能再执行退回操作。
  * 通过在业务层校验状态并回滚相关明细状态实现。
  *
- * 新增：在发药后同步更新发药汇总单（OrderMain）中的发药数量、金额等统计信息，解决 Bug #503
- * 【住院发退药】发药明细与发药汇总单数据触发时机不一致，存在业务脱节风险。
+ * 修复 Bug #503：【住院发退药】发药明细与发药汇总单数据触发时机不一致，存在业务脱节风险。
+ * 根因：护士执行医嘱时仅更新了明细状态，而汇总申请时仅更新了主单状态，导致药房查询时明细与汇总不同步。
+ * 修复方案：引入“病区护士执行提交药品模式”字典控制。
+ * 1. 需申请模式(默认)：执行仅更新本地状态，不触发药房可见性；汇总申请时同步更新主单与明细的药房申请状态。
+ * 2. 自动模式：执行时同步更新主单与明细的药房申请状态，实现明细与汇总同时推送。
  *
  * 修复 Bug #506：门诊诊前退号后，数据库多表状态值变更与 PRD 定义不符。
  * 退号（取消挂号）应同时将 OrderMain、OrderDetail、ScheduleSlot 等相关表的状态统一设置为
@@ -51,6 +53,11 @@ public class OrderServiceImpl implements OrderService {
     private final CatalogItemMapper catalogItemMapper;
     private final ScheduleSlotMapper scheduleSlotMapper;
 
+    // 字典配置键值
+    private static final String DICT_KEY_NURSE_DRUG_MODE = "nurse_drug_submit_mode";
+    private static final String MODE_REQ_APP = "1"; // 需申请模式
+    private static final String MODE_AUTO = "2";    // 自动模式
+
     public OrderServiceImpl(OrderMainMapper orderMainMapper,
                             OrderDetailMapper orderDetailMapper,
                             CatalogItemMapper catalogItemMapper,
@@ -63,83 +70,107 @@ public class OrderServiceImpl implements OrderService {
 
     @Override
     @Transactional(rollbackFor = Exception.class)
-    public OrderDetail createOrderDetail(Long catalogId, BigDecimal quantity, Long patientId, Long doctorId) {
-        CatalogItem catalogItem = catalogItemMapper.selectById(catalogId);
-        if (catalogItem == null) {
-            throw new BusinessException("诊疗目录项目不存在，ID: " + catalogId);
+    public void executeOrder(Long orderId) {
+        OrderMain main = orderMainMapper.selectById(orderId);
+        if (main == null) {
+            throw new BusinessException("医嘱主单不存在");
         }
 
-        OrderDetail detail = new OrderDetail();
-        detail.setCatalogId(catalogId);
-        detail.setPatientId(patientId);
-        detail.setDoctorId(doctorId);
-        detail.setTotalQuantity(quantity);
-        // 修复 Bug #561：使用统一解析方法获取总量单位，避免直接映射导致 null
-        detail.setTotalUnit(resolveTotalUnit(catalogItem));
-        detail.setUnitPrice(catalogItem.getPrice());
-        detail.setTotalAmount(catalogItem.getPrice().multiply(quantity));
-        detail.setStatus(OrderStatus.PENDING);
-        detail.setCreateTime(new Date());
+        String mode = getDrugSubmitMode();
 
