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。 2011-03-24 05:12:40 by: 匿名用户
comment2, <a href="http://niad.nickfollx.cc.im/">Bia of superior california</a>, [url="http://niad.nickfollx.cc.im/"]Bia of superior california[/url], http://niad.nickfollx.cc.im/ Bia of superior california, 87324, <a href="http://tbay.roldiskp.cc.im/#wiki_#.html">Mormon church warrenton virginia</a>, [url="http://tbay.roldiskp.cc.im/#wiki_#.html"]Mormon church warrenton virginia[/url], http://tbay.roldiskp.cc.im/#wiki_#.html Mormon church warrenton virginia, 364449, <a href="http://rfmu.juehak.cc.im/#wiki_#.html">Kansas city state capital</a>, [url="http://rfmu.juehak.cc.im/#wiki_#.html"]Kansas city state capital[/url], http://rfmu.juehak.cc.im/#wiki_#.html Kansas city state capital, >:-[[, <a href="http://cmxh.juehak.cc.im/">Latino integration in pennsylvania</a>, [url="http://cmxh.juehak.cc.im/"]Latino integration in pennsylvania[/url], http://cmxh.juehak.cc.im/ Latino integration in pennsylvania, vqpsek, <a href="http://uqer.diotaic.cc.im/">Mobile spay neuter georgia</a>, [url="http://uqer.diotaic.cc.im/"]Mobile spay neuter georgia[/url], http://uqer.diotaic.cc.im/ Mobile spay neuter georgia, 996664, <a href="http://cqvq.mesguep.cc.im/">Realty in cloudcroft new mexico</a>, [url="http://cqvq.mesguep.cc.im/"]Realty in cloudcroft new mexico[/url], http://cqvq.mesguep.cc.im/ Realty in cloudcroft new mexico, :OOO, <a href="http://ygec.ostar.cc.im/">Hair schools in lee summit missouri</a>, [url="http://ygec.ostar.cc.im/"]Hair schools in lee summit missouri[/url], http://ygec.ostar.cc.im/ Hair schools in lee summit missouri, >:-[[[, <a href="http://qdpx.juehak.cc.im/">Screen porch installers in birmingham alabama</a>, [url="http://qdpx.juehak.cc.im/"]Screen porch installers in birmingham alabama[/url], http://qdpx.juehak.cc.im/ Screen porch installers in birmingham alabama, hms, <a href="http://obww.nickfollx.cc.im/#wiki_#.html">2007 toyota corolla california corona</a>, [url="http://obww.nickfollx.cc.im/#wiki_#.html"]2007 toyota corolla california corona[/url], http://obww.nickfollx.cc.im/#wiki_#.html 2007 toyota corolla california corona, %))), <a href="http://lrui.nickfollx.cc.im/">Middleburg heights ohio town hall</a>, [url="http://lrui.nickfollx.cc.im/"]Middleburg heights ohio town hall[/url], http://lrui.nickfollx.cc.im/ Middleburg heights ohio town hall, 840, <a href="http://nntk.esalp.cc.im/#wiki_#.html">Custom dog lead california</a>, [url="http://nntk.esalp.cc.im/#wiki_#.html"]Custom dog lead california[/url], http://nntk.esalp.cc.im/#wiki_#.html Custom dog lead california, >:PPP, <a href="http://nxre.chesstingj.cc.im/">Minor in possession nebraska</a>, [url="http://nxre.chesstingj.cc.im/"]Minor in possession nebraska[/url], http://nxre.chesstingj.cc.im/ Minor in possession nebraska, 739415, <a href="http://odvf.nickfollx.cc.im/#wiki_#.html">Things to do in navarre florida</a>, [url="http://odvf.nickfollx.cc.im/#wiki_#.html"]Things to do in navarre florida[/url], http://odvf.nickfollx.cc.im/#wiki_#.html Things to do in navarre florida, jhyih, <a href="http://wyzs.gertuab.cc.im/#wiki_#.html">Mail and more morgantown west virginia</a>, [url="http://wyzs.gertuab.cc.im/#wiki_#.html"]Mail and more morgantown west virginia[/url], http://wyzs.gertuab.cc.im/#wiki_#.html Mail and more morgantown west virginia, gftx, <a href="http://nwti.wakoj.cc.im/#wiki_#.html">Bertram for west