rome criteria for diagnosing the irritable bowel syndrome

Predictive Value of the Rome Criteria

for Diagnosing the Irritable Bowel Syndrome

S.J.Vanner,M.D.,W.T.Depew,M.D.,W.G.Paterson,M.D.,L.R.DaCosta,M.D.,A.G.Groll,M.D., J.B.Simon,M.D.,and M.Djurfeldt,M.Sc.

GI Motility Education Centre,Queen’s University,Kingston,Ontario,Canada

OBJECTIVE:Our aim was to examine the predictive value of the Rome criteria and absence of so-called“red?ags”of clinical practice for diagnosing irritable bowel syndrome.Red ?ags were relevant abnormalities on physical examination, documented weight loss,nocturnal symptoms,blood in stools, history of antibiotic use,and family history of colon cancer. METHODS:In retrospective studies,98patients who had one or more Rome criteria and lacked red?ags were identi?ed by chart review of a1-yr period.In prospective studies,95 patients were identi?ed who met the Rome criteria and lacked red?ags.Sensitivity,speci?city,predictive value of Rome criteria,and absence of red?ags were determined. Consultant’s?nal diagnosis was the gold standard.Investi-gations before and after referral were recorded and reason for referral was determined in prospective studies. RESULTS:In the retrospective series,the Rome criteria and absence of red?ags had a sensitivity of65%,speci?city of 100%,and positive predictive value of100%.None of these patients required revision of their diagnosis during a2-yr follow-up.In the prospective study,the positive predictive value was98%.More than50%of the patients in this group had been referred because of diagnostic uncertainty and 24%had had an abdominal ultrasound;66%of those?45yr old underwent at least partial colonic evaluation. CONCLUSIONS:These?ndings suggest that the Rome crite-ria combined with a lack of red?ags have a very high predictive value for diagnosing irritable bowel syndrome. Application of these diagnostic criteria has the potential to alter utilization of health care resources.(Am J Gastroen-terol1999;94:2912–2917.?1999by Am.Coll.of Gastro-enterology)

INTRODUCTION

Irritable bowel syndrome(IBS)is a common disorder, which affects as many as15–20%of the general population in North America(1).Not all patients seek medical care,but about30%of patients who see their family doctor with gastrointestinal(GI)complaints have IBS(2).Some esti-mates suggest that next to the common cold,IBS and other functional GI disorders are the most common reason for absenteeism from work,and these disorders are responsible for as many as40%of referrals to general gastroenterology clinics(3).Not surprisingly,therefore,IBS places a major strain on the health care system.Recent estimates suggest that assessments and investigations of IBS may cost the US health care system as much as$6billion annually(4). The diagnosis of IBS is hampered by the absence of simple diagnostic tests.This can lead to uncertainty for patients and causes some physicians to approach IBS as a diagnosis of exclusion.This problem has stimulated the development of diagnostic criteria for making what is con-sidered a positive diagnosis.This approach originated with the Manning symptom criteria(5):pain eased with defeca-tion,pain associated with a change in the frequency of defecation,pain associated with a change in the consistency of defecation,abdominal distention,a feeling of incomplete evacuation after defecation,and mucus in the stool,al-though the latter two symptoms may be less predictive(6, 7).Evidence that this clustering of symptoms de?ned a distinct clinical entity was further supported by factor anal-ysis of community samples(6,7).The use of symptom criteria was modi?ed by Kruis et al.(8),who employed a scoring system based on historical features,physical exam-ination,and simple laboratory tests,but these latter criteria have proved cumbersome.Although the Manning criteria are widely accepted,some studies have questioned their pre-dictive value(9,10).In an effort to improve these diagnostic criteria,the symptom criteria were re?ned by a panel of international experts and called the Rome criteria(11,12). Although the Rome criteria are widely recommended for clinical use(3,13–15)and are employed in most current clinical studies of IBS,there are no data concerning their predictive value for diagnosing IBS.Therefore,the aim of this study was to determine the predictive value of these criteria for making the diagnosis of IBS.The use of so-called“red?ags”(e.g.,nocturnal symptoms,blood in stools, etc.)was incorporated into our study because these are also fundamental to the assessment of patients in day-to-day clinical practice.

MATERIALS AND METHODS

Retrospective and prospective studies were conducted on patients with abdominal symptoms referred to the general

T HE A MERICAN J OURNAL OF G ASTROENTEROLOGY Vol.94,No.10,1999?1999by Am.Coll.of Gastroenterology ISSN0002-9270/99/$20.00 Published by Elsevier Science Inc.PII S0002-9270(99)00493-1

GI clinics at Queen’s University.There are no community gastroenterologists within the immediate referral area, which minimized tertiary referral bias.Patients were as-sessed for the Rome criteria and for the absence of common red?ags in clinical practice(Table1).Perianal bleeding (blood streaked on the outside of the stool or on the tissue paper)was not considered to be a red?ag because it is very common in patients with IBS and usually is the result of hemorrhoidal bleeding.However,it was considered an in-dication for patients to undergo?exible sigmoidoscopy to con?rm the presence of hemorrhoids and absence of alter-native causes.