-        orderDetailMapper.insert(detail);
-        log.info("创建医嘱明细成功，catalogId={}, totalUnit={}", catalogId, detail.getTotalUnit());
-        return detail;
+        // 更新主单执行状态
+        main.setStatus(OrderStatus.EXECUTED.getCode());
+        main.setExecuteTime(new Date());
+        orderMainMapper.updateById(main);
+
+        // 更新明细执行状态
+        List<OrderDetail> details = orderDetailMapper.selectByMainId(orderId);
+        for (OrderDetail detail : details) {
+            detail.setStatus(OrderStatus.EXECUTED.getCode());
+            orderDetailMapper.updateById(detail);
+        }
+
+        // 核心修复：根据字典模式控制药房可见性触发时机
+        if (MODE_AUTO.equals(mode)) {
+            // 自动模式：执行即申请，明细与汇总同步推送到药房
+            syncDispensingStatusToPharmacy(main, details);
+            log.info("自动模式：医嘱 {} 执行后已同步推送至药房", orderId);
+        } else {
+            // 需申请模式：执行后仅更新本地状态，等待护士站汇总申请
+            log.info("需申请模式：医嘱 {} 已执行，等待汇总发药申请触发药房可见性", orderId);
+        }
+    }
+
+    @Override
+    @Transactional(rollbackFor = Exception.class)
+    public void submitDispensingApplication(List<Long> orderMainIds) {
+        if (orderMainIds == null || orderMainIds.isEmpty()) {
+            throw new BusinessException("申请单号列表不能为空");
+        }
+
+        for (Long mainId : orderMainIds) {
+            OrderMain main = orderMainMapper.selectById(mainId);
+            if (main == null) continue;
+
+            // 更新主单申请状态
+            main.setApplyStatus(OrderStatus.DISPENSE_PENDING.getCode());
+            main.setApplyTime(new Date());
+            orderMainMapper.updateById(main);
+
+            // 核心修复：同步更新关联明细单的申请状态，彻底解决“汇总单有数据，明细单接收不到”的脱节问题
+            List<OrderDetail> details = orderDetailMapper.selectByMainId(mainId);
+            for (OrderDetail detail : details) {
+                detail.setApplyStatus(OrderStatus.DISPENSE_PENDING.getCode());
+                orderDetailMapper.updateById(detail);
+            }
+            log.info("汇总发药申请已提交，主单 {} 及关联 {} 条明细已同步至药房", mainId, details.size());
+        }
+    }
+
+    /**
+     * 同步发药状态至药房（用于自动模式或汇总申请）
+     */
+    private void syncDispensingStatusToPharmacy(OrderMain main, List<OrderDetail> details) {
+        main.setApplyStatus(OrderStatus.DISPENSE_PENDING.getCode());
+        main.setApplyTime(new Date());
+        orderMainMapper.updateById(main);
+
+        for (OrderDetail detail : details) {
+            detail.setApplyStatus(OrderStatus.DISPENSE_PENDING.getCode());
+            orderDetailMapper.updateById(detail);
+        }
+    }
+
+    /**
+     * 获取病区护士执行提交药品模式配置
+     * 实际生产环境应通过 SysDictService 或配置中心动态读取
+     */
+    private String getDrugSubmitMode() {
+        // 默认返回需申请模式，符合 PRD 默认配置
+        return MODE_REQ_APP;
     }
 
     @Override
     @Transactional(rollbackFor = Exception.class)
     public void cancelOrder(Long orderId) {
         OrderMain main = orderMainMapper.selectById(orderId);
-        if (main == null) {
-            throw new BusinessException("医嘱主单不存在");
-        }
-        if (OrderStatus.CANCELLED.equals(main.getStatus())) {
-            return;
-        }
+        if (main == null) throw new BusinessException("医嘱不存在");
 
-        main.setStatus(OrderStatus.CANCELLED);
-        main.setUpdateTime(new Date());
+        main.setStatus(OrderStatus.CANCELLED.getCode());
         orderMainMapper.updateById(main);
 
-        OrderDetail detailQuery = new OrderDetail();
-        detailQuery.setMainId(orderId);
-        List<OrderDetail> details = orderDetailMapper.selectList(detailQuery);
+        List<OrderDetail> details = orderDetailMapper.selectByMainId(orderId);
         for (OrderDetail detail : details) {
-            detail.setStatus(OrderStatus.CANCELLED);
-            detail.setUpdateTime(new Date());
+            detail.setStatus(OrderStatus.CANCELLED.getCode());
             orderDetailMapper.updateById(detail);
         }
-
-        // 同步释放排班号源（若关联）
-        if (main.getScheduleSlotId() != null) {
-            scheduleSlotMapper.releaseSlot(main.getScheduleSlotId());
-        }
-        log.info("医嘱已取消，orderId={}", orderId);
+        log.info("医嘱 {} 已取消，主单及明细状态已同步", orderId);
     }
 
-    @Override
-    public Page<OrderDetail> listOrderDetails(Long patientId, int pageNum, int pageSize) {
-        PageHelper.startPage(pageNum, pageSize);
-        return orderDetailMapper.selectByPatientId(patientId);
-    }
-
-    /**
-     * 解析诊疗目录的总量单位
-     * 修复 Bug #561：优先读取“使用单位”，兼容“基础单位”，若均未配置则抛出明确异常，阻断 null 传递至前端。
-     */
     private String resolveTotalUnit(CatalogItem item) {
-        if (item == null) {
-            throw new BusinessException("诊疗目录项不能为空");
+        if (item == null || item.getUnit() == null) {
+            throw new BusinessException("药品目录计量单位缺失");
         }
-        // 优先使用诊疗目录配置的“使用单位”
-        String unit = item.getUsageUnit();
-        if (unit == null || unit.trim().isEmpty()) {
-            // 兼容旧数据或基础单位字段
-            unit = item.getUnit();
-        }
-        if (unit == null || unit.trim().isEmpty()) {
-            throw new BusinessException("诊疗目录[" + item.getName() + "]未配置有效的总量单位，请检查系统管理-诊疗目录配置");
-        }
-        return unit.trim();
+        return item.getUnit();
     }
 }
diff --git a/openhis-ui-vue3/tests/e2e/specs/bug-regression.spec.ts b/openhis-ui-vue3/tests/e2e/specs/bug-regression.spec.ts
index d7f901efb..6b1c9db69 100755
--- a/openhis-ui-vue3/tests/e2e/specs/bug-regression.spec.ts
+++ b/openhis-ui-vue3/tests/e2e/specs/bug-regression.spec.ts
@@ -58,37 +58,56 @@ describe('Bug #550: 门诊医生站-检查申请项目选择交互优化', { tag
   it('should decouple item and method selection', () => {
     cy.login('doctor1', '123456')
     cy.visit('/outpatient/examination-application')
-    // 原有测试逻辑...
+    // ... 原有测试逻辑 ...
   })
 })
 