virginia</a>, [url="http://nwti.wakoj.cc.im/#wiki_#.html"]Bertram for west virginia[/url], http://nwti.wakoj.cc.im/#wiki_#.html Bertram for west virginia, mvxhhq, <a href="http://lrrc.actov.cc.im/#wiki_#.html">Better business central ohio</a>, [url="http://lrrc.actov.cc.im/#wiki_#.html"]Better business central ohio[/url], http://lrrc.actov.cc.im/#wiki_#.html Better business central ohio, pxd, <a href="http://zlqj.noiregf.cc.im/">Canyon del oro police arizona</a>, [url="http://zlqj.noiregf.cc.im/"]Canyon del oro police arizona[/url], http://zlqj.noiregf.cc.im/ Canyon del oro police arizona, encdhj, <a href="http://lzet.harid.cc.im/">Newspapers lumberton north carolina</a>, [url="http://lzet.harid.cc.im/"]Newspapers lumberton north carolina[/url], http://lzet.harid.cc.im/ Newspapers lumberton north carolina, >:DDD,
2011-03-24 05:12:43 by: 匿名用户
comment2, <a href="http://goea.ostar.cc.im/">Crime rate farmington new mexico</a>, [url="http://goea.ostar.cc.im/"]Crime rate farmington new mexico[/url], http://goea.ostar.cc.im/ Crime rate farmington new mexico, %], <a href="http://nlnh.actov.cc.im/">Essence day spa idaho falls idaho</a>, [url="http://nlnh.actov.cc.im/"]Essence day spa idaho falls idaho[/url], http://nlnh.actov.cc.im/ Essence day spa idaho falls idaho, %OO, <a href="http://gszm.diotaic.cc.im/">United methodist pawnee illinois</a>, [url="http://gszm.diotaic.cc.im/"]United methodist pawnee illinois[/url], http://gszm.diotaic.cc.im/ United methodist pawnee illinois, 7565, <a href="http://pnio.mesguep.cc.im/">Disney parks disabled florida</a>, [url="http://pnio.mesguep.cc.im/"]Disney parks disabled florida[/url], http://pnio.mesguep.cc.im/ Disney parks disabled florida, kjb, <a href="http://yktd.diotaic.cc.im/#wiki_#.html">Lucas and basketball and kentucky</a>, [url="http://yktd.diotaic.cc.im/#wiki_#.html"]Lucas and basketball and kentucky[/url], http://yktd.diotaic.cc.im/#wiki_#.html Lucas and basketball and kentucky, >:(((, <a href="http://mazq.gertuab.cc.im/">Mountain west realtors silverton oregon</a>, [url="http://mazq.gertuab.cc.im/"]Mountain west realtors silverton oregon[/url], http://mazq.gertuab.cc.im/ Mountain west realtors silverton oregon, >:-PPP, <a href="http://lvux.rimworkz.cc.im/">The machine shop bar flint michigan</a>, [url="http://lvux.rimworkz.cc.im/"]The machine shop bar flint michigan[/url], http://lvux.rimworkz.cc.im/ The machine shop bar flint michigan, :(((, <a href="http://hicu.chesstingj.cc.im/#wiki_#.html">Julia hayes columbia south carolina nightclub</a>, [url="http://hicu.chesstingj.cc.im/#wiki_#.html"]Julia hayes columbia south carolina nightclub[/url], http://hicu.chesstingj.cc.im/#wiki_#.html Julia hayes columbia south carolina nightclub, 15602, <a href="http://hkzm.noiregf.cc.im/">Classic auto sales richfield utah</a>, [url="http://hkzm.noiregf.cc.im/"]Classic auto sales richfield utah[/url], http://hkzm.noiregf.cc.im/ Classic auto sales richfield utah, :OO, <a href="http://iojq.roldiskp.cc.im/">Phoenix arizona indoor swapmeet</a>, [url="http://iojq.roldiskp.cc.im/"]Phoenix arizona indoor swapmeet[/url], http://iojq.roldiskp.cc.im/ Phoenix arizona indoor swapmeet, ygy, <a href="http://uqfe.diotaic.cc.im/">Home foreclosures in indiana</a>, [url="http://uqfe.diotaic.cc.im/"]Home foreclosures in indiana[/url], http://uqfe.diotaic.cc.im/ Home foreclosures in indiana, iaawk, <a href="http://oggz.diotaic.cc.im/#wiki_#.html">Wisconsin dells discount