INSERT INTO his_lab_request (patient_id, status, symptom, sign, related_result, create_time, del_flag)
VALUES (#{patientId}, #{status}, #{symptom}, #{sign}, #{relatedResult}, NOW(), 0)
UPDATE his_lab_request
SET symptom = #{symptom}, sign = #{sign}, related_result = #{relatedResult}, update_time = NOW()
WHERE id = #{id} AND del_flag = 0