霍勇教授访谈——介入治疗准入制度及规范化管理任重而道远
发布于:2009-12-07 15:28
医心：霍主任您好，此次敦煌心血管病论坛上您的讲课内容为“中国心血管介入治疗准入制度及规范化管理”，您能谈谈该准入制度及规范化管理对于我国介入医生来说有哪些益处？该准入制度对于甘肃省的介入医生来说又有哪些特殊的意义？
霍勇教授：我们国家心血管介入诊疗规范化的工作启动于2003年，正式开始于2007年，卫生部公布了222号文件——《心血管疾病介入诊疗技术管理规范》，正是这个文件的颁布，全国各个地区都开展了心血管介入诊疗的规范化管理的工作。应当说我们国家无论是心血管介入诊疗的发展还是规范化工作的开展，都具有地区的不平衡性。在西北地区，可能这些工作总体上慢于内地的一些省份。在甘肃省，尽管从医生或者医院层面上也做了大量的工作，但是与行政管理部门还存在衔接问题。所以，以目前看来甘肃省心血管介入诊疗最基本的医疗机构和医生的准入到目前为止都没有完全开展，所以从这个角度来说还需要做一些工作。但是现在看来我们总体只要是按照卫生部的安排，应当说今年年底完成心血管介入诊疗第一步资质的准入应当是没有问题的，全国都要完成，我相信甘肃省也没有问题。但是在此次会议上介绍“中国心血管介入治疗准入制度及规范化管理”，总体来说对于甘肃省的心血管介入治疗的发展乃至对全国的发展都有意义。甘肃省现在正是处于心血管介入诊疗发展比较快的一个时期，医院开展的例数越来越多，医院从事这项工作的医生也越来越多，从这个层面上很好地进行规范化管理，对于该专业长久健康的发展有着重要的意义。
医心：目前这一制度已经颁布，相关工作的进展如何？对于如何能够让全国的介入医生严格地遵照制度的规定进行操作，您有哪些好的建议？卫生部对违反规定进行操作的医生将采取哪些惩罚措施呢？
霍勇教授：目前看来，按照卫生部心血管介入诊疗规范化管理的安排，全国已经逐渐在建立三项规范化的制度：一个是认证制度，对于医疗机构和人员进行资质认证；第二个是培训制度，对于要进入这个行业、从事这个行业的人员进行正规的规范化的培训；第三个是质量控制和指标监控的一个质控制度。这三个制度的建立显然为我们国家心血管介入诊疗规范化的总体工作构成了一个很好的框架，应当说到目前为止全世界没有任何一个国家能够像中国这样从国家层面上做到规范化管理。我相信卫生部和卫生部医政司，对于这些工作的开展是很积极认真很严肃的，实际上对于这三项制度的建立和以后工作的开展都有一个详细的计划，当然这个工作不可能一蹴而就。对于心血管介入而言又是一个相对专业性很强的行业，对于卫生部来说有些工作还是要慎重地、逐渐地推进。当然，要有严格的奖惩制度，做得好的要奖励，做得不好的要进行一定的惩戒或者处罚。但是到目前为止，我相信由于中国地域发展的不平衡，各个省的这种情况都有，因此，我们应当逐渐的把工作稳步的推展开。但是不是没有底线，实际上从现在来看要求各个省今年年底要完成所有的心血管介入诊疗准入的工作，明年的上半年重点要完成质量控制的工作，明年下半年重点完成第一期心血管介入诊疗培训基地的培训工作。这三步的安排为我们近期完善这个工作提供了重要的部署。
医心：随着药物洗脱支架的不断发展，广泛应用于冠心病患者，但是很多患者同时还合并糖尿病，因此，药物洗脱支架在糖尿病患者中应用的安全性成了大家讨论的热点问题，近期雅培公司的XIENCE PRIMETM和XIENCE V®获得欧盟的批准可以用于糖尿病患者，您是如何评价药物洗脱支架对于糖尿病患者的安全性问题？
霍勇教授：实际上对糖尿病患者无论任何一种介入的治疗方法比起那些没有糖尿病的患者它的效果都是差的，到目前为止无论是金属裸支架、药物洗脱支架，其对糖尿病的效果显然劣于没有糖尿病的患者，这和疾病本身是有关系的。但是，糖尿病患者不治疗预后更差，在药物洗脱支架这个层面上，许多的药物洗脱支架尽管与金属裸支架相比在非糖尿病的一些病变中显示很显著的优越性，但是一旦在糖尿病的患者中，它的优势就显著地减少或者说它的优势就不太明显。当然这里我认为更重要的是我们从总体来说，药物洗脱支架无论对有糖尿病还是没有糖尿病的患者都是适合的，总体的事件率是降低的，但只是糖尿病的患者获益相对小。鉴于这种情况的产生，应当说我们对糖尿病本身、对于糖尿病血管病变的这种认识可能还有值得探讨的地方。对于糖尿病的患者如何选择更适合的药物洗脱支架可能还是一个值得探讨的问题。XIENCE V®依维莫司洗脱支架的推出也同样反映这个问题，就是说它本身对于糖尿病的治疗效果也还是好的，只是于SPIRIT Ⅲ和SPIRIT Ⅳ这两项研究里面都能看出来对于糖尿病患者它和紫杉醇涂层的TAXUS支架相比得益差别不大。但这个事情要从两方面看，一方面是XIENCE V®包括所有的药物洗脱支架对于糖尿病的效果是比较差的，就像我刚才已经提到的。但是另一方面，在以往的研究中，我们不难发现TAXUS支架在糖尿病的患者中比起其他支架比如CYPHER支架，还是有自己的优势。在这两个研究中，XIENCE V®和TAXUS相比在糖尿病患者中差别不大，提示XIENCE V®支架在糖尿病患者中比起其它支架如CYPHER支架，也可能有其一定优势。但是对糖尿病的患者到底怎么治疗，尤其是牵扯到应用药物洗脱支架的时候哪种药物洗脱支架更为有效安全，这确实是值得进一步研究的问题。
来源： 医心网
上一篇：围手术期抗凝和抗血小板治疗的桥接
下一篇：黄从新教授专访
相关文章:
评论列表：（评论 6233 ）以下网友评论只代表网友个人观点，不代表本站观点。 2011-03-09 03:20:01 by: 匿名用户
comment5, <a href="http://phhy.unadw.2y.net/zx.html">In absentia health care north carolina</a>, [url="http://phhy.unadw.2y.net/zx.html"]In absentia health care north carolina[/url], http://phhy.unadw.2y.net/zx.html In absentia health care north carolina, ctte, <a href="http://tonolr.ddns-dvr.com/LAND+ROVER+DEALER+AMARILLO+TEXAS.html">Land rover dealer amarillo texas</a>, [url="http://tonolr.ddns-dvr.com/LAND+ROVER+DEALER+AMARILLO+TEXAS.html"]Land rover dealer amarillo texas[/url], http://tonolr.ddns-dvr.com/LAND+ROVER+DEALER+AMARILLO+TEXAS.html Land rover dealer amarillo texas, >:-((, <a href="http://chavet.minidns.net/douglas_james_hickey_nurse_ohio.html">Douglas james hickey nurse ohio</a>, [url="http://chavet.minidns.net/douglas_james_hickey_nurse_ohio.html"]Douglas james hickey nurse ohio[/url], http://chavet.minidns.net/douglas_james_hickey_nurse_ohio.html Douglas james hickey nurse ohio, 69095, <a href="http://speakhardd.ddns-dvr.com/refmett/">Ft lauderdale florida crisis councelors</a>, [url="http://speakhardd.ddns-dvr.com/refmett/"]Ft lauderdale florida crisis councelors[/url], http://speakhardd.ddns-dvr.com/refmett/ Ft lauderdale florida crisis councelors, 885826, <a href="http://saps.barscessb.2y.net/">Oregon real estate law hostile property</a>, [url="http://saps.barscessb.2y.net/"]Oregon real estate law hostile property[/url], http://saps.barscessb.2y.net/ Oregon real estate law hostile property, 8PPP, <a href="http://prunund.ddns-dvr.com/NEW+YORK+MESSENGER+COURIERS+LICENSE.html">New york messenger couriers license</a>, [url="http://prunund.ddns-dvr.com/NEW+YORK+MESSENGER+COURIERS+LICENSE.html"]New york messenger couriers license[/url], http://prunund.ddns-dvr.com/NEW+YORK+MESSENGER+COURIERS+LICENSE.html New york messenger couriers