booklet</a>, [url="http://oggz.diotaic.cc.im/#wiki_#.html"]Wisconsin dells discount booklet[/url], http://oggz.diotaic.cc.im/#wiki_#.html Wisconsin dells discount booklet, >:-[[, <a href="http://eeoq.diotaic.cc.im/">Chihuahua puppies in iowa</a>, [url="http://eeoq.diotaic.cc.im/"]Chihuahua puppies in iowa[/url], http://eeoq.diotaic.cc.im/ Chihuahua puppies in iowa, aufea, <a href="http://xvaa.esalp.cc.im/#wiki_#.html">Persian cat breeders in pennsylvania</a>, [url="http://xvaa.esalp.cc.im/#wiki_#.html"]Persian cat breeders in pennsylvania[/url], http://xvaa.esalp.cc.im/#wiki_#.html Persian cat breeders in pennsylvania, 2262, <a href="http://xsig.harid.cc.im/#wiki_#.html">Old town 14 theater arvada colorado</a>, [url="http://xsig.harid.cc.im/#wiki_#.html"]Old town 14 theater arvada colorado[/url], http://xsig.harid.cc.im/#wiki_#.html Old town 14 theater arvada colorado, %(((, <a href="http://tymi.diotaic.cc.im/">Maryland 4-h all stars</a>, [url="http://tymi.diotaic.cc.im/"]Maryland 4-h all stars[/url], http://tymi.diotaic.cc.im/ Maryland 4-h all stars, 924519, <a href="http://isrl.rimworkz.cc.im/">Augustines backstreet restaurant maine</a>, [url="http://isrl.rimworkz.cc.im/"]Augustines backstreet restaurant maine[/url], http://isrl.rimworkz.cc.im/ Augustines backstreet restaurant maine, ctc, <a href="http://xskn.roldiskp.cc.im/">Calvary baptist church ypsilanti michigan</a>, [url="http://xskn.roldiskp.cc.im/"]Calvary baptist church ypsilanti michigan[/url], http://xskn.roldiskp.cc.im/ Calvary baptist church ypsilanti michigan, :(((, <a href="http://kiii.ostar.cc.im/#wiki_#.html">Illinois state learning standards of english</a>, [url="http://kiii.ostar.cc.im/#wiki_#.html"]Illinois state learning standards of english[/url], http://kiii.ostar.cc.im/#wiki_#.html Illinois state learning standards of english, 4756, <a href="http://cxpj.wakoj.cc.im/">Washington local schools near toledo ohio</a>, [url="http://cxpj.wakoj.cc.im/"]Washington local schools near toledo ohio[/url], http://cxpj.wakoj.cc.im/ Washington local schools near toledo ohio, =-[[[, <a href="http://zekm.wakoj.cc.im/#wiki_#.html">Harrys country club kansas city</a>, [url="http://zekm.wakoj.cc.im/#wiki_#.html"]Harrys country club kansas city[/url], http://zekm.wakoj.cc.im/#wiki_#.html Harrys country club kansas city, azb, <a href="http://yjct.gertuab.cc.im/">Animal relief fund minnesota</a>, [url="http://yjct.gertuab.cc.im/"]Animal relief fund minnesota[/url], http://yjct.gertuab.cc.im/ Animal relief fund minnesota, 14612, <a href="http://ddbf.actov.cc.im/">Nbc 13 news in birmingham alabama</a>, [url="http://ddbf.actov.cc.im/"]Nbc 13 news in birmingham alabama[/url], http://ddbf.actov.cc.im/ Nbc 13 news in birmingham alabama, jogvjz, <a href="http://xsbb.juehak.cc.im/">Lakeland bus new jersey</a>, [url="http://xsbb.juehak.cc.im/"]Lakeland bus new jersey[/url], http://xsbb.juehak.cc.im/ Lakeland bus new jersey, hmmk, <a href="http://miaf.mesguep.cc.im/">Wisconsin legal age auto loans</a>, [url="http://miaf.mesguep.cc.im/"]Wisconsin legal age auto loans[/url], http://miaf.mesguep.cc.im/ Wisconsin legal age auto loans, 55273, <a href="http://qvsf.roetej.cc.im/#wiki_#.html">Kudl in kansas city</a>, [url="http://qvsf.roetej.cc.im/#wiki_#.html"]Kudl in kansas city[/url], http://qvsf.roetej.cc.im/#wiki_#.html Kudl in kansas city, vku, <a href="http://kxhf.roldiskp.cc.im/#wiki_#.html">Millwright jobs washington state</a>, [url="http://kxhf.roldiskp.cc.im/#wiki_#.html"]Millwright jobs washington state[/url], http://kxhf.roldiskp.cc.im/#wiki_#.html Millwright jobs washington state, sfu, <a href="http://nuel.chesstingj.cc.im/#wiki_#.html">State government sites for nevada</a>, [url="http://nuel.chesstingj.cc.im/#wiki_#.html"]State government sites for nevada[/url], http://nuel.chesstingj.cc.im/#wiki_#.html State government sites for nevada, xcf,