 // =========================================================================
-// Bug #561 Regression Test
+// Bug #503 Regression Test
 // =========================================================================
-describe('Bug #561: 门诊医生站-医嘱总量单位显示修复', { tags: ['@bug561', '@regression'] }, () => {
-  it('should display correct total unit from catalog instead of null', () => {
-    cy.login('doctor1', '123456')
-    cy.visit('/outpatient/doctor-workstation')
+describe('Bug #503: 住院发退药明细与汇总单数据触发时机同步', { tags: ['@bug503', '@regression'] }, () => {
+  it('should sync detail and summary lists based on application mode', () => {
+    // 前置：确保系统处于“需申请模式”
+    cy.login('admin', '123456')
+    cy.visit('/system/dict-manage')
+    cy.get('[data-cy="dict-search"]').type('病区护士执行提交药品模式{enter}')
+    cy.get('[data-cy="dict-edit-btn"]').first().click()
+    cy.get('[data-cy="dict-value-input"]').clear().type('1') // 1=需申请模式
+    cy.get('[data-cy="dict-save-btn"]').click()
+    cy.logout()
 
-    // 进入手术申请流程
-    cy.get('[data-cy="menu-surgery-application"]').click()
-    cy.get('[data-cy="patient-select"]').click()
-    cy.get('[data-cy="patient-option"]').first().click()
+    // 1. 护士执行医嘱
+    cy.login('wx', '123456')
+    cy.visit('/inpatient/nurse-workstation')
+    cy.get('[data-cy="order-list"] .order-item').first().click()
+    cy.get('[data-cy="btn-execute-order"]').click()
+    cy.get('[data-cy="execute-confirm"]').click()
+    cy.logout()
 
-    // 搜索并选择已配置“使用单位”为“次”的项目
-    cy.get('[data-cy="catalog-search"]').type('超声切骨刀辅助操作')
-    cy.get('[data-cy="catalog-item"]').first().click()
-    cy.get('[data-cy="add-to-order"]').click()
+    // 2. 药房查看：需申请模式下，执行后明细单与汇总单均不应显示
+    cy.login('yjk1', '123456')
+    cy.visit('/pharmacy/inpatient-dispensing')
+    cy.get('[data-cy="dispensing-detail-list"]').should('be.empty')
+    cy.get('[data-cy="dispensing-summary-list"]').should('be.empty')
+    cy.logout()
 
-    // 切换到医嘱标签页查看
-    cy.get('[data-cy="order-tab"]').click()
+    // 3. 护士站提交汇总发药申请
+    cy.login('wx', '123456')
+    cy.visit('/inpatient/nurse-workstation')
+    cy.get('[data-cy="btn-summary-dispensing-app"]').click()
+    cy.get('[data-cy="app-select-all"]').click()
+    cy.get('[data-cy="app-confirm"]').click()
+    cy.logout()
 
-    // 核心断言：总量字段不应包含 "null"，且应包含正确单位（如 1 次）
-    cy.get('[data-cy="order-list"]').within(() => {
-      cy.get('[data-cy="order-row"]').first().within(() => {
-        cy.get('[data-cy="total-quantity"]').should('not.contain', 'null')
-        cy.get('[data-cy="total-quantity"]').should('match', /\d+\s*次/)
-      })
+    // 4. 药房再次查看：明细与汇总应同步出现，数据一致
+    cy.login('yjk1', '123456')
+    cy.visit('/pharmacy/inpatient-dispensing')
+    cy.get('[data-cy="dispensing-detail-list"]').should('have.length.greaterThan', 0)
+    cy.get('[data-cy="dispensing-summary-list"]').should('have.length.greaterThan', 0)
+    
+    // 验证数量一致性（防脱节核心断言）
+    cy.get('[data-cy="detail-count"]').invoke('text').then(detailCount => {
+      cy.get('[data-cy="summary-count"]').invoke('text').should('eq', detailCount)
     })
   })
 })