update str_consultation_note name = #{item.name}, sex = #{item.sex}, age = #{item.age}, bed_no = #{item.bedNo}, dept_name = #{item.deptName}, record_date = #{item.recordDate}, behospital_date = #{item.behospitalDate}, apply_dept = #{item.applyDept}, apply_doctor = #{item.applyDoctor}, apply_date = #{item.applyDate}, invite_type = #{item.inviteType}, invite_dept = #{item.inviteDept}, invite_doctor = #{item.inviteDoctor}, brief_note = #{item.briefNote}, diagnosis = #{item.diagnosis}, treatment_situation = #{item.treatmentSituation}, consultation_date = #{item.consultationDate}, consultation_purpose = #{item.consultationPurpose}, consultation_opinions = #{item.consultationOpinions}, rec_doctor = #{item.recDoctor}, rec_date = #{item.recDate}, audit_doctor = #{item.auditDoctor}, audit_date = #{item.auditDate}, whole_data = #{item.wholeData}, remark = #{item.remark}, gmt_modified = #{item.gmtModified}, modifier = #{item.modifier}, where rec_id = #{item.recId} and hospital_id = #{item.hospitalId} and behospital_code = #{item.behospitalCode}