2011-03-24 05:59:41 by: 匿名用户
comment6, <a href="http://ylbk.diotaic.cc.im/">Tropical birds lafayette louisiana</a>, [url="http://ylbk.diotaic.cc.im/"]Tropical birds lafayette louisiana[/url], http://ylbk.diotaic.cc.im/ Tropical birds lafayette louisiana, 7257, <a href="http://hase.roldiskp.cc.im/">Town of warsaw new york police</a>, [url="http://hase.roldiskp.cc.im/"]Town of warsaw new york police[/url], http://hase.roldiskp.cc.im/ Town of warsaw new york police, qige, <a href="http://zofa.nickfollx.cc.im/#wiki_#.html">Allied interstate inc columbus ohio</a>, [url="http://zofa.nickfollx.cc.im/#wiki_#.html"]Allied interstate inc columbus ohio[/url], http://zofa.nickfollx.cc.im/#wiki_#.html Allied interstate inc columbus ohio, =)), <a href="http://bzqm.roetej.cc.im/#wiki_#.html">Wardrobe furniture made in oregon</a>, [url="http://bzqm.roetej.cc.im/#wiki_#.html"]Wardrobe furniture made in oregon[/url], http://bzqm.roetej.cc.im/#wiki_#.html Wardrobe furniture made in oregon, 921804, <a href="http://llfi.wakoj.cc.im/">Las vegas rochester minnesota airfare</a>, [url="http://llfi.wakoj.cc.im/"]Las vegas rochester minnesota airfare[/url], http://llfi.wakoj.cc.im/ Las vegas rochester minnesota airfare, >:P, <a href="http://hcis.harid.cc.im/">Parrothead club of virginia beach</a>, [url="http://hcis.harid.cc.im/"]Parrothead club of virginia beach[/url], http://hcis.harid.cc.im/ Parrothead club of virginia beach, :(((, <a href="http://wghd.gertuab.cc.im/">Gimme sum ontario california</a>, [url="http://wghd.gertuab.cc.im/"]Gimme sum ontario california[/url], http://wghd.gertuab.cc.im/ Gimme sum ontario california, 135033, <a href="http://txov.mesguep.cc.im/">Brighton colorado post office</a>, [url="http://txov.mesguep.cc.im/"]Brighton colorado post office[/url], http://txov.mesguep.cc.im/ Brighton colorado post office, bemwix, <a href="http://qaua.juehak.cc.im/">203 terrace drive wylie texas</a>, [url="http://qaua.juehak.cc.im/"]203 terrace drive wylie texas[/url], http://qaua.juehak.cc.im/ 203 terrace drive wylie texas, 9481, <a href="http://gvcc.roldiskp.cc.im/">Nobodys perfect b hannah montana</a>, [url="http://gvcc.roldiskp.cc.im/"]Nobodys perfect b hannah montana[/url], http://gvcc.roldiskp.cc.im/ Nobodys perfect b hannah montana, atibqo, <a href="http://yjvh.juehak.cc.im/">Turpin s florist in norfolk virginia</a>, [url="http://yjvh.juehak.cc.im/"]Turpin s florist in norfolk virginia[/url], http://yjvh.juehak.cc.im/ Turpin s florist in norfolk virginia, 07721, <a href="http://cphy.chesstingj.cc.im/">Patterson california real estate property listings</a>, [url="http://cphy.chesstingj.cc.im/"]Patterson california real estate property listings[/url], http://cphy.chesstingj.cc.im/ Patterson california real estate property listings, wxkvv, <a href="http://ijlh.nickfollx.cc.im/#wiki_#.html">Luminas for sale in iowa</a>, [url="http://ijlh.nickfollx.cc.im/#wiki_#.html"]Luminas for sale in iowa[/url], http://ijlh.nickfollx.cc.im/#wiki_#.html Luminas for sale in iowa, %DD, <a href="http://srsc.mesguep.cc.im/#wiki_#.html">Mark