Retrospective Study

A review of384consecutive patients referred to a general GI clinic in1994was conducted.The listed presenting complaint was?rst examined;all patients were included who had a feature suggestive of IBS,such as abdominal pain,constipation,diarrhea,query gastrointestinal dysmo-tility,query malabsorption,query lactose intolerance,query in?ammatory bowel disease,etc.Patients with symptoms referable to the upper GI tract and those referred for colon screening and abnormal blood tests were excluded from further review.A chart review was then initiated for each patient and exclusion criteria were the patient having pre-viously diagnosed IBS or in?ammatory bowel disease;a past history of colon surgery;insuf?cient documentation or unclear?nal diagnosis by the consultant;the patient failed to keep their clinic appointment;or the chart could not be located.Eligible charts were then reviewed to identify pa-tients who lacked the red?ags and met the complete Rome criteria.The investigations were then recorded.True and false positives and the true and false negatives were deter-mined using the consultant’s?nal diagnosis as the gold standard.A2-yr follow-up was conducted on all true pos-itives.This was carried out by contacting the family doctor to determine if the diagnosis had required revision(87%)or by talking directly to the patient(13%).

Prospective Study

A standardized data entry form was used to identify95 patients referred to the general gastroenterology clinics over a9-month period in1995–1996who met the Rome criteria and lacked any red?ags.The reason for referral was iden-ti?ed from the referral letter and,if absent,by talking to the patient.Prior investigations were recorded and investiga-tions performed were left to the discretion of one of six attending gastroenterologists.All charts were then reviewed and the?nal diagnosis recorded.This diagnosis was the gold standard.

RESULTS

Retrospective Study

Review of the presenting complaints listed on the clinic schedule(Fig.1)and records of the initial clinic visit ex-cluded230of the384consecutive patients(see earlier). These included all patients whose complaints related to the upper GI tract and an additional36cases because of poor documentation or no?nal diagnosis listed(n?10),estab-lished in?ammatory bowel disease or IBS patients(n?10), previous colon surgery(n?3),failure to keep their ap-pointment(n?11),and inability to locate the chart(n?2). Fifty-six cases were then excluded because of the presence of one or more red?ag symptoms or signs.The remaining 98cases were then evaluated to determine if they met the complete Rome criteria,and the true and false positives and negatives were determined using the consultant’s?nal di-agnosis as the gold standard.Thirty-one percent(n?30) met the Rome criteria and all were true positives.Fifty-three percent(n?52)were true negatives but a signi?cant proportion(16%)were false negatives(n?16).The sen-sitivity of the Rome criteria combined with the absence of red?ags was65%,the speci?city was100%,the positive predictive value was100%,and the negative predictive value was76%.

The ages of the true positives(26women,four men) ranged from18to68yr.Forty-three percent(13/30)of the true positives had some imaging of their colon before re-ferral(?exible sigmoidoscopy alone?one,?exible sig-moidoscopy plus air contrast barium enema[ACBE]?three,ACBE alone?seven,colonoscopy?two),27% (8/30)had a complete blood count(CBC),and37%(11/30) had no tests.All patients who did not have some imaging of

Table1.Description of Rome Criteria(I)and(II)and Common Red Flags

Rome Criteria

Three months or more of continuous or recurrent

symptoms of:

(I)Abdominal pain or discomfort that is:

●Relieved with defecation

●And/or associated with a change in the frequency

of stool

●And/or associated with a change in consistency

of stool

AND

(II)Two or more of the following,at least25%of

occasions or days:

●Altered stool freqneucy(?3movements/day or

?3/wk)

●Altered stool form(lumpy and hard or loose and

watery)

●Altered stool passage(straining,urgency,tenesmus)

●Passage of mucus

●Bloating or feeling abdominal distension

Red Flags

●Documented weight loss

●Nocturnal symptoms

●Blood mixed in the stools

●Recent antibiotic use

●Family history of colon cancer

●Relevant abnormalities on physical examination 2913

AJG–October,1999IBS Diagnostic Criteria

their colon before referral had a minimum of a ?exible sigmoidoscopy performed by the consultants,except for one patient who refused.None of these investigations altered the diagnosis of IBS.Six patients also had a lactose hydrogen breath test,all of which were normal.In the 2-yr follow-up of the true positives (n ?30),documentation was obtained for 27patients.None of these patients required revision of their diagnosis.

The data were reanalyzed to examine the impact of the red ?ags.When the cases with red ?ags were included,six false positives were identi?ed.These were cases of Crohn’s disease (n ?1),ulcerative colitis (n ?2),rectal carcinoma (n ?1),and pseudomembranous colitis (n ?2).The role of the red ?ags alone was also examined by including the cases with red ?ags and dividing the cases into two groups (see Fig.1),based on the presence or absence of red ?ags rather than whether the Rome criteria were positive or negative.The sensitivity of one or more Rome criteria and the absence of red ?ags was 78%,the speci?city was 35%,and the positive predictive value was 47%.

Prospective Study

More than 50%of the 95patients who met the Rome criteria and lacked red ?ags were referred by their family doctor or specialist because of diagnostic uncertainty (Fig.2).Twen-ty-four percent had an abdominal ultrasound before their referral.The decision to order additional investigations was left to the discretion of the gastroenterologist.

The ages ranged from 17to 89yr (women ?86%,men ?14%).Analysis of investigations was separated into two age groups,those ?45yr and those ?45yr of age (Fig.

3).

Figure 1.Flow diagram demonstrating steps in retrospective anal-ysis of Rome criteria for determination of true and false positive and negatives.Investigations were conducted based on the clinical judgement of the clinician and the consultant’s ?nal diagnosis was the gold standard.Rome criteria and red ?ags are listed in Table 1.UGI ?upper

gastrointestinal.