license, 877, <a href="http://chiorev.ddns-dvr.com/vintpur/ywnnw.html">Escrow signors in washington</a>, [url="http://chiorev.ddns-dvr.com/vintpur/ywnnw.html"]Escrow signors in washington[/url], http://chiorev.ddns-dvr.com/vintpur/ywnnw.html Escrow signors in washington, >:PP, <a href="http://mudpep.minidns.net/post_nj.html">Carols creations in north haven connecticut</a>, [url="http://mudpep.minidns.net/post_nj.html"]Carols creations in north haven connecticut[/url], http://mudpep.minidns.net/post_nj.html Carols creations in north haven connecticut, 86298, <a href="http://abfreqh.ddns-dvr.com/rumting/">Windsor colorado eastman park</a>, [url="http://abfreqh.ddns-dvr.com/rumting/"]Windsor colorado eastman park[/url], http://abfreqh.ddns-dvr.com/rumting/ Windsor colorado eastman park, jzzd, <a href="http://bandtworx.minidns.net/ohio_bmv_change_of_address.html">Ohio bmv change of address</a>, [url="http://bandtworx.minidns.net/ohio_bmv_change_of_address.html"]Ohio bmv change of address[/url], http://bandtworx.minidns.net/ohio_bmv_change_of_address.html Ohio bmv change of address, vrhu, <a href="http://cztl.barscessb.2y.net/tg.html">Car dealerships in rogers minnesota</a>, [url="http://cztl.barscessb.2y.net/tg.html"]Car dealerships in rogers minnesota[/url], http://cztl.barscessb.2y.net/tg.html Car dealerships in rogers minnesota, 274, <a href="http://ezqq.tintiol.2y.net/">Zip code parrish alabama</a>, [url="http://ezqq.tintiol.2y.net/"]Zip code parrish alabama[/url], http://ezqq.tintiol.2y.net/ Zip code parrish alabama, >:-OOO, <a href="http://neydisd.perl.sh/post_zj.html">Florida amateur radio traffic nets</a>, [url="http://neydisd.perl.sh/post_zj.html"]Florida amateur radio traffic nets[/url], http://neydisd.perl.sh/post_zj.html Florida amateur radio traffic nets, kmbfof, <a href="http://qwww.ddns-dvr.com/drenbin/knslo.html">A famous quote by george washington</a>, [url="http://qwww.ddns-dvr.com/drenbin/knslo.html"]A famous quote by george washington[/url], http://qwww.ddns-dvr.com/drenbin/knslo.html A famous quote by george washington, %-))), <a href="http://natenf.ddns-dvr.com/sibmo/">Off road adventures florence arizona</a>, [url="http://natenf.ddns-dvr.com/sibmo/"]Off road adventures florence arizona[/url], http://natenf.ddns-dvr.com/sibmo/ Off road adventures florence arizona, wuwm, <a href="http://inelq.ddns-dvr.com/STACIE+COLUMBUS+JO+MCKINNEY+HAIR+OHIO.html">Stacie columbus jo mckinney hair ohio</a>, [url="http://inelq.ddns-dvr.com/STACIE+COLUMBUS+JO+MCKINNEY+HAIR+OHIO.html"]Stacie columbus jo mckinney hair ohio[/url], http://inelq.ddns-dvr.com/STACIE+COLUMBUS+JO+MCKINNEY+HAIR+OHIO.html Stacie columbus jo mckinney hair ohio, imf, <a href="http://mudpep.minidns.net/post_fn.html">Lobster shipped from maine</a>, [url="http://mudpep.minidns.net/post_fn.html"]Lobster shipped from maine[/url], http://mudpep.minidns.net/post_fn.html Lobster shipped from maine, zusfhx, <a href="http://riofrothg.ddns-dvr.com/tipmai/yuvfe.html">Power sports in michigan</a>, [url="http://riofrothg.ddns-dvr.com/tipmai/yuvfe.html"]Power sports in michigan[/url], http://riofrothg.ddns-dvr.com/tipmai/yuvfe.html Power sports in michigan, 8-OOO, <a href="http://ppba.katzsil.2y.net/gd.html">St clements honolulu hawaii</a>, [url="http://ppba.katzsil.2y.net/gd.html"]St clements honolulu hawaii[/url], http://ppba.katzsil.2y.net/gd.html St clements honolulu hawaii, >:O, <a href="http://quwoodh.minidns.net/occupational_therapy_schools_in_louisiana.html">Occupational therapy schools in louisiana</a>, [url="http://quwoodh.minidns.net/occupational_therapy_schools_in_louisiana.html"]Occupational therapy schools in louisiana[/url], http://quwoodh.minidns.net/occupational_therapy_schools_in_louisiana.html Occupational therapy schools in louisiana, 506, <a href="http://sofbooksw.ddns-dvr.com/portri/xrvnb.html">Rhode island moped laws</a>, [url="http://sofbooksw.ddns-dvr.com/portri/xrvnb.html"]Rhode island moped laws[/url], http://sofbooksw.ddns-dvr.com/portri/xrvnb.html Rhode island moped laws, 0277, <a href="http://saylof.ddns-dvr.com/mindme/oxpnl.html">Michigan butterfly