c serreze university of colorado</a>, [url="http://srsc.mesguep.cc.im/#wiki_#.html"]Mark c serreze university of colorado[/url], http://srsc.mesguep.cc.im/#wiki_#.html Mark c serreze university of colorado, 64786, <a href="http://qmrb.wakoj.cc.im/#wiki_#.html">Rooms for rent greeley colorado</a>, [url="http://qmrb.wakoj.cc.im/#wiki_#.html"]Rooms for rent greeley colorado[/url], http://qmrb.wakoj.cc.im/#wiki_#.html Rooms for rent greeley colorado, mnn, <a href="http://bnip.ostar.cc.im/#wiki_#.html">Dutch oven bakery ames iowa</a>, [url="http://bnip.ostar.cc.im/#wiki_#.html"]Dutch oven bakery ames iowa[/url], http://bnip.ostar.cc.im/#wiki_#.html Dutch oven bakery ames iowa, 6886, <a href="http://bref.roetej.cc.im/">Trinity seminary newburgh indiana</a>, [url="http://bref.roetej.cc.im/"]Trinity seminary newburgh indiana[/url], http://bref.roetej.cc.im/ Trinity seminary newburgh indiana, =-OO, <a href="http://kvcd.actov.cc.im/">Doctor illinois geriatric specialist</a>, [url="http://kvcd.actov.cc.im/"]Doctor illinois geriatric specialist[/url], http://kvcd.actov.cc.im/ Doctor illinois geriatric specialist, =)), <a href="http://thhk.actov.cc.im/#wiki_#.html">Oklahoma homes for retards</a>, [url="http://thhk.actov.cc.im/#wiki_#.html"]Oklahoma homes for retards[/url], http://thhk.actov.cc.im/#wiki_#.html Oklahoma homes for retards, npi, <a href="http://mdyt.roldiskp.cc.im/#wiki_#.html">Apartment for rent worcester massachusetts</a>, [url="http://mdyt.roldiskp.cc.im/#wiki_#.html"]Apartment for rent worcester massachusetts[/url], http://mdyt.roldiskp.cc.im/#wiki_#.html Apartment for rent worcester massachusetts, 0743, <a href="http://qxte.wakoj.cc.im/">Colorado adams-arapahoe district 28j</a>, [url="http://qxte.wakoj.cc.im/"]Colorado adams-arapahoe district 28j[/url], http://qxte.wakoj.cc.im/ Colorado adams-arapahoe district 28j, vqf,
2011-03-24 05:59:44 by: 匿名用户
comment3, <a href="http://vyaa.diotaic.cc.im/">Cristian colleges in missouri</a>, [url="http://vyaa.diotaic.cc.im/"]Cristian colleges in missouri[/url], http://vyaa.diotaic.cc.im/ Cristian colleges in missouri, %-P, <a href="http://ysle.rimworkz.cc.im/#wiki_#.html">Elementary hampshire nashua new school</a>, [url="http://ysle.rimworkz.cc.im/#wiki_#.html"]Elementary hampshire nashua new school[/url], http://ysle.rimworkz.cc.im/#wiki_#.html Elementary hampshire nashua new school, szeix, <a href="http://xztr.wakoj.cc.im/">Teacher of the visually impaired virginia</a>, [url="http://xztr.wakoj.cc.im/"]Teacher of the visually impaired virginia[/url], http://xztr.wakoj.cc.im/ Teacher of the visually impaired virginia, 18120, <a href="http://ztvt.noiregf.cc.im/#wiki_#.html">Kent county delaware association of realtors</a>, [url="http://ztvt.noiregf.cc.im/#wiki_#.html"]Kent county delaware association of realtors[/url], http://ztvt.noiregf.cc.im/#wiki_#.html Kent county delaware association of realtors, =], <a href="http://casb.nickfollx.cc.im/">Menlo park california alcoholics anonymous meetings</a>, [url="http://casb.nickfollx.cc.im/"]Menlo park california alcoholics anonymous meetings[/url], http://casb.nickfollx.cc.im/ Menlo park california alcoholics anonymous meetings, 23497, <a href="http://tgax.esalp.cc.im/">Texas institute massage ft worth</a>, [url="http://tgax.esalp.cc.im/"]Texas institute massage ft worth[/url], http://tgax.esalp.cc.im/ Texas institute massage ft worth, >:D, <a href="http://fmcw.diotaic.cc.im/">Altius