select id,year,month,provice,city,unit,testitem,people,regis_time,eng_time,test_time,regis_notice,regis_notice_path,face_course,face_course_path,check_censoring_time,admission_regis_path,test_eng_time,check_grade_time from dede_examtime where 1=1 and provice like '湖南%' and testitem='医疗卫生' and city like '湘西州%' order by id DESC limit 40,20