conservation class</a>, [url="http://saylof.ddns-dvr.com/mindme/oxpnl.html"]Michigan butterfly conservation class[/url], http://saylof.ddns-dvr.com/mindme/oxpnl.html Michigan butterfly conservation class, 954, <a href="http://zhco.spokneuc.2y.net/">Adult personals bryn mawr washington</a>, [url="http://zhco.spokneuc.2y.net/"]Adult personals bryn mawr washington[/url], http://zhco.spokneuc.2y.net/ Adult personals bryn mawr washington, mssthy, <a href="http://westconsd.minidns.net/post_fq.html">Tennessee river marina guide</a>, [url="http://westconsd.minidns.net/post_fq.html"]Tennessee river marina guide[/url], http://westconsd.minidns.net/post_fq.html Tennessee river marina guide, xqe, <a href="http://subkew.ddns-dvr.com/fapul/">Ski boat rental southern california</a>, [url="http://subkew.ddns-dvr.com/fapul/"]Ski boat rental southern california[/url], http://subkew.ddns-dvr.com/fapul/ Ski boat rental southern california, :-[[, <a href="http://klis.neydisd.2y.net/da.html">Train stations in stanford connecticut</a>, [url="http://klis.neydisd.2y.net/da.html"]Train stations in stanford connecticut[/url], http://klis.neydisd.2y.net/da.html Train stations in stanford connecticut, =), <a href="http://viecar.ddns-dvr.com/haeca/rbjyc.html">Geneology and barnes and pennsylvania</a>, [url="http://viecar.ddns-dvr.com/haeca/rbjyc.html"]Geneology and barnes and pennsylvania[/url], http://viecar.ddns-dvr.com/haeca/rbjyc.html Geneology and barnes and pennsylvania, 727, <a href="http://loworx.ddns-dvr.com/brower/qobpn.html">Bike rally iowa august 25</a>, [url="http://loworx.ddns-dvr.com/brower/qobpn.html"]Bike rally iowa august 25[/url], http://loworx.ddns-dvr.com/brower/qobpn.html Bike rally iowa august 25, %]],
2011-03-09 03:20:04 by: 匿名用户
comment5, <a href="http://codac.minidns.net/temporary_disability_aid_indiana.html">Temporary disability aid indiana</a>, [url="http://codac.minidns.net/temporary_disability_aid_indiana.html"]Temporary disability aid indiana[/url], http://codac.minidns.net/temporary_disability_aid_indiana.html Temporary disability aid indiana, 011571, <a href="http://killsar.minidns.net/post_aa.html">Steve king iowa voting record</a>, [url="http://killsar.minidns.net/post_aa.html"]Steve king iowa voting record[/url], http://killsar.minidns.net/post_aa.html Steve king iowa voting record, cjrfy, <a href="http://feimaz.ddns-dvr.com/TOYOTA+DEALERS+IN+HUNTINGTON+NEW+YORK.html">Toyota dealers in huntington new york</a>, [url="http://feimaz.ddns-dvr.com/TOYOTA+DEALERS+IN+HUNTINGTON+NEW+YORK.html"]Toyota dealers in huntington new york[/url], http://feimaz.ddns-dvr.com/TOYOTA+DEALERS+IN+HUNTINGTON+NEW+YORK.html Toyota dealers in huntington new york, ahj, <a href="http://renyl.minidns.net/post_qj.html">Robson optometrist athens texas</a>, [url="http://renyl.minidns.net/post_qj.html"]Robson optometrist athens texas[/url], http://renyl.minidns.net/post_qj.html Robson optometrist athens texas, tmize, <a href="http://barscessb.perl.sh/post_sk.html">Binghamton new york water storage</a>, [url="http://barscessb.perl.sh/post_sk.html"]Binghamton new york water storage[/url], http://barscessb.perl.sh/post_sk.html Binghamton new york water storage, :[[[, <a href="http://linknonf.ddns-dvr.com/hortio/">15 passenger van rental oklahoma city</a>, [url="http://linknonf.ddns-dvr.com/hortio/"]15 passenger van rental oklahoma city[/url], http://linknonf.ddns-dvr.com/hortio/ 15 passenger van rental oklahoma city, >:DDD, <a href="http://pmen.katzsil.2y.net/sw.html">Sunsets restaurant woodbury minnesota</a>, [url="http://pmen.katzsil.2y.net/sw.html"]Sunsets restaurant woodbury minnesota[/url], http://pmen.katzsil.2y.net/sw.html Sunsets restaurant woodbury minnesota, lcsvt, <a href="http://danin.minidns.net/post_zd.html">State of utah recorders office</a>, [url="http://danin.minidns.net/post_zd.html"]State of utah recorders office[/url], http://danin.minidns.net/post_zd.html State of utah recorders office, =[[[, <a href="http://goos.spokneuc.2y.net/rj.html">Educational opportunity center in washington dc</a>, [url="http://goos.spokneuc.2y.net/rj.html"]Educational opportunity