In multi-center scenarios, One-Shot Federated Learning (OSFL) has attracted increasing attention due to its low communication overhead, requiring only a single round of transmission. However, existing generative model-based OSFL methods suffer from low training efficiency and potential privacy leakage in the healthcare domain. Additionally, achieving convergence within a single round of model aggregation is challenging under non-Independent and Identically Distributed (non-IID) data. To address these challenges, in this paper a modified OSFL framework is proposed, in which a new Feature-Guided Rectified Flow Model (FG-RF) and Dual-Layer Knowledge Distillation (DLKD) aggregation method are developed. FG-RF on the client side accelerates generative modeling in medical imaging scenarios while preserving privacy by synthesizing feature-level images rather than pixel-level images. To handle non-IID distributions, DLKD enables the global student model to simultaneously mimic the output logits and align the intermediate-layer features of client-side teacher models during aggregation. Experimental results on three non-IID medical imaging datasets show that our new framework and method outperform multi-round federated learning approaches, achieving up to 21.73% improvement, and exceeds the baseline FedISCA by an average of 21.75%. Furthermore, our experiments demonstrate that feature-level synthetic images significantly reduce privacy leakage risks compared to pixel-level synthetic images. The code is available at https://github.com/LMIAPC/one-shot-fl-medical.