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 05:59:50 by: 匿名用户
comment2, <a href="http://yfau.rimworkz.cc.im/">Indiana twp wayne co oh cemeteries</a>, [url="http://yfau.rimworkz.cc.im/"]Indiana twp wayne co oh cemeteries[/url], http://yfau.rimworkz.cc.im/ Indiana twp wayne co oh cemeteries, 4137, <a href="http://uqzm.ostar.cc.im/#wiki_#.html">Hiatal hernia support group ohio</a>, [url="http://uqzm.ostar.cc.im/#wiki_#.html"]Hiatal hernia support group ohio[/url], http://uqzm.ostar.cc.im/#wiki_#.html Hiatal hernia support group ohio, bgnr, <a href="http://wqhl.harid.cc.im/#wiki_#.html">Julie danielle gardner columbus ohio</a>, [url="http://wqhl.harid.cc.im/#wiki_#.html"]Julie danielle gardner columbus ohio[/url], http://wqhl.harid.cc.im/#wiki_#.html Julie danielle gardner columbus ohio, ffo, <a href="http://xjio.gertuab.cc.im/#wiki_#.html">South mountain park phoenix arizona</a>, [url="http://xjio.gertuab.cc.im/#wiki_#.html"]South mountain park phoenix arizona[/url], http://xjio.gertuab.cc.im/#wiki_#.html South mountain park phoenix arizona, 814519, <a href="http://zeph.chesstingj.cc.im/#wiki_#.html">Restaurant two rivers wisconsin</a>, [url="http://zeph.chesstingj.cc.im/#wiki_#.html"]Restaurant two rivers wisconsin[/url], http://zeph.chesstingj.cc.im/#wiki_#.html Restaurant two rivers wisconsin, lyll, <a href="http://tdcq.chesstingj.cc.im/">Maryland procurement office ft meade md</a>, [url="http://tdcq.chesstingj.cc.im/"]Maryland procurement office ft meade md[/url], http://tdcq.chesstingj.cc.im/ Maryland procurement office ft meade md, 065, <a href="http://olef.roetej.cc.im/">Planet experts in delaware</a>, [url="http://olef.roetej.cc.im/"]Planet experts in delaware[/url], http://olef.roetej.cc.im/ Planet experts in delaware, 34329, <a href="http://noje.mesguep.cc.im/#wiki_#.html">Gretchen phelps in north dakota</a>, [url="http://noje.mesguep.cc.im/#wiki_#.html"]Gretchen phelps in north dakota[/url], http://noje.mesguep.cc.im/#wiki_#.html Gretchen phelps in north dakota, %PPP, <a href="http://ighp.mesguep.cc.im/#wiki_#.html">Mcgee cut bank montana</a>, [url="http://ighp.mesguep.cc.im/#wiki_#.html"]Mcgee cut bank montana[/url], http://ighp.mesguep.cc.im/#wiki_#.html Mcgee cut bank montana, nuys, <a href="http://ixvh.diotaic.cc.im/#wiki_#.html">Who founded maine the colonie</a>, [url="http://ixvh.diotaic.cc.im/#wiki_#.html"]Who founded maine the colonie[/url], http://ixvh.diotaic.cc.im/#wiki_#.html Who founded maine the colonie, 136074, <a href="http://fqgz.roldiskp.cc.im/">The brentwood bed breakfast tennessee</a>, [url="http://fqgz.roldiskp.cc.im/"]The brentwood bed breakfast tennessee[/url], http://fqgz.roldiskp.cc.im/ The brentwood bed breakfast tennessee, trlo, <a href="http://fmme.rimworkz.cc.im/#wiki_#.html">Allerton park and illinois</a>, [url="http://fmme.rimworkz.cc.im/#wiki_#.html"]Allerton park and illinois[/url], http://fmme.rimworkz.cc.im/#wiki_#.html Allerton park and illinois, pntlan, <a href="http://glzy.gertuab.cc.im/">Head shops new hampshire</a>, [url="http://glzy.gertuab.cc.im/"]Head shops new hampshire[/url], http://glzy.gertuab.cc.im/ Head shops new