Figure 2.Summary of reasons for referral from family practitio-ners and surgeons to gastroenterologist in the prospective studies.Reasons were determined from referral note and,if unclear,clar-i?ed by consultation with the patient.The majority of referrals were made because of diagnostic

uncertainty.

Figure 3.Summary of investigations of the colon conducted on patients aged ?45yr and ?45in prospective studies.Speci?c investigations were left to the discretion of the consultants.Some investigations were ordered by the referring https://www.wendangku.net/doc/bd8991101.html,plete colonic imaging was conducted by either air contrast barium en-ema with or without ?exible sigmoidoscopy or colonoscopy.

2914Vanner et al.AJG –Vol.94,No.10,1999

Almost all patients (91%)?45yr (n ?30/33)had their colon imaged either by ACBE or colonoscopy.Two patients declined investigation and one patient had a ?exible sig-moidoscopy.Only 45%of patients ?45yr of age had their colon imaged by either ACBE or colonoscopy.Sigmoidos-copy alone was carried out in 21%of subjects.Thirty-eight patients were referred without any previous imaging of the colon (age range 17–40yr,mean age 26yr).Six of these had a history of perianal bleeding and a ?exible sigmoid-oscopy was performed.One of these patients was found to have ulcerative proctitis.In the remaining 32patients who did not have perianal bleeding,the consultant did not image the colon with ?exible sigmoidoscopy,ACBE,or colonos-copy in 72%(n ?23).

The ?nal diagnosis for each patient was determined by chart review 2yr after the initial presentation.Ninety-three cases were true positives and two cases were false positives.One patient had perianal bleeding that was found to be due to ulcerative proctitis.Although perianal bleeding was not considered a red ?ag because hemorrhoidal bleeding is so common in this patient group,it was considered an indica-tion for a sigmoidoscopic assessment in all cases.The other false-positive patient was taking thyroid supplementation and blood tests demonstrated she was mildly hyperthyroid.Reduction in her thyroxin dose correlated with a signi?cant improvement in her symptoms.The positive predictive value of the Rome criteria plus the absence of red ?ags was 98%.

DISCUSSION

Diagnostic criteria to facilitate a positive diagnosis of IBS have evolved from the original Manning criteria (5)to the most recently established Rome criteria (11,12).The Rome criteria were established by an international Rome working committee (11,12),using expert opinion that relied on the Manning criteria (5)and to a lesser degree on the Kruis scoring system (8).The Rome criteria are recommended for use in clinical practice (3,13–15)and have been adopted by

the pharmaceutical industry to de?ne patient eligibility for IBS clinical trials.Despite their widespread use,they had not been validated for use in clinical practice.The results of both the retrospective and prospective series in this study suggest that the Rome criteria,combined with common red ?ags of clinical practice,have a very high positive predic-tive value for diagnosing IBS.

Although the Rome criteria have not been previously validated,a number of studies have examined the validity of the Manning criteria and Kruis scoring system for diagnos-ing IBS (Table 2).These studies show a considerable range in sensitivity (42–90%,and 47–81%,respectively)and speci?city (70–97%,and 91–99%,respectively)for both the Manning criteria and Kruis scoring system.Taken together,however,they suggest that these criteria have a relatively high speci?city but a signi?cantly lower sensitivity for IBS.Differences in sensitivity and speci?city depend in part upon whether four or six Manning criteria are applied (20)and upon the study populations examined.It has also been suggested that the Manning criteria are more speci?c for women than for men (21–23).Pain-related symptoms ap-pear to be similar for men and women but complaints of mucus,abdominal distention,incomplete evacuation,and scybala appear to be less commonly reported by men than women (23).The ?ndings of the present study suggest that the Rome criteria,combined with the absence of red ?ags,have as good or better positive predictive value than the Manning criteria or Kruis scoring system for diagnosing IBS.

The greater predictive value of the diagnostic criteria examined in the current study re?ects,at least in part,the red ?ag restrictions.It is generally accepted that the Rome criteria alone are more restrictive than the Manning criteria,particularly if all six Manning criteria are applied.The addition of red ?ags has further restricted the patient group,although many of these are incorporated into the Kruis scoring system (8).Indeed,when our retrospective data were analyzed without red ?ags,six false positives were found.The addition of the red ?ags,however,re?ects the

Table 2.Summary of Studies Examining the Validity of Diagnostic Criteria Symptom Criteria in Study N Sensitivity Speci?ty PPV Study,Year,Reference Manning 347

90%87%Dogan et al.1996(16)Manning ?Kruis 80%97%Manning 12367%83%Rao et al.1993(17)Manning ?3/617267%70%Jeong et al.1990(18)Manning 36142%85%Talley et al.1990(10)Manning ?3/410963%85%Smith 1992(19)Manning ?3/6

84%76%Talley 1992(20)47964%99%94%Kruis et al.1984(8)Kruis Kruis

1257M

47%94%54%Figerio et al.1992(9)F 60%95%82%Kruis

34781%91%Dogan et al.1996(16)Rome Retrospective 38463%

100%

100%Vanner et al.1999*

Prospective

95

98%

*Present study;M ?male;F ?female.