center in washington dc[/url], http://goos.spokneuc.2y.net/rj.html Educational opportunity center in washington dc, %-)), <a href="http://ctpf.barscessb.2y.net/">Rick amos perry ohio</a>, [url="http://ctpf.barscessb.2y.net/"]Rick amos perry ohio[/url], http://ctpf.barscessb.2y.net/ Rick amos perry ohio, =-)), <a href="http://nauclesj.ddns-dvr.com/RETIREMENT+COMMUNITIES+IN+CONNECTICUT.html">Retirement communities in connecticut</a>, [url="http://nauclesj.ddns-dvr.com/RETIREMENT+COMMUNITIES+IN+CONNECTICUT.html"]Retirement communities in connecticut[/url], http://nauclesj.ddns-dvr.com/RETIREMENT+COMMUNITIES+IN+CONNECTICUT.html Retirement communities in connecticut, :[, <a href="http://tanmaz.ddns-dvr.com/over/yrfrb.html">Cow gap brady texas</a>, [url="http://tanmaz.ddns-dvr.com/over/yrfrb.html"]Cow gap brady texas[/url], http://tanmaz.ddns-dvr.com/over/yrfrb.html Cow gap brady texas, >:), <a href="http://natenf.ddns-dvr.com/cheybras/">Grand manor trailer park celina ohio</a>, [url="http://natenf.ddns-dvr.com/cheybras/"]Grand manor trailer park celina ohio[/url], http://natenf.ddns-dvr.com/cheybras/ Grand manor trailer park celina ohio, vimd, <a href="http://viecar.ddns-dvr.com/ctivig/hlvzv.html">Arkansas request for birth certificates</a>, [url="http://viecar.ddns-dvr.com/ctivig/hlvzv.html"]Arkansas request for birth certificates[/url], http://viecar.ddns-dvr.com/ctivig/hlvzv.html Arkansas request for birth certificates, vxy, <a href="http://tinggroutl.ddns-dvr.com/taiprud/nccnx.html">Usaa casualty insurance company in texas</a>, [url="http://tinggroutl.ddns-dvr.com/taiprud/nccnx.html"]Usaa casualty insurance company in texas[/url], http://tinggroutl.ddns-dvr.com/taiprud/nccnx.html Usaa casualty insurance company in texas, 1967, <a href="http://naluf.ddns-dvr.com/orook/">Virginia beach va and county</a>, [url="http://naluf.ddns-dvr.com/orook/"]Virginia beach va and county[/url], http://naluf.ddns-dvr.com/orook/ Virginia beach va and county, =DD, <a href="http://mtdg.neydisd.2y.net/">Climate fort leonard wood missouri</a>, [url="http://mtdg.neydisd.2y.net/"]Climate fort leonard wood missouri[/url], http://mtdg.neydisd.2y.net/ Climate fort leonard wood missouri, 8-))), <a href="http://bandtworx.minidns.net/spiders_poisonous_southern_oregon.html">Spiders poisonous southern oregon</a>, [url="http://bandtworx.minidns.net/spiders_poisonous_southern_oregon.html"]Spiders poisonous southern oregon[/url], http://bandtworx.minidns.net/spiders_poisonous_southern_oregon.html Spiders poisonous southern oregon, >:-))), <a href="http://ycvr.unadw.2y.net/">Stanley steemer new jersey</a>, [url="http://ycvr.unadw.2y.net/"]Stanley steemer new jersey[/url], http://ycvr.unadw.2y.net/ Stanley steemer new jersey, 2973, <a href="http://lystzuq.perl.sh/post_bb.html">Christian family campground wisconsin</a>, [url="http://lystzuq.perl.sh/post_bb.html"]Christian family campground wisconsin[/url], http://lystzuq.perl.sh/post_bb.html Christian family campground wisconsin, ejcgbs, <a href="http://tintiol.perl.sh/post_mf.html">Online pharmacy degree escalante utah</a>, [url="http://tintiol.perl.sh/post_mf.html"]Online pharmacy degree escalante utah[/url], http://tintiol.perl.sh/post_mf.html Online pharmacy degree escalante utah, 77311, <a href="http://barscessb.perl.sh/post_co.html">Washington state university in 1972</a>, [url="http://barscessb.perl.sh/post_co.html"]Washington state university in 1972[/url], http://barscessb.perl.sh/post_co.html Washington state university in 1972, 260368, <a href="http://pretvax.ddns-dvr.com/ARIZONA+BOATING+WATERSPORTS+2007.html">Arizona boating watersports 2007</a>, [url="http://pretvax.ddns-dvr.com/ARIZONA+BOATING+WATERSPORTS+2007.html"]Arizona boating watersports 2007[/url], http://pretvax.ddns-dvr.com/ARIZONA+BOATING+WATERSPORTS+2007.html Arizona boating watersports 2007, jkjvk,
2011-03-09 03:20:10 by: 匿名用户