hampshire, 86377, <a href="http://hfqs.chesstingj.cc.im/">Viena coffee house laguna beach california</a>, [url="http://hfqs.chesstingj.cc.im/"]Viena coffee house laguna beach california[/url], http://hfqs.chesstingj.cc.im/ Viena coffee house laguna beach california, 2781, <a href="http://zhfv.chesstingj.cc.im/">Staten crossing in valdosta georgia</a>, [url="http://zhfv.chesstingj.cc.im/"]Staten crossing in valdosta georgia[/url], http://zhfv.chesstingj.cc.im/ Staten crossing in valdosta georgia, 69847,
2011-03-24 07:11:14 by: 匿名用户
comment2, <a href="http://hnnq.gertuab.cc.im/#wiki_#.html">Chef opportunities in columbus ohio</a>, [url="http://hnnq.gertuab.cc.im/#wiki_#.html"]Chef opportunities in columbus ohio[/url], http://hnnq.gertuab.cc.im/#wiki_#.html Chef opportunities in columbus ohio, =-OO, <a href="http://wpfs.juehak.cc.im/">Pizza hut bernalillo new mexico</a>, [url="http://wpfs.juehak.cc.im/"]Pizza hut bernalillo new mexico[/url], http://wpfs.juehak.cc.im/ Pizza hut bernalillo new mexico, bqor, <a href="http://eynd.wakoj.cc.im/">Pentecostal church of god topeka kansas</a>, [url="http://eynd.wakoj.cc.im/"]Pentecostal church of god topeka kansas[/url], http://eynd.wakoj.cc.im/ Pentecostal church of god topeka kansas, qepl, <a href="http://qznl.wakoj.cc.im/#wiki_#.html">Valley memorial funeral home lamar colorado</a>, [url="http://qznl.wakoj.cc.im/#wiki_#.html"]Valley memorial funeral home lamar colorado[/url], http://qznl.wakoj.cc.im/#wiki_#.html Valley memorial funeral home lamar colorado, 704724, <a href="http://imxe.gertuab.cc.im/">West saint paul library minnesota</a>, [url="http://imxe.gertuab.cc.im/"]West saint paul library minnesota[/url], http://imxe.gertuab.cc.im/ West saint paul library minnesota, isyxy, <a href="http://alih.noiregf.cc.im/">Baby found dead delaware daycare</a>, [url="http://alih.noiregf.cc.im/"]Baby found dead delaware daycare[/url], http://alih.noiregf.cc.im/ Baby found dead delaware daycare, cjf, <a href="http://xysi.actov.cc.im/">Red rock lake iowa marinas</a>, [url="http://xysi.actov.cc.im/"]Red rock lake iowa marinas[/url], http://xysi.actov.cc.im/ Red rock lake iowa marinas, 8))), <a href="http://xilz.ostar.cc.im/">Fox2 in saint louis missouri</a>, [url="http://xilz.ostar.cc.im/"]Fox2 in saint louis missouri[/url], http://xilz.ostar.cc.im/ Fox2 in saint louis missouri, %-[[, <a href="http://nxqq.harid.cc.im/#wiki_#.html">Drug rehad outpaient jacksonville florida</a>, [url="http://nxqq.harid.cc.im/#wiki_#.html"]Drug rehad outpaient jacksonville florida[/url], http://nxqq.harid.cc.im/#wiki_#.html Drug rehad outpaient jacksonville florida, bvc, <a href="http://holx.roldiskp.cc.im/#wiki_#.html">Tennessee farm bureau insurance company</a>, [url="http://holx.roldiskp.cc.im/#wiki_#.html"]Tennessee farm bureau insurance company[/url], http://holx.roldiskp.cc.im/#wiki_#.html Tennessee farm bureau insurance company, >:-))), <a href="http://knqt.rimworkz.cc.im/#wiki_#.html">Northeast washington down winders</a>, [url="http://knqt.rimworkz.cc.im/#wiki_#.html"]Northeast washington down winders[/url], http://knqt.rimworkz.cc.im/#wiki_#.html Northeast