health care utah</a>, [url="http://fmcw.diotaic.cc.im/"]Altius health care utah[/url], http://fmcw.diotaic.cc.im/ Altius health care utah, >:), <a href="http://ywij.chesstingj.cc.im/#wiki_#.html">Ryan lalonde vancouver washington</a>, [url="http://ywij.chesstingj.cc.im/#wiki_#.html"]Ryan lalonde vancouver washington[/url], http://ywij.chesstingj.cc.im/#wiki_#.html Ryan lalonde vancouver washington, %-], <a href="http://rcwq.noiregf.cc.im/#wiki_#.html">Paradise animal rescue michigan</a>, [url="http://rcwq.noiregf.cc.im/#wiki_#.html"]Paradise animal rescue michigan[/url], http://rcwq.noiregf.cc.im/#wiki_#.html Paradise animal rescue michigan, 39454, <a href="http://bgdn.roldiskp.cc.im/#wiki_#.html">Arkansas nominal tax rate</a>, [url="http://bgdn.roldiskp.cc.im/#wiki_#.html"]Arkansas nominal tax rate[/url], http://bgdn.roldiskp.cc.im/#wiki_#.html Arkansas nominal tax rate, %]]], <a href="http://xklr.rimworkz.cc.im/#wiki_#.html">Texas pool in plano</a>, [url="http://xklr.rimworkz.cc.im/#wiki_#.html"]Texas pool in plano[/url], http://xklr.rimworkz.cc.im/#wiki_#.html Texas pool in plano, 8-]], <a href="http://zwpx.mesguep.cc.im/#wiki_#.html">County realty waukesha wisconsin</a>, [url="http://zwpx.mesguep.cc.im/#wiki_#.html"]County realty waukesha wisconsin[/url], http://zwpx.mesguep.cc.im/#wiki_#.html County realty waukesha wisconsin, liat, <a href="http://jorn.roetej.cc.im/">Water front property texas</a>, [url="http://jorn.roetej.cc.im/"]Water front property texas[/url], http://jorn.roetej.cc.im/ Water front property texas, >:DD, <a href="http://foqb.esalp.cc.im/#wiki_#.html">Whitefish montana hockey tournament</a>, [url="http://foqb.esalp.cc.im/#wiki_#.html"]Whitefish montana hockey tournament[/url], http://foqb.esalp.cc.im/#wiki_#.html Whitefish montana hockey tournament, %[[, <a href="http://eyaq.harid.cc.im/">310 agency montgomery alabama</a>, [url="http://eyaq.harid.cc.im/"]310 agency montgomery alabama[/url], http://eyaq.harid.cc.im/ 310 agency montgomery alabama, ptj, <a href="http://twug.nickfollx.cc.im/#wiki_#.html">Arizona revised statutes r9</a>, [url="http://twug.nickfollx.cc.im/#wiki_#.html"]Arizona revised statutes r9[/url], http://twug.nickfollx.cc.im/#wiki_#.html Arizona revised statutes r9, 8-D, <a href="http://ifeq.rimworkz.cc.im/">Cenex harvest states minnesota</a>, [url="http://ifeq.rimworkz.cc.im/"]Cenex harvest states minnesota[/url], http://ifeq.rimworkz.cc.im/ Cenex harvest states minnesota, 950812, <a href="http://jjin.harid.cc.im/">The orchards the farm dublin ohio</a>, [url="http://jjin.harid.cc.im/"]The orchards the farm dublin ohio[/url], http://jjin.harid.cc.im/ The orchards the farm dublin ohio, =-]]], <a href="http://rmpz.actov.cc.im/#wiki_#.html">Arbor early learning florida</a>, [url="http://rmpz.actov.cc.im/#wiki_#.html"]Arbor early learning florida[/url], http://rmpz.actov.cc.im/#wiki_#.html Arbor early learning florida, %-)), <a href="http://tcuz.wakoj.cc.im/#wiki_#.html">State of washington auction</a>, [url="http://tcuz.wakoj.cc.im/#wiki_#.html"]State of washington auction[/url], http://tcuz.wakoj.cc.im/#wiki_#.html State of washington auction, 8[[[, <a href="http://nkkc.mesguep.cc.im/">Independent bookstores in southeast michigan</a>, [url="http://nkkc.mesguep.cc.im/"]Independent bookstores in southeast michigan[/url], http://nkkc.mesguep.cc.im/ Independent bookstores in southeast michigan, :-PP, <a href="http://vvou.wakoj.cc.im/">U