comment1, <a href="http://enac.unadw.2y.net/xs.html">Sheridan california real estate investment property</a>, [url="http://enac.unadw.2y.net/xs.html"]Sheridan california real estate investment property[/url], http://enac.unadw.2y.net/xs.html Sheridan california real estate investment property, nypp, <a href="http://srod.arcank.2y.net/">Black point oyster bar oregon</a>, [url="http://srod.arcank.2y.net/"]Black point oyster bar oregon[/url], http://srod.arcank.2y.net/ Black point oyster bar oregon, 508, <a href="http://pigasg.minidns.net/post_pj.html">Holiday inn rapid city south dakota</a>, [url="http://pigasg.minidns.net/post_pj.html"]Holiday inn rapid city south dakota[/url], http://pigasg.minidns.net/post_pj.html Holiday inn rapid city south dakota, >:-O, <a href="http://deskkan.perl.sh/post_cp.html">Motel 8 anderson california</a>, [url="http://deskkan.perl.sh/post_cp.html"]Motel 8 anderson california[/url], http://deskkan.perl.sh/post_cp.html Motel 8 anderson california, 78413, <a href="http://cwzt.katzsil.2y.net/bl.html">President s biography georgia perimeter college</a>, [url="http://cwzt.katzsil.2y.net/bl.html"]President s biography georgia perimeter college[/url], http://cwzt.katzsil.2y.net/bl.html President s biography georgia perimeter college, dniu, <a href="http://ntelapz.ddns-dvr.com/zapea/">Annotated code of maryland article 27</a>, [url="http://ntelapz.ddns-dvr.com/zapea/"]Annotated code of maryland article 27[/url], http://ntelapz.ddns-dvr.com/zapea/ Annotated code of maryland article 27, 06013, <a href="http://nesnerbr.minidns.net/the_realty_shoppe_darden_tennessee.html">The realty shoppe darden tennessee</a>, [url="http://nesnerbr.minidns.net/the_realty_shoppe_darden_tennessee.html"]The realty shoppe darden tennessee[/url], http://nesnerbr.minidns.net/the_realty_shoppe_darden_tennessee.html The realty shoppe darden tennessee, 30134, <a href="http://sirab.minidns.net/post_wm.html">Party boats atlantic highlands new jersey</a>, [url="http://sirab.minidns.net/post_wm.html"]Party boats atlantic highlands new jersey[/url], http://sirab.minidns.net/post_wm.html Party boats atlantic highlands new jersey, dfq, <a href="http://hrcb.rekriz.2y.net/">Agganis arena boston massachusetts</a>, [url="http://hrcb.rekriz.2y.net/"]Agganis arena boston massachusetts[/url], http://hrcb.rekriz.2y.net/ Agganis arena boston massachusetts, 263, <a href="http://ginonn.ddns-dvr.com/CAMPING+AT+LAKE+ARCADIA+OKLAHOMA.html">Camping at lake arcadia oklahoma</a>, [url="http://ginonn.ddns-dvr.com/CAMPING+AT+LAKE+ARCADIA+OKLAHOMA.html"]Camping at lake arcadia oklahoma[/url], http://ginonn.ddns-dvr.com/CAMPING+AT+LAKE+ARCADIA+OKLAHOMA.html Camping at lake arcadia oklahoma, 8O, <a href="http://tinggroutl.ddns-dvr.com/ospo/tgrnb.html">Sperryville virginia va houses for sale</a>, [url="http://tinggroutl.ddns-dvr.com/ospo/tgrnb.html"]Sperryville virginia va houses for sale[/url], http://tinggroutl.ddns-dvr.com/ospo/tgrnb.html Sperryville virginia va houses for sale, jqjt, <a href="http://paget.minidns.net/post_fs.html">Biodiesel price per gallon washington state</a>, [url="http://paget.minidns.net/post_fs.html"]Biodiesel price per gallon washington state[/url], http://paget.minidns.net/post_fs.html Biodiesel price per gallon washington state, ewhcw, <a href="http://arcank.perl.sh/post_dj.html">Fatal teen auto accidents in colorado</a>, [url="http://arcank.perl.sh/post_dj.html"]Fatal teen auto accidents in colorado[/url], http://arcank.perl.sh/post_dj.html Fatal teen auto accidents in colorado, %]], <a href="http://arcank.perl.sh/post_ec.html">Westgate times share florida</a>, [url="http://arcank.perl.sh/post_ec.html"]Westgate times share florida[/url], http://arcank.perl.sh/post_ec.html Westgate times share florida, 99408, <a href="http://bandtworx.minidns.net/adult_friends_in_west_richfield_ohio.html">Adult friends in west richfield ohio</a>, [url="http://bandtworx.minidns.net/adult_friends_in_west_richfield_ohio.html"]Adult friends in west richfield ohio[/url], http://bandtworx.minidns.net/adult_friends_in_west_richfield_ohio.html Adult friends in west richfield ohio, :-]], <a href="http://ginonn.ddns-dvr.com/GOLD+LEAF+GRAPHICS+IN+CENTRAL+FLORIDA.html">Gold leaf graphics in central florida</a>, [url="http://ginonn.ddns-dvr.com/GOLD+LEAF+GRAPHICS+IN+CENTRAL+FLORIDA.html"]Gold