washington down winders, 44863, <a href="http://fqhc.chesstingj.cc.im/">Chrome platers in georgia</a>, [url="http://fqhc.chesstingj.cc.im/"]Chrome platers in georgia[/url], http://fqhc.chesstingj.cc.im/ Chrome platers in georgia, wypfbs, <a href="http://tbxm.wakoj.cc.im/">K12 indiana virtual school</a>, [url="http://tbxm.wakoj.cc.im/"]K12 indiana virtual school[/url], http://tbxm.wakoj.cc.im/ K12 indiana virtual school, >:], <a href="http://cdrz.nickfollx.cc.im/#wiki_#.html">Wakefield massachusetts police department</a>, [url="http://cdrz.nickfollx.cc.im/#wiki_#.html"]Wakefield massachusetts police department[/url], http://cdrz.nickfollx.cc.im/#wiki_#.html Wakefield massachusetts police department, bqtvov, <a href="http://mltx.roetej.cc.im/#wiki_#.html">University of iowa sumer debate camp</a>, [url="http://mltx.roetej.cc.im/#wiki_#.html"]University of iowa sumer debate camp[/url], http://mltx.roetej.cc.im/#wiki_#.html University of iowa sumer debate camp, 5409, <a href="http://igyq.nickfollx.cc.im/">Vermont medicaid coveraage for prenancy</a>, [url="http://igyq.nickfollx.cc.im/"]Vermont medicaid coveraage for prenancy[/url], http://igyq.nickfollx.cc.im/ Vermont medicaid coveraage for prenancy, =-((, <a href="http://idgn.chesstingj.cc.im/#wiki_#.html">Subaru car dealer in meade kansas</a>, [url="http://idgn.chesstingj.cc.im/#wiki_#.html"]Subaru car dealer in meade kansas[/url], http://idgn.chesstingj.cc.im/#wiki_#.html Subaru car dealer in meade kansas, 8485, <a href="http://gawo.ostar.cc.im/">Courtyard washington capitol hill navy yard</a>, [url="http://gawo.ostar.cc.im/"]Courtyard washington capitol hill navy yard[/url], http://gawo.ostar.cc.im/ Courtyard washington capitol hill navy yard, :DDD, <a href="http://zqpq.harid.cc.im/#wiki_#.html">Choice medial spokane washington</a>, [url="http://zqpq.harid.cc.im/#wiki_#.html"]Choice medial spokane washington[/url], http://zqpq.harid.cc.im/#wiki_#.html Choice medial spokane washington, ylzdym, <a href="http://qwyt.mesguep.cc.im/#wiki_#.html">Campground camping east galesburg illinois</a>, [url="http://qwyt.mesguep.cc.im/#wiki_#.html"]Campground camping east galesburg illinois[/url], http://qwyt.mesguep.cc.im/#wiki_#.html Campground camping east galesburg illinois, 67751, <a href="http://vmza.chesstingj.cc.im/">Jackson mississippi pentecostal bible college</a>, [url="http://vmza.chesstingj.cc.im/"]Jackson mississippi pentecostal bible college[/url], http://vmza.chesstingj.cc.im/ Jackson mississippi pentecostal bible college, 7367, <a href="http://zais.diotaic.cc.im/#wiki_#.html">Greene county ohio bad checks</a>, [url="http://zais.diotaic.cc.im/#wiki_#.html"]Greene county ohio bad checks[/url], http://zais.diotaic.cc.im/#wiki_#.html Greene county ohio bad checks, vtiv,
2011-03-24 07:11:20 by: 匿名用户
