insert into lab_result_re (jyrq, yq, ybh,xmdh,csjg) values (#{jyrq},#{yq},#{ybh},#{xmdh},#{csjg}) update lab_result_re xmdh = #{xmdh}, csjg = #{csjg}, and jyrq = #{jyrq} and yq = #{yq} and ybh = #{ybh} and xmdh = #{xmdh}