leaf graphics in central florida[/url], http://ginonn.ddns-dvr.com/GOLD+LEAF+GRAPHICS+IN+CENTRAL+FLORIDA.html Gold leaf graphics in central florida, 85739, <a href="http://neydisd.perl.sh/post_zg.html">State parks central florida</a>, [url="http://neydisd.perl.sh/post_zg.html"]State parks central florida[/url], http://neydisd.perl.sh/post_zg.html State parks central florida, mrr, <a href="http://viecar.ddns-dvr.com/wingou/katez.html">Marion county florida property appraisal</a>, [url="http://viecar.ddns-dvr.com/wingou/katez.html"]Marion county florida property appraisal[/url], http://viecar.ddns-dvr.com/wingou/katez.html Marion county florida property appraisal, uplu, <a href="http://fulboub.minidns.net/post_db.html">Female mutilation case in atlanta georgia</a>, [url="http://fulboub.minidns.net/post_db.html"]Female mutilation case in atlanta georgia[/url], http://fulboub.minidns.net/post_db.html Female mutilation case in atlanta georgia, 959, <a href="http://ghpp.rekriz.2y.net/">Oregon and the occult</a>, [url="http://ghpp.rekriz.2y.net/"]Oregon and the occult[/url], http://ghpp.rekriz.2y.net/ Oregon and the occult, 906, <a href="http://reburr.ddns-dvr.com/PERRY+COUNTY+RECORDER+OHIO.html">Perry county recorder ohio</a>, [url="http://reburr.ddns-dvr.com/PERRY+COUNTY+RECORDER+OHIO.html"]Perry county recorder ohio[/url], http://reburr.ddns-dvr.com/PERRY+COUNTY+RECORDER+OHIO.html Perry county recorder ohio, 2590, <a href="http://faroomh.minidns.net/missouri_water_conservation_record_crappie.html">Missouri water conservation record crappie</a>, [url="http://faroomh.minidns.net/missouri_water_conservation_record_crappie.html"]Missouri water conservation record crappie[/url], http://faroomh.minidns.net/missouri_water_conservation_record_crappie.html Missouri water conservation record crappie, =]]], <a href="http://websig.ddns-dvr.com/MIDDLE+TOWNSHIP+NEW+JERSEY+RECREATION+PROGRAMS.html">Middle township new jersey recreation programs</a>, [url="http://websig.ddns-dvr.com/MIDDLE+TOWNSHIP+NEW+JERSEY+RECREATION+PROGRAMS.html"]Middle township new jersey recreation programs[/url], http://websig.ddns-dvr.com/MIDDLE+TOWNSHIP+NEW+JERSEY+RECREATION+PROGRAMS.html Middle township new jersey recreation programs, =-P, <a href="http://miegef.minidns.net/post_wl.html">Rick kane in naperville illinois</a>, [url="http://miegef.minidns.net/post_wl.html"]Rick kane in naperville illinois[/url], http://miegef.minidns.net/post_wl.html Rick kane in naperville illinois, 8556, <a href="http://sorpnordv.ddns-dvr.com/EASTERN+MICHIGAN+UNIVERSITY+FIGHT+SONG.html">Eastern michigan university fight song</a>, [url="http://sorpnordv.ddns-dvr.com/EASTERN+MICHIGAN+UNIVERSITY+FIGHT+SONG.html"]Eastern michigan university fight song[/url], http://sorpnordv.ddns-dvr.com/EASTERN+MICHIGAN+UNIVERSITY+FIGHT+SONG.html Eastern michigan university fight song, :-)), <a href="http://fqmj.spokneuc.2y.net/du.html">Noblesville coffee and tea indiana</a>, [url="http://fqmj.spokneuc.2y.net/du.html"]Noblesville coffee and tea indiana[/url], http://fqmj.spokneuc.2y.net/du.html Noblesville coffee and tea indiana, 8505,
2011-03-09 04:24:01 by: 匿名用户
comment2, <a href="http://anmel.ddns-dvr.com/tanal/">Landmark nicknames in cleveland ohio</a>, [url="http://anmel.ddns-dvr.com/tanal/"]Landmark nicknames in cleveland ohio[/url], http://anmel.ddns-dvr.com/tanal/ Landmark nicknames in cleveland ohio, =))), <a href="http://galib.ddns-dvr.com/unfer/">Endangered or threatened plants in tennessee</a>, [url="http://galib.ddns-dvr.com/unfer/"]Endangered or threatened plants in tennessee[/url], http://galib.ddns-dvr.com/unfer/ Endangered or threatened plants in tennessee, =-DDD, <a href="http://killsar.minidns.net/post_no.html">Cobb county georgia court cases custody</a>, [url="http://killsar.minidns.net/post_no.html"]Cobb county georgia court cases custody[/url], http://killsar.minidns.net/post_no.html Cobb county georgia court cases custody, kna, <a href="http://loworx.ddns-dvr.com/guinan/dccds.html">Oberlin sally d florida</a>, [url="http://loworx.ddns-dvr.com/guinan/dccds.html"]Oberlin sally d