2915

AJG –October,1999IBS Diagnostic Criteria

day-to-day approach in clinical practice.Given these con-siderations,the?ndings of our study suggest that when the Rome criteria are positive when combined with the absence of red?ags,clinicians can make a diagnosis of IBS with a great deal of con?dence.When these criteria are not met, there will be still be cases that most gastroenterologists would ultimately consider to have IBS.

Although our data demonstrate that the red?ag restric-tions contribute to the high predictive value of the diagnostic criteria,they alone cannot account for this?nding.When the data were reanalyzed based on the presence and absence of red?ags rather than the Rome criteria,the sensitivity in-creased marginally,to78%from65%,but the speci?city and positive predictive values fell dramatically(100%to 35%and100%to47%,respectively).These?ndings dem-onstrate that the Rome criteria markedly enhance the diag-nostic accuracy beyond simply screening for the red?ags. Support for positive diagnostic criteria for IBS has also come from studies that examined whether the diagnosis required revision over time because of undetected organic disease(24–28).Misdiagnosis rates ranged from0to5%in these studies but unfortunately many of these results are dif?cult to interpret,either because clear diagnostic criteria were not used or because the investigations were not clear. In one prospective series,in which101patients met four Manning criteria and all patients initially received a sig-moidoscopy but only12%had an ACBE,5-yr follow-up found that none of the patients required revision of the diagnosis(24).In the present study,the2-yr follow-up of patients with positive Rome criteria combined with the absence of red?ags also failed to?nd any patients who required revision of the diagnosis.These data support the conclusion by many experts that when patients meet the Manning or Rome criteria and limited investigations are negative,the diagnosis of IBS seldom requires revision(26, 29).

The need for additional investigations in patients who meet the Rome or Manning criteria has received little formal evaluation.In the present study,additional investigations altered the diagnosis in two patients:one was found to have ulcerative proctitis but this patient had a history of perianal bleeding,an indication for additional tests;the other was an elderly patient taking thyroid supplements who proved to be hyperthyroid.One important but unknown variable was whether patients at the primary care level met our diagnostic criteria,but investigations demonstrated an alternative di-agnosis.Most experts recommend that patients?45–50yr of age who present with symptoms of IBS for the?rst time require colonic evaluation with either air contrast barium enema and?exible sigmoidoscopy or colonoscopy(14,15). These tests are advised to ensure that patients do not have colon cancer.Recommendations concerning the need for colon imaging in younger patients are less clear,ranging from no tests or a?exible sigmoidoscopy to a full colonic evaluation(14,15).In the current prospective study,34%of patients in the younger age group did not have any imaging of their colon.The absence of any?ndings in the patients investigated(except one patient with perianal bleeding found to have ulcerative proctitis;see earlier)supports the contention that these tests are not necessary in patients with positive Rome criteria and the absence of red?ags.Many experts would suggest that a screening CBC is suf?cient for patients?45yr of age,unless perianal bleeding is also present.For those physicians who argue that sigmoidoscopy may have therapeutic value,one alternative may be to ed-ucate the patients about the positive predictive value of the combined Rome criteria and absence of red?ags.

The results of this study suggest that,when a patient’s symptoms meet the Rome criteria and there are no red?ags, a diagnosis of IBS is very secure.The majority of patients in this study were referred because of diagnostic uncer-tainty.Our?ndings suggest that applying these diagnostic criteria in clinical practice has the potential to signi?cantly alter the utilization of health care resources. ACKNOWLEDGMENTS

The Canadian Association of Gastroenterology GI Motility Education Centre at Queen’s University is supported by an unrestricted educational grant from Janssen-Ortho Inc. (Canada).

Reprint requests and correspondence:S.J.Vanner,M.D.,GI Motility Education Centre,Hotel Dieu Hospital,166Brock Street, Kingston,Ontario Canada K7L5G2.

Received Oct.23,1998;accepted Mar.25,1999.

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Hibernate中Criteria的完整用法

QBE (Query By Example) Criteria cri = session.createCriteria(Student.class); cri.add(Example.create(s)); //s是一个Student对象 list cri.list(); 实质：创建一个模版，比如我有一个表serial有一个giftortoy字段，我设置serial.setgifttoy("2"), 则这个表中的所有的giftortoy为2的数据都会出来 2: QBC (Query By Criteria) 主要有Criteria,Criterion,Oder,Restrictions类组成 session = this.getSession(); Criteria cri = session.createCriteria(JdItemSerialnumber.class); Criterion cron = Restrictions.like("customer",name); cri.add(cron); list = cri.list(); ============================== 比较运算符 HQL运算符QBC运算符含义 = Restrictions.eq() 等于 <> Restrictions.not(Exprission.eq()) 不等于 > Restrictions.gt() 大于 >= Restrictions.ge() 大于等于 < Restrictions.lt() 小于 <= Restrictions.le() 小于等于 is null Restrictions.isnull() 等于空值 is not null Restrictions.isNotNull() 非空值 like Restrictions.like() 字符串模式匹配 and Restrictions.and() 逻辑与 and Restrictions.conjunction() 逻辑与 or Restrictions.or() 逻辑或 or Restrictions.disjunction() 逻辑或 not Restrictions.not() 逻辑非 in(列表) Restrictions.in() 等于列表中的某一个值 ont in(列表) Restrictions.not(Restrictions.in())不等于列表中任意一个值 between x and y Restrictions.between() 闭区间xy中的任意值 not between x and y Restrictions.not(Restrictions..between()) 小于值X或者大于值y 3: HQL String hql = "select https://www.wendangku.net/doc/bd8991101.html, ,avg(s.age) from Student s group by https://www.wendangku.net/doc/bd8991101.html,"; Query query = session.createQuery(hql); list = query.list(); .... 4: 本地SQL查询 session = sessionFactory.openSession(); tran = session.beginTransaction();