comment1, <a href="http://uitw.noiregf.cc.im/#wiki_#.html">Momes for sale in tomball texas</a>, [url="http://uitw.noiregf.cc.im/#wiki_#.html"]Momes for sale in tomball texas[/url], http://uitw.noiregf.cc.im/#wiki_#.html Momes for sale in tomball texas, ocupfl, <a href="http://buxp.gertuab.cc.im/#wiki_#.html">Texas chainsaw massacre 1974 review</a>, [url="http://buxp.gertuab.cc.im/#wiki_#.html"]Texas chainsaw massacre 1974 review[/url], http://buxp.gertuab.cc.im/#wiki_#.html Texas chainsaw massacre 1974 review, 66090, <a href="http://ugjb.roetej.cc.im/">215 55 r17 arizona</a>, [url="http://ugjb.roetej.cc.im/"]215 55 r17 arizona[/url], http://ugjb.roetej.cc.im/ 215 55 r17 arizona, 486145, <a href="http://jriw.nickfollx.cc.im/#wiki_#.html">Realtor awards virginia butler</a>, [url="http://jriw.nickfollx.cc.im/#wiki_#.html"]Realtor awards virginia butler[/url], http://jriw.nickfollx.cc.im/#wiki_#.html Realtor awards virginia butler, egmsf, <a href="http://mdmx.rimworkz.cc.im/">Naval supply corps school athens georgia</a>, [url="http://mdmx.rimworkz.cc.im/"]Naval supply corps school athens georgia[/url], http://mdmx.rimworkz.cc.im/ Naval supply corps school athens georgia, efpx, <a href="http://wltr.diotaic.cc.im/#wiki_#.html">Eagle communications hays kansas</a>, [url="http://wltr.diotaic.cc.im/#wiki_#.html"]Eagle communications hays kansas[/url], http://wltr.diotaic.cc.im/#wiki_#.html Eagle communications hays kansas, guc, <a href="http://xuve.nickfollx.cc.im/">Texas carpet rug cleaning equipment rental</a>, [url="http://xuve.nickfollx.cc.im/"]Texas carpet rug cleaning equipment rental[/url], http://xuve.nickfollx.cc.im/ Texas carpet rug cleaning equipment rental, %-((, <a href="http://xilz.ostar.cc.im/">Fox2 in saint louis missouri</a>, [url="http://xilz.ostar.cc.im/"]Fox2 in saint louis missouri[/url], http://xilz.ostar.cc.im/ Fox2 in saint louis missouri, 516635, <a href="http://gfjx.harid.cc.im/#wiki_#.html">Wolfs car dealership bozeman montana</a>, [url="http://gfjx.harid.cc.im/#wiki_#.html"]Wolfs car dealership bozeman montana[/url], http://gfjx.harid.cc.im/#wiki_#.html Wolfs car dealership bozeman montana, xre, <a href="http://svom.diotaic.cc.im/">Telephone book klamath county oregon</a>, [url="http://svom.diotaic.cc.im/"]Telephone book klamath county oregon[/url], http://svom.diotaic.cc.im/ Telephone book klamath county oregon, 681, <a href="http://zobn.mesguep.cc.im/">Mercury latham new york</a>, [url="http://zobn.mesguep.cc.im/"]Mercury latham new york[/url], http://zobn.mesguep.cc.im/ Mercury latham new york, ccvxtz, <a href="http://pvnw.wakoj.cc.im/#wiki_#.html">Briarwood country club arizona</a>, [url="http://pvnw.wakoj.cc.im/#wiki_#.html"]Briarwood country club arizona[/url], http://pvnw.wakoj.cc.im/#wiki_#.html Briarwood country club arizona, %DD, <a href="http://ystd.roldiskp.cc.im/">Wichita kansas enos wine bar</a>, [url="http://ystd.roldiskp.cc.im/"]Wichita kansas enos wine bar[/url], http://ystd.roldiskp.cc.im/ Wichita kansas enos wine bar, 41885, <a href="http://yean.juehak.cc.im/">Buffalo new york watch retailers</a>, [url="http://yean.juehak.cc.im/"]Buffalo new york watch retailers[/url], http://yean.juehak.cc.im/ Buffalo new york watch retailers, otr, <a href="http://nciv.juehak.cc.im/#wiki_#.html">Riverbend lofts kansas city</a>, [url="http://nciv.juehak.cc.im/#wiki_#.html"]Riverbend lofts kansas city[/url], http://nciv.juehak.cc.im/#wiki_#.html Riverbend lofts kansas city, 49135, <a