florida[/url], http://loworx.ddns-dvr.com/guinan/dccds.html Oberlin sally d florida, pyejq, <a href="http://fucu.tintiol.2y.net/yp.html">Smoky mountain pizza boise idaho</a>, [url="http://fucu.tintiol.2y.net/yp.html"]Smoky mountain pizza boise idaho[/url], http://fucu.tintiol.2y.net/yp.html Smoky mountain pizza boise idaho, owt, <a href="http://sietib.ddns-dvr.com/olbay/njgma.html">Dental hygienist job outlook in colorado</a>, [url="http://sietib.ddns-dvr.com/olbay/njgma.html"]Dental hygienist job outlook in colorado[/url], http://sietib.ddns-dvr.com/olbay/njgma.html Dental hygienist job outlook in colorado, 556646, <a href="http://lelq.spokneuc.2y.net/">Dentists websites las vegas nevada</a>, [url="http://lelq.spokneuc.2y.net/"]Dentists websites las vegas nevada[/url], http://lelq.spokneuc.2y.net/ Dentists websites las vegas nevada, ezefh, <a href="http://nahasb.minidns.net/post_cw.html">Christine j diaz md massachusetts</a>, [url="http://nahasb.minidns.net/post_cw.html"]Christine j diaz md massachusetts[/url], http://nahasb.minidns.net/post_cw.html Christine j diaz md massachusetts, =]]], <a href="http://guisgarv.ddns-dvr.com/forna/">Florida adult civil patrol</a>, [url="http://guisgarv.ddns-dvr.com/forna/"]Florida adult civil patrol[/url], http://guisgarv.ddns-dvr.com/forna/ Florida adult civil patrol, 167962, <a href="http://nauclesj.ddns-dvr.com/TEMECULA+RIVERSIDE+COUNTY+CALIFORNIA+WINE+COUNTRY.html">Temecula riverside county california wine country</a>, [url="http://nauclesj.ddns-dvr.com/TEMECULA+RIVERSIDE+COUNTY+CALIFORNIA+WINE+COUNTRY.html"]Temecula riverside county california wine country[/url], http://nauclesj.ddns-dvr.com/TEMECULA+RIVERSIDE+COUNTY+CALIFORNIA+WINE+COUNTRY.html Temecula riverside county california wine country, 0190, <a href="http://senmingl.ddns-dvr.com/isic/">Thinning investments roseburg oregon</a>, [url="http://senmingl.ddns-dvr.com/isic/"]Thinning investments roseburg oregon[/url], http://senmingl.ddns-dvr.com/isic/ Thinning investments roseburg oregon, 718, <a href="http://mudpep.minidns.net/post_hq.html">Tooth colored fillings phoenix arizona</a>, [url="http://mudpep.minidns.net/post_hq.html"]Tooth colored fillings phoenix arizona[/url], http://mudpep.minidns.net/post_hq.html Tooth colored fillings phoenix arizona, 8543, <a href="http://nesnerbr.minidns.net/altec_services_in_arizona.html">Altec services in arizona</a>, [url="http://nesnerbr.minidns.net/altec_services_in_arizona.html"]Altec services in arizona[/url], http://nesnerbr.minidns.net/altec_services_in_arizona.html Altec services in arizona, 396381, <a href="http://vfhi.rekriz.2y.net/">Oklahoma cerebral palsy legal</a>, [url="http://vfhi.rekriz.2y.net/"]Oklahoma cerebral palsy legal[/url], http://vfhi.rekriz.2y.net/ Oklahoma cerebral palsy legal, 25073, <a href="http://unadw.perl.sh/post_er.html">Texas historically underutilized business</a>, [url="http://unadw.perl.sh/post_er.html"]Texas historically underutilized business[/url], http://unadw.perl.sh/post_er.html Texas historically underutilized business, vrwcna, <a href="http://speakhardd.ddns-dvr.com/hardgest/mevtz.html">Bull riding rodeo in ohio</a>, [url="http://speakhardd.ddns-dvr.com/hardgest/mevtz.html"]Bull riding rodeo in ohio[/url], http://speakhardd.ddns-dvr.com/hardgest/mevtz.html Bull riding rodeo in ohio, =]], <a href="http://ladaz.minidns.net/hotel_north_of_jackson_hole_wyoming.html">Hotel north of jackson hole wyoming</a>, [url="http://ladaz.minidns.net/hotel_north_of_jackson_hole_wyoming.html"]Hotel north of jackson hole wyoming[/url], http://ladaz.minidns.net/hotel_north_of_jackson_hole_wyoming.html Hotel north of jackson hole wyoming, 510576,
2011-03-09 04:24:02 by: 匿名用户
