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 testitem='医疗卫生' and regis_time like '2023%' and month='04' order by id DESC limit 580,20