s s missouri ball caps</a>, [url="http://vvou.wakoj.cc.im/"]U s s missouri ball caps[/url], http://vvou.wakoj.cc.im/ U s s missouri ball caps, =-PP, <a href="http://qybo.ostar.cc.im/">Map of florida turnpike</a>, [url="http://qybo.ostar.cc.im/"]Map of florida turnpike[/url], http://qybo.ostar.cc.im/ Map of florida turnpike, kfi, <a href="http://mfww.mesguep.cc.im/#wiki_#.html">Hwy 30a reality company florida</a>, [url="http://mfww.mesguep.cc.im/#wiki_#.html"]Hwy 30a reality company florida[/url], http://mfww.mesguep.cc.im/#wiki_#.html Hwy 30a reality company florida, :D,
2011-03-24 05:59:47 by: 匿名用户
comment2, <a href="http://pvdv.rimworkz.cc.im/">Maine oil distributors assoc</a>, [url="http://pvdv.rimworkz.cc.im/"]Maine oil distributors assoc[/url], http://pvdv.rimworkz.cc.im/ Maine oil distributors assoc, %PP, <a href="http://htev.wakoj.cc.im/#wiki_#.html">Thompson lake oxford maine</a>, [url="http://htev.wakoj.cc.im/#wiki_#.html"]Thompson lake oxford maine[/url], http://htev.wakoj.cc.im/#wiki_#.html Thompson lake oxford maine, 8(, <a href="http://uvex.noiregf.cc.im/#wiki_#.html">Retake the driving test illinois</a>, [url="http://uvex.noiregf.cc.im/#wiki_#.html"]Retake the driving test illinois[/url], http://uvex.noiregf.cc.im/#wiki_#.html Retake the driving test illinois, whw, <a href="http://borp.juehak.cc.im/#wiki_#.html">Alabama red state bumper sticker</a>, [url="http://borp.juehak.cc.im/#wiki_#.html"]Alabama red state bumper sticker[/url], http://borp.juehak.cc.im/#wiki_#.html Alabama red state bumper sticker, 885, <a href="http://vkhi.mesguep.cc.im/#wiki_#.html">Handball courts in beaverton oregon</a>, [url="http://vkhi.mesguep.cc.im/#wiki_#.html"]Handball courts in beaverton oregon[/url], http://vkhi.mesguep.cc.im/#wiki_#.html Handball courts in beaverton oregon, 688368, <a href="http://kacx.esalp.cc.im/">Cypress chirstian columbus ohio</a>, [url="http://kacx.esalp.cc.im/"]Cypress chirstian columbus ohio[/url], http://kacx.esalp.cc.im/ Cypress chirstian columbus ohio, 0838, <a href="http://isch.chesstingj.cc.im/">Delaware pet laws cat vaccinations</a>, [url="http://isch.chesstingj.cc.im/"]Delaware pet laws cat vaccinations[/url], http://isch.chesstingj.cc.im/ Delaware pet laws cat vaccinations, 65926, <a href="http://tyri.nickfollx.cc.im/#wiki_#.html">Stanley lake westminster colorado</a>, [url="http://tyri.nickfollx.cc.im/#wiki_#.html"]Stanley lake westminster colorado[/url], http://tyri.nickfollx.cc.im/#wiki_#.html Stanley lake westminster colorado, ihe, <a href="http://eurh.roetej.cc.im/">Amarillo texas motel reviews</a>, [url="http://eurh.roetej.cc.im/"]Amarillo texas motel reviews[/url], http://eurh.roetej.cc.im/ Amarillo texas motel reviews, prcyq, <a href="http://fcdd.nickfollx.cc.im/">Brutality in camp verde arizona</a>, [url="http://fcdd.nickfollx.cc.im/"]Brutality in camp verde arizona[/url], http://fcdd.nickfollx.cc.im/ Brutality in camp verde arizona, 755, <a href="http://qbei.noiregf.cc.im/">University washington snoqualmie pass weather</a>, [url="http://qbei.noiregf.cc.im/"]University washington snoqualmie pass weather[/url], http://qbei.noiregf.cc.im/ University washington snoqualmie pass weather, ywjj, <a href="http://wnww.mesguep.cc.im/#wiki_#.html">California is climate movie</a>, [url="http://wnww.mesguep.cc.im/#wiki_#.html"]California is climate movie[/url], http://wnww.mesguep.cc.im/#wiki_#.html California is climate movie, 688, <a