comment1, <a href="http://rvkk.lystzuq.2y.net/">Chevrolet dealer in liberty texas</a>, [url="http://rvkk.lystzuq.2y.net/"]Chevrolet dealer in liberty texas[/url], http://rvkk.lystzuq.2y.net/ Chevrolet dealer in liberty texas, yzdqx, <a href="http://riofrothg.ddns-dvr.com/rayser/zaiwd.html">Meteor shower 2008 illinois</a>, [url="http://riofrothg.ddns-dvr.com/rayser/zaiwd.html"]Meteor shower 2008 illinois[/url], http://riofrothg.ddns-dvr.com/rayser/zaiwd.html Meteor shower 2008 illinois, xeu, <a href="http://lunssaj.ddns-dvr.com/LARGEST+EARTHQUAKE+IN+OKLAHOMA.html">Largest earthquake in oklahoma</a>, [url="http://lunssaj.ddns-dvr.com/LARGEST+EARTHQUAKE+IN+OKLAHOMA.html"]Largest earthquake in oklahoma[/url], http://lunssaj.ddns-dvr.com/LARGEST+EARTHQUAKE+IN+OKLAHOMA.html Largest earthquake in oklahoma, 6325, <a href="http://linknonf.ddns-dvr.com/compcred/">Find ged records in california</a>, [url="http://linknonf.ddns-dvr.com/compcred/"]Find ged records in california[/url], http://linknonf.ddns-dvr.com/compcred/ Find ged records in california, :-OO, <a href="http://duxilh.ddns-dvr.com/lover/wdgtu.html">Ohio fish markets twinsburg ohio</a>, [url="http://duxilh.ddns-dvr.com/lover/wdgtu.html"]Ohio fish markets twinsburg ohio[/url], http://duxilh.ddns-dvr.com/lover/wdgtu.html Ohio fish markets twinsburg ohio, 79570, <a href="http://bandtworx.minidns.net/beaches_resorts_vacation_frisco_texas.html">Beaches resorts vacation frisco texas</a>, [url="http://bandtworx.minidns.net/beaches_resorts_vacation_frisco_texas.html"]Beaches resorts vacation frisco texas[/url], http://bandtworx.minidns.net/beaches_resorts_vacation_frisco_texas.html Beaches resorts vacation frisco texas, %P, <a href="http://lisigl.ddns-dvr.com/ctivig/">State farm maryland offices</a>, [url="http://lisigl.ddns-dvr.com/ctivig/"]State farm maryland offices[/url], http://lisigl.ddns-dvr.com/ctivig/ State farm maryland offices, rcngf, <a href="http://evsourn.ddns-dvr.com/provta/">Waterford estates richmond heights ohio</a>, [url="http://evsourn.ddns-dvr.com/provta/"]Waterford estates richmond heights ohio[/url], http://evsourn.ddns-dvr.com/provta/ Waterford estates richmond heights ohio, qbhz, <a href="http://deskkan.perl.sh/post_ep.html">Liberty missionary baptist association texas</a>, [url="http://deskkan.perl.sh/post_ep.html"]Liberty missionary baptist association texas[/url], http://deskkan.perl.sh/post_ep.html Liberty missionary baptist association texas, =O, <a href="http://chiorev.ddns-dvr.com/snoopor/kilzq.html">Movie 8 cinema greenwood indiana</a>, [url="http://chiorev.ddns-dvr.com/snoopor/kilzq.html"]Movie 8 cinema greenwood indiana[/url], http://chiorev.ddns-dvr.com/snoopor/kilzq.html Movie 8 cinema greenwood indiana, =-PPP, <a href="http://poee.lystzuq.2y.net/">Daystar employment agency dallas texas</a>, [url="http://poee.lystzuq.2y.net/"]Daystar employment agency dallas texas[/url], http://poee.lystzuq.2y.net/ Daystar employment agency dallas texas, 9231, <a href="http://tintiol.perl.sh/post_md.html">Chances houston texas hit by hurricane</a>, [url="http://tintiol.perl.sh/post_md.html"]Chances houston texas hit by hurricane[/url], http://tintiol.perl.sh/post_md.html Chances houston texas hit by hurricane, >:-]], <a href="http://inadr.minidns.net/allen_equipment_denver_colorado.html">Allen equipment denver colorado</a>, [url="http://inadr.minidns.net/allen_equipment_denver_colorado.html"]Allen equipment denver colorado[/url], http://inadr.minidns.net/allen_equipment_denver_colorado.html Allen equipment denver colorado, 6624, <a href="http://faroomh.minidns.net/streptococcal_macrolide_resistance_in_missouri.html">Streptococcal macrolide resistance in missouri</a>, [url="http://faroomh.minidns.net/streptococcal_macrolide_resistance_in_missouri.html"]Streptococcal macrolide resistance in missouri[/url], http://faroomh.minidns.net/streptococcal_macrolide_resistance_in_missouri.html Streptococcal macrolide resistance in missouri, :-)), <a href="http://bandtworx.minidns.net/new_dawn_dover_ohio.html">New dawn dover ohio</a>, [url="http://bandtworx.minidns.net/new_dawn_dover_ohio.html"]New dawn dover ohio[/url], http://bandtworx.minidns.net/new_dawn_dover_ohio.html New dawn dover ohio, tfv, <a href="http://fulboub.minidns.net/post_zy.html">Gordon food service traverse city michigan</a>, [url="http://fulboub.minidns.net/post_zy.html"]Gordon food service traverse city michigan[/url], http://fulboub.minidns.net/post_zy.html Gordon food service traverse city michigan, ajats,
最短5个字
医心微信 >
京公网安备 11010102002968号