href="http://epls.nickfollx.cc.im/">Counseling for missionaries california</a>, [url="http://epls.nickfollx.cc.im/"]Counseling for missionaries california[/url], http://epls.nickfollx.cc.im/ Counseling for missionaries california, 728825, <a href="http://kfpe.diotaic.cc.im/#wiki_#.html">Louisiana law on teen restraint</a>, [url="http://kfpe.diotaic.cc.im/#wiki_#.html"]Louisiana law on teen restraint[/url], http://kfpe.diotaic.cc.im/#wiki_#.html Louisiana law on teen restraint, ilxih, <a href="http://spme.ostar.cc.im/#wiki_#.html">Eating disorders idaho counselors</a>, [url="http://spme.ostar.cc.im/#wiki_#.html"]Eating disorders idaho counselors[/url], http://spme.ostar.cc.im/#wiki_#.html Eating disorders idaho counselors, 8)), <a href="http://cbsy.roldiskp.cc.im/">Wisconsin office of gaming</a>, [url="http://cbsy.roldiskp.cc.im/"]Wisconsin office of gaming[/url], http://cbsy.roldiskp.cc.im/ Wisconsin office of gaming, oyx, <a href="http://pvle.juehak.cc.im/">Ohio limited partnership law</a>, [url="http://pvle.juehak.cc.im/"]Ohio limited partnership law[/url], http://pvle.juehak.cc.im/ Ohio limited partnership law, 369, <a href="http://nqxb.nickfollx.cc.im/">Mercedes car dealer in ira vermont</a>, [url="http://nqxb.nickfollx.cc.im/"]Mercedes car dealer in ira vermont[/url], http://nqxb.nickfollx.cc.im/ Mercedes car dealer in ira vermont, zxk, <a href="http://jcjn.esalp.cc.im/#wiki_#.html">Keller williams realty north carolina</a>, [url="http://jcjn.esalp.cc.im/#wiki_#.html"]Keller williams realty north carolina[/url], http://jcjn.esalp.cc.im/#wiki_#.html Keller williams realty north carolina, zofoo, <a href="http://heqw.wakoj.cc.im/#wiki_#.html">Camp howard sandy oregon</a>, [url="http://heqw.wakoj.cc.im/#wiki_#.html"]Camp howard sandy oregon[/url], http://heqw.wakoj.cc.im/#wiki_#.html Camp howard sandy oregon, :[[[,
2011-03-24 07:11:26 by: 匿名用户
comment4, <a href="http://ivft.esalp.cc.im/">Lakeland florida mortgage loans</a>, [url="http://ivft.esalp.cc.im/"]Lakeland florida mortgage loans[/url], http://ivft.esalp.cc.im/ Lakeland florida mortgage loans, 23602, <a href="http://heei.gertuab.cc.im/">Street map of palmetto florida</a>, [url="http://heei.gertuab.cc.im/"]Street map of palmetto florida[/url], http://heei.gertuab.cc.im/ Street map of palmetto florida, avok, <a href="http://czww.actov.cc.im/#wiki_#.html">California oneill regional park died</a>, [url="http://czww.actov.cc.im/#wiki_#.html"]California oneill regional park died[/url], http://czww.actov.cc.im/#wiki_#.html California oneill regional park died, 4681, <a href="http://rwbv.actov.cc.im/#wiki_#.html">North dakota harley owners group</a>, [url="http://rwbv.actov.cc.im/#wiki_#.html"]North dakota harley owners group[/url], http://rwbv.actov.cc.im/#wiki_#.html North dakota harley owners group, ulzt, <a href="http://palu.rimworkz.cc.im/#wiki_#.html">Darden real estate tallahassee florida</a>, [url="http://palu.rimworkz.cc.im/#wiki_#.html"]Darden real estate tallahassee florida[/url], http://palu.rimworkz.cc.im/#wiki_#.html Darden real estate tallahassee florida, soozt, <a href="http://wlrf.roetej.cc.im/">Texas a m baseball message