presentation evaluation criteria

Professional Studies Presentation Evaluation Criteria The numbers in the top of the boxes are points in a continuum. For example, you can assign 20 points for Organization. As long as you do not give more points than suggested in the leftmost box, the score will range between 0 and 100 when you add up the numbers. Organization (20%) 20 Consistently clear, concise, well organized. Points were easy to follow because of the organization. Transitions between sections smooth and coordinated. 15Usually clear, concise, well organized. Most of the presentation was easy to follow. Transitions between sections usually coordinated. 10Not always clear or concise. Organization was adequate, but weak. Occasionally wandered and was sometimes difficult to follow. Transitions between sections weak. 5Often unclear and disorganized, rambled too much. The presentation was confusing and difficult to follow. Transitions between sections awkward. Topic Knowledge (20%) 20Displayed an excellent grasp of the material. Demonstrated excellent mastery of content, application and implications. Excellent research depth. 15Displayed a general grasp of the material. Demonstrated good mastery of content, application and implications. Good research depth. 10Displayed some grasp of the material. Demonstrated adequate mastery of content, application and implications. Research not very deep. 5Displayed a poor grasp of the material. Demonstrated a superficial handling of content, application and implications. Little depth of research. Creativity (10%) 10Very creative and original. Imaginative design and use of materials. Novel handouts, visual aids, or methods. 8 Exhibited some originality and creativity. 5 Routine treatment, minimal thought given to originality or creativity. 3Lacked creativity. Very ordinary and mundane. Visual Aids (15%) 15Simple, clear, easy to interpret, easy to read. Well coordinated with content, well designed, used very effectively. Excellent example of how to prepare and use good visual aids 11Usually clear, easy to interpret, easy to read. Generally well coordinated with content, design was okay, generally used effectively. Demonstrated some understanding of how to use visual aids. 8 Marginally acceptable, too complex, crowded, difficult to read or interpret. Adequate coordination with content. Used only adequately. Showed little understanding of how to prepare and use visual aids. 4Poor quality visual aids (or none), hard to read, technically inaccurate, poorly constructed. Poor coordination with content. Used poorly. The presenter did not seem to know how to prepare or use visual aids effectively. Summary (15%) 15Clear, concise, major points emphasized, clear recommendations, strong conclusion or call for action. 11Referred to main points, recommendations weak or missing, weak conclusion or call for action. 8Vague mention of major points, no recommendations, weak conclusion, weak or no call for action. 4No summary, no recommendations, no conclusions, no call for action. Stage Presence (20%) 20 Excellent stage presence. Confident, used notes well, at ease, excellent gestures, good audience attention, good eye contact. 15Good stage presence. Fairly confident, used notes fairly well, good gestures, acceptable audience attention and eye contact. 10 Adequate stage presence. Read parts, fumbled with notes, several distracting mannerisms, minimal gestures, minimal eye contact, too many um=s. 5Poor stage presence. Unprepared, awkward, shuffled papers, poor eye contact, lots of um=s, turned from audience to read overheads, shuffled feet, fidgeted. Poor gestures. TOTAL POINTS COMMENTS:

Design Criteria

Design Criteria Building optimization must be followed by design criteria; these design criteria are given by the corresponding code. With the aim to determine the optimization criteria I personally have chosen the IBC 2013 Code with the corresponding related codes, such as ACI 318 and ASCE-7, concrete and load codes. Firstly we should determine the basic requirements for a high-rise building with shear wall structure and deep foundation as a foundation system, being this kind of building the objective of the study in situ. ?Building use and occupancy: (CHAPTER 3)Residential group R-2, residential occupancies containing sleeping units or more than two dwelling units where the occupants are primarily permanent in nature, including: Apartment houses, Boarding houses (non-transient), Convents, Dormitories, Fraternities and sororities, Hotels (non-transient), I Live/work units, Monasteries, Motels (non-transient), Vacation timeshare properties. ?Requirements based on occupancy:(CHAPTER 4) 1. For buildings not greater than 420 feet (128 m) in building height, the fire-resistance rating of the building elements in Type IA construction shall be permitted to be reduced to the minimum fire-resistance ratings for the building elements in Type IB. 2. In other than Group F-1, M and S-1 occupancies, the fire-resistance rating of the building elements in Type IB construction shall be permitted to be reduced to the fire-resistance ratings in Type IIA. 3. Bond strength:

criteria范文

criteria范文 我抄袭作业的原因是因为我想早点写完作业早点玩，谁都想玩，但是假如为了玩就抄 作业的话太不值了，现在玩只能玩一会，假如学习不好，以后找不着工作，没钱吃饭，还 谈的上玩吗我抄袭作业抱有一种作业是做给老师看的这种想法，其实根本不是，我们不 做作业，老师就不用批改作业，反而更轻松。所以，作业是为自己做的，我这么想辜负了 老师的一片好心，所以，我向老师表现出深深地歉意! One point is clear that different issues have different objective criteria. For example, criteria of price talking will include factors of cost, market situation, depreciation, price competition and other necessary factors. In other negotiations, exper ts’ opinions, international conventions and norms and legal documents will all serve as objective criteria. 为解决本人衣服无人洗，饭菜无人做，花钱无节制，生活无压力的现状，本人新引进 一招商项目，将于2020年02月20(26)日17时30分举行盛大的庆典活动，请亲朋好友准时参加! In the Sino—US negotiation on China’s accession into WTO, the two parties disputed over China’s developing country status. US took the position that China should be treated as a developed country. To back US stance, American negotiators cited China’s growing exports and large foreign reserve holdings. They a rgued that in developing countries China’s sophisticated technology in launching and retrieving satellites had no parallel. One American negotiator even compared the situation in China with that in India and some African countries. He said when he opened the door of a family in a poorest area randomly chosen by the Chinese government and asked the people if they had their breakfast, he was told they did, and he went on asking if lunch and supper were guaranteed, the answer was yes. However he had a very different story in some African countries and even in some areas in India. People there had little food for breakfast, not mention lunch and supper. The two countries insisted on their own standards and it was hard to bridge the discrepancy. Here the focus is which criterion to apply to for resolving the dispute. In fact there is a ready criterion provided by the World Bank, which is measured by per capita GNP. According to the World Bank’s standard, countries whose per capita GNP below $785 (1996) are the poorest countries. China’s per capita GNP in 1997 was $750, which is among the poorest countries. 甲方聘用乙方的月薪为_____元(含养老、医疗、住房公积金)。试用期满后，并经考 核合格，可根据平等协商的原则，签订正式劳动合同。

条件类Criteria的用法

复合查询主要是处理，具有关联关系的两个实体怎样进行关联查询，比如User 实体对象与Addres实体对象具有一对多的关联关系，我们可以如下构造 符合查询： Criteria criteria=session.createCriteria(User.class); Criteria addcriteria=criteria.createCriteria(“addresses”);(1) addcriteria.add(Express.like(“address”,”%tianjin%”)); List list=criteria.list(); for(int i=0;i User user=(User)list.get(i); System.out.println(user.getName()+”\n”); Set addresses=user.getAddresses(); Iterator it=addresses.iterator(); while(it.hasNext(){ Address address=(Address)it.next(); Syste m.out.println(address.getAddress()+”\n”); } } 当执行到了（1）处时，表明要针对User对象的addresses属性添加新的查询条件，因此当执行criteria.list()时，Hibernate会生成类似如下的SQL语句： Select * from user inner join address on user.id=address.id where address.address like …%shanghai%?; 正如我们所见，我们可以通过向Criteria中添加保存关联对象的集合属性（addresses属性保存与User对象相关联的Address对象），来构造复合查询，在数据库一端是通过内连接查询来实现。 Hibernate QBC查询 QBC查询：

criteria使用总结(目前只会单表)

Criteria的使用总结 1、目前只遇到用于单表查询（多表查询期待中。。。） public Integer getqueryTamArchivesCount(String content, String fileNumber, String fileType, Date beginDate,Date endDate){ DetachedCriteria criteria = DetachedCriteria .forClass(TamArch.class); if (content != null && content.trim().length() > 0) { //模糊匹配 criteria.add(Restrictions.like("subject", "%" + content + "%")); } if (fileNumber != null && fileNumber.trim().length() > 0) { //相等 criteria.add(Restrictions.eq("archivesNo", fileNumber)); } if ("1".equals(fileType)) { //或者 criteria.add(Restrictions.or(Restrictions.eq("archivesStatus", "1"), Restrictions.eq("archivesStatus", "2"))); }else if("2".equals(fileType)){ criteria.add(Restrictions.eq("archivesStatus", "99")); } if(beginDate!=null&&endDate!=null){ //两者之间 criteria.add(Restrictions.between("issueDate",beginDate,endDate)); } //按日期降序排列 criteria.addOrder(Order.desc("inputDate")); return archDao.getRowCount(criteria) ; } 注意： ①对于日期有点bug，如果查询的日期为空，则查询不到数据。貌似日期为必填。 ②对于Restrictions.or：只能处理2种的情况 ③ //处理或情况（archivesStatus为2、3、99） criteria.add(Restrictions.in("archivesStatus", new Object[]{"2","3","99"}));

Criteria的几种查询方法使用

Criteria的几种查询方法使用 QBC常用限定方法 Restrictions.eq --> equal,等于. Restrictions.allEq --> 参数为Map对象,使用key/value进行多个等于的比对,相当于多个Restrictions.eq的效果 Restrictions.gt --> great-than > 大于 Restrictions.ge --> great-equal >= 大于等于 Restrictions.lt --> less-than, < 小于 Restrictions.le --> less-equal <= 小于等于 Restrictions.between --> 对应SQL的between子句 Restrictions.like --> 对应SQL的LIKE子句 Restrictions.in --> 对应SQL的in子句 Restrictions.and --> and 关系 Restrictions.or --> or 关系 Restrictions.isNull --> 判断属性是否为空,为空则返回true Restrictions.isNotNull --> 与isNull相反 Restrictions.sqlRestriction --> SQL限定的查询 Order.asc --> 根据传入的字段进行升序排序 Order.desc --> 根据传入的字段进行降序排序 MacthMode.EXACT :字符串精确匹配。相当于like …value? MathMode.ANYWHERE:字符串在中间匹配.相当于like …%value%? MathMode.START:字符串在最前端匹配位置.相当于:like …value%? MatchMode.END:字符串在最后端匹配.相当于:like …%value? 1.查询年龄在20-30之间的所有学生对象。 List list = session.createCriteria(Student.class) .add(Restrictions.between(“amout”,new BigDecimal(1),new BigDec imal(10)).list(); 2.查询S tudent名字开头有t的所有Student: List list = sesison.createCriteria(Student.class) .add(Restrictions.like(“name”,”t%”)).list(); 3.或者使用另一种查询Student名字开头有t的所有Student: List list = sesison.createCriteria(Student.class)