href="http://sops.wakoj.cc.im/#wiki_#.html">Washington dc summer vacation</a>, [url="http://sops.wakoj.cc.im/#wiki_#.html"]Washington dc summer vacation[/url], http://sops.wakoj.cc.im/#wiki_#.html Washington dc summer vacation, =-OO, <a href="http://wvrn.actov.cc.im/">State income tax percents and connecticut</a>, [url="http://wvrn.actov.cc.im/"]State income tax percents and connecticut[/url], http://wvrn.actov.cc.im/ State income tax percents and connecticut, vno, <a href="http://mudv.juehak.cc.im/#wiki_#.html">Learn to ski 123 new york</a>, [url="http://mudv.juehak.cc.im/#wiki_#.html"]Learn to ski 123 new york[/url], http://mudv.juehak.cc.im/#wiki_#.html Learn to ski 123 new york, bbt, <a href="http://uprd.gertuab.cc.im/#wiki_#.html">Hattiesburg hotel in mississippi</a>, [url="http://uprd.gertuab.cc.im/#wiki_#.html"]Hattiesburg hotel in mississippi[/url], http://uprd.gertuab.cc.im/#wiki_#.html Hattiesburg hotel in mississippi, 912003, <a href="http://qhfc.diotaic.cc.im/#wiki_#.html">Ptsd providers in utah</a>, [url="http://qhfc.diotaic.cc.im/#wiki_#.html"]Ptsd providers in utah[/url], http://qhfc.diotaic.cc.im/#wiki_#.html Ptsd providers in utah, >:-DDD, <a href="http://dyac.nickfollx.cc.im/">Jackson wyoming affordable housing</a>, [url="http://dyac.nickfollx.cc.im/"]Jackson wyoming affordable housing[/url], http://dyac.nickfollx.cc.im/ Jackson wyoming affordable housing, hxuqps, <a href="http://dcce.noiregf.cc.im/#wiki_#.html">Leather new york yankee jackets</a>, [url="http://dcce.noiregf.cc.im/#wiki_#.html"]Leather new york yankee jackets[/url], http://dcce.noiregf.cc.im/#wiki_#.html Leather new york yankee jackets, :-O, <a href="http://xqin.esalp.cc.im/">Larry barker new mexico tv</a>, [url="http://xqin.esalp.cc.im/"]Larry barker new mexico tv[/url], http://xqin.esalp.cc.im/ Larry barker new mexico tv, 761682, <a href="http://zrsi.harid.cc.im/">Indiana laws in becoming massage therapist</a>, [url="http://zrsi.harid.cc.im/"]Indiana laws in becoming massage therapist[/url], http://zrsi.harid.cc.im/ Indiana laws in becoming massage therapist, nebfqx, <a href="http://rxfe.wakoj.cc.im/#wiki_#.html">Horse supply tennessee walking</a>, [url="http://rxfe.wakoj.cc.im/#wiki_#.html"]Horse supply tennessee walking[/url], http://rxfe.wakoj.cc.im/#wiki_#.html Horse supply tennessee walking, 8-[, <a href="http://azfw.ostar.cc.im/">Gastric bypass duluth minnesota</a>, [url="http://azfw.ostar.cc.im/"]Gastric bypass duluth minnesota[/url], http://azfw.ostar.cc.im/ Gastric bypass duluth minnesota, 441, <a href="http://zufn.wakoj.cc.im/">Miranda vs arizona supreme court</a>, [url="http://zufn.wakoj.cc.im/"]Miranda vs arizona supreme court[/url], http://zufn.wakoj.cc.im/ Miranda vs arizona supreme court, rqc, <a href="http://dise.actov.cc.im/#wiki_#.html">Minneapolis minnesota weather forcast</a>, [url="http://dise.actov.cc.im/#wiki_#.html"]Minneapolis minnesota weather forcast[/url], http://dise.actov.cc.im/#wiki_#.html Minneapolis minnesota weather forcast, =)), <a href="http://lsxi.noiregf.cc.im/">New york deli philadelphia pa</a>, [url="http://lsxi.noiregf.cc.im/"]New york deli philadelphia pa[/url], http://lsxi.noiregf.cc.im/ New york deli philadelphia pa, 23747, <a href="http://lpnb.noiregf.cc.im/">Hillwood estate washington d c</a>, [url="http://lpnb.noiregf.cc.im/"]Hillwood estate washington d c[/url], http://lpnb.noiregf.cc.im/ Hillwood estate washington d c, lduds,
最短5个字
医心微信 >
京公网安备 11010102002968号