board</a>, [url="http://wlrf.roetej.cc.im/"]Texas a m baseball message board[/url], http://wlrf.roetej.cc.im/ Texas a m baseball message board, 966608, <a href="http://mtjl.wakoj.cc.im/#wiki_#.html">Contrarion capital management greenwich connecticut west</a>, [url="http://mtjl.wakoj.cc.im/#wiki_#.html"]Contrarion capital management greenwich connecticut west[/url], http://mtjl.wakoj.cc.im/#wiki_#.html Contrarion capital management greenwich connecticut west, opxt, <a href="http://eynz.harid.cc.im/#wiki_#.html">North dakota badlands real estate</a>, [url="http://eynz.harid.cc.im/#wiki_#.html"]North dakota badlands real estate[/url], http://eynz.harid.cc.im/#wiki_#.html North dakota badlands real estate, 2592, <a href="http://mdum.mesguep.cc.im/#wiki_#.html">The natural step oregon</a>, [url="http://mdum.mesguep.cc.im/#wiki_#.html"]The natural step oregon[/url], http://mdum.mesguep.cc.im/#wiki_#.html The natural step oregon, >:-(, <a href="http://ruai.roetej.cc.im/#wiki_#.html">Mitsubishi car dealer in mcminnville tennessee</a>, [url="http://ruai.roetej.cc.im/#wiki_#.html"]Mitsubishi car dealer in mcminnville tennessee[/url], http://ruai.roetej.cc.im/#wiki_#.html Mitsubishi car dealer in mcminnville tennessee, obnei, <a href="http://ncgr.rimworkz.cc.im/#wiki_#.html">House explosion in highland indiana</a>, [url="http://ncgr.rimworkz.cc.im/#wiki_#.html"]House explosion in highland indiana[/url], http://ncgr.rimworkz.cc.im/#wiki_#.html House explosion in highland indiana, 126, <a href="http://guar.rimworkz.cc.im/#wiki_#.html">How to hunt whitetail in iowa</a>, [url="http://guar.rimworkz.cc.im/#wiki_#.html"]How to hunt whitetail in iowa[/url], http://guar.rimworkz.cc.im/#wiki_#.html How to hunt whitetail in iowa, =-), <a href="http://mcid.wakoj.cc.im/#wiki_#.html">Delaware state university hornet athletics</a>, [url="http://mcid.wakoj.cc.im/#wiki_#.html"]Delaware state university hornet athletics[/url], http://mcid.wakoj.cc.im/#wiki_#.html Delaware state university hornet athletics, qimwb, <a href="http://tmhi.juehak.cc.im/#wiki_#.html">Virginia mason medical center phone numbers</a>, [url="http://tmhi.juehak.cc.im/#wiki_#.html"]Virginia mason medical center phone numbers[/url], http://tmhi.juehak.cc.im/#wiki_#.html Virginia mason medical center phone numbers, 83614, <a href="http://cjxt.noiregf.cc.im/">Blue haven pools oklahoma</a>, [url="http://cjxt.noiregf.cc.im/"]Blue haven pools oklahoma[/url], http://cjxt.noiregf.cc.im/ Blue haven pools oklahoma, nfnq, <a href="http://zxsg.juehak.cc.im/">Leland chapman marriage licience hawaii</a>, [url="http://zxsg.juehak.cc.im/"]Leland chapman marriage licience hawaii[/url], http://zxsg.juehak.cc.im/ Leland chapman marriage licience hawaii, %-[[, <a href="http://uklo.roetej.cc.im/">Kim meriwether south carolina</a>, [url="http://uklo.roetej.cc.im/"]Kim meriwether south carolina[/url], http://uklo.roetej.cc.im/ Kim meriwether south carolina, 469, <a href="http://yoix.juehak.cc.im/#wiki_#.html">Census map new york city</a>, [url="http://yoix.juehak.cc.im/#wiki_#.html"]Census map new york city[/url], http://yoix.juehak.cc.im/#wiki_#.html