深入浅出Hibernate学习笔记 Criteria Query

本文是对深入浅出Hibernate学习做的学习笔记，是个人在对深入浅出Hibernate学习中的一点认识和看法，下边是具体的内容。 本文是对深入浅出Hibernate学习做的学习笔记，是个人在对深入浅出Hibernate学习中的一点认识和看法，下边是具体的内容。 Criteria Query通过面向对象的设计，将数据查询条件封装为一个对象。简单来说，Criteria Query可以看作是传统SQL的对象化表示，如： 1.Criteria criteria=session.createCriteria(TUser.class); 2.criteria.add(Expression.eq("name","Erica")); 3.criteria.add(Expression.eq("sex",new Integer(1)); 这里的criteria实例本质上是对SQL“select * from t_user where name='Erica' and sex=1”的封装。Hibernate在运行期会根据Criteria中指定的查询条件生成相应的SQL语句。 Criteria查询表达式：Criteria本身只是一个容器，具体的查询条件要通过Criteria.add方法添加到Criteria实例中。 方法描述：Expression.eq 对应SQL “field=value”表达式 如：Expression.eq("name","Erica") 4.Expression.allEq 参数为一个Map对象，其中包含了多个属性-值对应关系。相当于多个 Expression.eq关系的叠加 5.Expression.gt 对应SQL“field>value”表达式 6.Expression.ge 对应SQL“field>=v alue”表达式 7.Expression.lt 对应SQL“fieldfield” 14.Expression.gtProperty 用于比较两个属性之间的值，对应SQL“field>=field” 15.Expression.ltProperty 用于比较两个属性之间的值，对应SQL"field

Hibernate中Criteria的完整用法

最近在项目中使用Spring 和Hibernate 进行开发，有感于Criteria 比较好用，在查询方法设计上可以灵活的根据Criteria 的特点来方便地进行查询条件的组装。现在对Hibernate的Criteria 的用法进行总结： Hibernate 设计了CriteriaSpecification 作为Criteria 的父接口，下面提供了Criteria和DetachedCriteria 。 Criteria 和DetachedCriteria 的主要区别在于创建的形式不一样，Criteria 是在线的，所以它是由Hibernate Session 进行创建的；而DetachedCriteria 是离线的，创建时无需 Session，DetachedCriteria 提供了 2 个静态方法forClass(Class) 或forEntityName(Name) 进行DetachedCriteria 实例的创建。Spring 的框架提供了getHibernateTemplate ().findByCriteria(detachedCriteria) 方法可以很方便地根据DetachedCriteria 来返回查询结 果。 Criteria 和DetachedCriteria 均可使用Criterion 和Projection 设置查询条件。可以设 置FetchMode( 联合查询抓取的模式) ，设置排序方式。对于Criteria 还可以设置FlushModel （冲刷Session 的方式）和LockMode （数据库锁模式）。 下面对Criterion 和Projection 进行详细说明。 Criterion 是Criteria 的查询条件。Criteria 提供了add(Criterion criterion) 方法来 添加查询条件。

Criteria用法详解

hibernate:Hibernate中Criteria的完整使用方法 疯狂代码 https://www.wendangku.net/doc/bd8991101.html,/ ?:http:/https://www.wendangku.net/doc/bd8991101.html,/Java/Article58225.html 最近在项目中使用 Spring 和 Hibernate 进行开发有感于 Criteria 比较好用在查询思路方法设计上可以灵活根据 Criteria 特点来方便地进行查询条件组装现在对 HibernateCriteria 使用方法进行整理总结: Hibernate 设计了 CriteriaSpecication 作为 Criteria 父接口下面提供了 Criteria和DetachedCriteria Criteria 和 DetachedCriteria 主要区别在于创建形式不样 Criteria 是在线所以它是由 Hibernate Session 进行创建；而 DetachedCriteria 是离线创建时无需SessionDetachedCriteria 提供了 2 个静态思路方法forClass(Class) 或 forEntityName(Name) 进行DetachedCriteria 例子创建 Spring 框架提供了getHibernateTemplate.findByCriteria(detachedCriteria) 思路方法可以很方便地根据DetachedCriteria 来返回查询结果 Criteria 和 DetachedCriteria 均可使用 Criterion 和 Projection 设置查询条件可以设置 FetchMode( 联合查询抓取模式 ) 设置排序方式对于 Criteria 还可以设置 FlushModel(冲刷 Session 方式)和 LockMode (数据库锁模式) 下面对 Criterion 和 Projection 进行详细介绍说明 Criterion 是 Criteria 查询条件Criteria 提供了 add(Criterion criterion) 思路方法来添加查询条件 Criterion 接口主要实现包括: Example 、 Junction 和 SimpleExpression 而 Junction 实际使用是它两个子类 conjunction 和 disjunction 分别是使用 AND 和 OR 操作符进行来联结查询条件集合 Criterion 例子可以通过 Restrictions 工具类来创建Restrictions 提供了大量静态思路方法如 eq (等于)、ge (大于等于)、 between 等来思路方法创建 Criterion 查询条件 (SimpleExpression 例子)除此的外Restrictions 还提供了思路方法来创建 conjunction 和 disjunction 例子通过往该例子 add(Criteria) 思路方法来增加查询条件形成个查询条件集合 至于 Example 创建有所区别 Example 本身提供了个静态思路方法 create(Object entity) 即根据个对象(实际使用中般是映射到数据库对象)来创建然后可以设置些过滤条件: Example exampleUser =Example.create(u) .ignoreCase // 忽略大小写