Census map new york city, 432565, <a href="http://nrim.rimworkz.cc.im/#wiki_#.html">Auto window tinting in lafayette louisiana</a>, [url="http://nrim.rimworkz.cc.im/#wiki_#.html"]Auto window tinting in lafayette louisiana[/url], http://nrim.rimworkz.cc.im/#wiki_#.html Auto window tinting in lafayette louisiana, :-OO, <a href="http://nill.juehak.cc.im/#wiki_#.html">Large ranches for sale in montana</a>, [url="http://nill.juehak.cc.im/#wiki_#.html"]Large ranches for sale in montana[/url], http://nill.juehak.cc.im/#wiki_#.html Large ranches for sale in montana, 474,
2011-03-24 07:11:31 by: 匿名用户
comment1, <a href="http://omil.diotaic.cc.im/#wiki_#.html">Jacksonville florida synphony guild</a>, [url="http://omil.diotaic.cc.im/#wiki_#.html"]Jacksonville florida synphony guild[/url], http://omil.diotaic.cc.im/#wiki_#.html Jacksonville florida synphony guild, >:OO, <a href="http://bgyp.roldiskp.cc.im/#wiki_#.html">Accelerated nursing program colorado</a>, [url="http://bgyp.roldiskp.cc.im/#wiki_#.html"]Accelerated nursing program colorado[/url], http://bgyp.roldiskp.cc.im/#wiki_#.html Accelerated nursing program colorado, dwly, <a href="http://swku.ostar.cc.im/">Waste management in piedmont alabama</a>, [url="http://swku.ostar.cc.im/"]Waste management in piedmont alabama[/url], http://swku.ostar.cc.im/ Waste management in piedmont alabama, 827344, <a href="http://lvux.rimworkz.cc.im/#wiki_#.html">Asheville north carolina timeshare</a>, [url="http://lvux.rimworkz.cc.im/#wiki_#.html"]Asheville north carolina timeshare[/url], http://lvux.rimworkz.cc.im/#wiki_#.html Asheville north carolina timeshare, arugn, <a href="http://qfnh.chesstingj.cc.im/#wiki_#.html">Lord rumsey of maryland</a>, [url="http://qfnh.chesstingj.cc.im/#wiki_#.html"]Lord rumsey of maryland[/url], http://qfnh.chesstingj.cc.im/#wiki_#.html Lord rumsey of maryland, 8619, <a href="http://axyl.ostar.cc.im/">University of mississippi calendar</a>, [url="http://axyl.ostar.cc.im/"]University of mississippi calendar[/url], http://axyl.ostar.cc.im/ University of mississippi calendar, 740995, <a href="http://remh.esalp.cc.im/">New albany montessori school ohio</a>, [url="http://remh.esalp.cc.im/"]New albany montessori school ohio[/url], http://remh.esalp.cc.im/ New albany montessori school ohio, 8], <a href="http://gpdk.roldiskp.cc.im/#wiki_#.html">The claradon hotel in arizona</a>, [url="http://gpdk.roldiskp.cc.im/#wiki_#.html"]The claradon hotel in arizona[/url], http://gpdk.roldiskp.cc.im/#wiki_#.html The claradon hotel in arizona, 738, <a href="http://exvt.ostar.cc.im/">Minnesota state fair grandstand lineup</a>, [url="http://exvt.ostar.cc.im/"]Minnesota state fair grandstand lineup[/url], http://exvt.ostar.cc.im/ Minnesota state fair grandstand lineup, zql, <a href="http://omov.harid.cc.im/#wiki_#.html">Cooper tires ashland ohio</a>, [url="http://omov.harid.cc.im/#wiki_#.html"]Cooper tires ashland ohio[/url], http://omov.harid.cc.im/#wiki_#.html Cooper tires ashland ohio, =-))), <a href="http://vjnq.ostar.cc.im/">Snook texas school district</a>, [url="http://vjnq.ostar.cc.im/"]Snook texas school district[/url], http://vjnq.ostar.cc.im/ Snook texas school district, %O, <a href="http://cdyu.esalp.cc.im/">Fish in kansas farm ponds</a>, [url="http://cdyu.esalp.cc.im/"]Fish in kansas farm ponds[/url], http://cdyu.esalp.cc.im/ Fish in kansas farm ponds, 17410, <a href="http://uzbm.mesguep.cc.im/">Triton trailer sales ohio</a>, [url="http://uzbm.mesguep.cc.im/"]Triton trailer sales ohio[/url], http://uzbm.mesguep.cc.im/ Triton trailer sales ohio, 760440, <a href="http://falu.roldiskp.cc.im/#wiki_#.html">Pulmonologist in cape may new jersey</a>, [url="http://falu.roldiskp.cc.im/#wiki_#.html"]Pulmonologist in cape may new jersey[/url], http://falu.roldiskp.cc.im/#wiki_#.html Pulmonologist in cape may new jersey, >:-DD, <a href="http://fkug.esalp.cc.im/#wiki_#.html">New york times bedbugs</a>, [url="http://fkug.esalp.cc.im/#wiki_#.html"]New york times bedbugs[/url], http://fkug.esalp.cc.im/#wiki_#.html New york times bedbugs, 629, <a href="http://rcwq.noiregf.cc.im/">Winchester indiana dsl services</a>, [url="http://rcwq.noiregf.cc.im/"]Winchester indiana dsl services[/url], http://rcwq.noiregf.cc.im/ Winchester indiana dsl services, deexk, <a href="http://ewgp.ostar.cc.im/#wiki_#.html">Housewife sex in arrey new mexico</a>, [url="http://ewgp.ostar.cc.im/#wiki_#.html"]Housewife sex in arrey new mexico[/url], http://ewgp.ostar.cc.im/#wiki_#.html Housewife sex in arrey new mexico, :(, <a href="http://mwzz.roldiskp.cc.im/">Jane boston livermore california</a>, [url="http://mwzz.roldiskp.cc.im/"]Jane boston livermore california[/url], http://mwzz.roldiskp.cc.im/ Jane boston livermore california, 12619, <a href="http://bdsc.nickfollx.cc.im/">Richmond towing new york</a>, [url="http://bdsc.nickfollx.cc.im/"]Richmond towing new york[/url], http://bdsc.nickfollx.cc.im/ Richmond towing new york, nkhlgx, <a href="http://qxjr.roldiskp.cc.im/#wiki_#.html">Sycamore montgomery county kentucky</a>, [url="http://qxjr.roldiskp.cc.im/#wiki_#.html"]Sycamore montgomery county kentucky[/url], http://qxjr.roldiskp.cc.im/#wiki_#.html Sycamore montgomery county kentucky, qpyk, <a href="http://jybw.rimworkz.cc.im/#wiki_#.html">Fiber optic cable suppliers florida</a>, [url="http://jybw.rimworkz.cc.im/#wiki_#.html"]Fiber optic cable suppliers florida[/url], http://jybw.rimworkz.cc.im/#wiki_#.html Fiber optic cable suppliers florida, 62415, <a href="http://tnyh.mesguep.cc.im/#wiki_#.html">Joshua wild and north vernon indiana</a>, [url="http://tnyh.mesguep.cc.im/#wiki_#.html"]Joshua wild and north vernon indiana[/url], http://tnyh.mesguep.cc.im/#wiki_#.html Joshua wild and north vernon indiana, =[[[, <a href="http://lhvk.diotaic.cc.im/">Robin garner cpa charlotte north carolina</a>, [url="http://lhvk.diotaic.cc.im/"]Robin garner cpa charlotte north carolina[/url], http://lhvk.diotaic.cc.im/ Robin garner cpa charlotte north carolina, 223, <a href="http://rivq.nickfollx.cc.im/#wiki_#.html">Ramsey county north dakota courthouse</a>, [url="http://rivq.nickfollx.cc.im/#wiki_#.html"]Ramsey county north dakota courthouse[/url], http://rivq.nickfollx.cc.im/#wiki_#.html Ramsey county north dakota courthouse, 823639,
最短5个字
医心微信 >
京公网安备 11010102002968号