CriteriaType【_or、子查询】的使用

CriteriaType _or 的使用 生成的语句： select * from (select this_.ID as ID13_0_, this_.USER_NAME as USER2_13_0_, this_.USER_ID as USER3_13_0_, this_.ORG_NAME as ORG4_13_0_, this_.ORG_ID as ORG5_13_0_, this_.DEPT_NAME as DEPT6_13_0_, this_.DEPT_ID as DEPT7_13_0_,

this_.USER_TITLE as USER8_13_0_, this_.APPRAISER_NAME as APPRAISER9_13_0_, this_.APPRAISER_ID as APPRAISER10_13_0_, this_.APPRAISER_TITLE as APPRAISER11_13_0_, this_.APPRAISER_MIND as APPRAISER12_13_0_, this_.REVIEW_DATE as REVIEW13_13_0_, this_.REVIEW_STATUS as REVIEW14_13_0_, this_.YEAR as YEAR13_0_, this_.BEGIN_DATE as BEGIN16_13_0_, this_.END_DATE as END17_13_0_, this_.CREATE_DATE as CREATE18_13_0_, this_.SIGN_DATE as SIGN19_13_0_, this_.SIGN_STATUS as SIGN20_13_0_, this_.POSITION_DESC as POSITION21_13_0_, this_.SCORE as SCORE13_0_, this_.CONTRACT_TYPE as CONTRACT23_13_0_, this_.DEL_FLAG as DEL24_13_0_ from PERF_PA_APRL_CONTRACT this_ where ((this_.ID in (select this0__.ID from PERF_PA_APRL_CONTRACT this0__ where this0__.USER_ID = ?) or this_.ID in (select this0__.ID from PERF_PA_APRL_CONTRACT this0__ where this0__.APPRAISER_ID = ?)) and this_.DEL_FLAG = ?)) where rownum <= ?

criteria的一些示例语句或方法

Criteria的一些语句范例（方法） 一、Criteria的一些基本查询 Criteria有一个方法add(“限定条件”)，这个方法可以添加限定条件，好得到自己应该要的查询结果；例如：有两个实体类，student和teacher已经有一个Criteria的关于Student 类的实例Criteria crit = session.createCriteria(Student.class)； 1）在一个班级中要查询姓“王”的学生都有谁，就可以这样:List list = crit.add(Restrictions.like(“name”,”王%”)).list(); 2）查询年龄在17-20之间的学生：List list = crit.add(Restrictions.between(“age”,new Integer(17),new Integer(20))).list(); 3）查询没有手机号码的学生：List list = crit.add(Restrictions.isNull(tel)).list(); 4）查询90后的学生：List list = crit.add(Restrictions.ge(new Date(1990-01-01)).list(); 5）查询考试分数在前十名的学生（可用于分页查询）：List list = crit.addOrder(Order.desc(“grades”)).setFirstResult(0).setMaxResult(10).list(); 6）查询学生小明的个人信息：crit.add(Restriction.eq(“name”,”小明”)).list().iterator().next(); 7）查询小明的化学教师的信息：crit.add(Restricrions.eq(“name”,”小明”)).createCriteria(“teacher_id”).add(Restrictions.equ(“subject”,”化 学”)).list().iterator().next(); 8）以上都是先创建session根据session得到Criteria的实体对象（即在线查询），下面来看看离线查询，离线查询用的是DetachedCriteria类，DetachedCriteria类使你 在一个session范围之外创建一个查询，并且可以使用任意的Session来执行它。 下面写还按照上面的条件，写一个例子吧： DetachedCriteria query = DetachedCriteria.forClass(Student.class) .add( Property.forName("name").eq("小明") ); Session session = Configuration().configure().buildSessionFactory().openSession; Transaction txn = session.beginTransaction(); List results = query.getExecutableCriteria(session).setMaxResults(100).list(); https://www.wendangku.net/doc/bd8991101.html,mit(); session.close(); 二、常用的一些基本的限定方法 Restrictions.eq --> equal,等于. Restrictions.allEq -->参数为Map对象,使用key/value进行多个等于的比对,相当于多个Restrictions.eq的效果 Restrictions.gt --> great-than >大于 Restrictions.ge --> great-equal >= 大于等于 Restrictions.lt --> less-than, <小于 Restrictions.le --> less-equal <= 小于等于 Restrictions.between -->对应SQL的between子句 Restrictions.like -->对应SQL的LIKE子句 Restrictions.in -->对应SQL的in子句 Restrictions.and --> and 关系