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 22:11:20 by: 匿名用户
comment2, <a href="http://boxz.horodm.cc.im/#post_#.html">Gymnastics camps new hampshire</a>, [url="http://boxz.horodm.cc.im/#post_#.html"]Gymnastics camps new hampshire[/url], http://boxz.horodm.cc.im/#post_#.html Gymnastics camps new hampshire, pdq, <a href="http://mmak.bretas.cc.im/">Parenting second judicial district court montana</a>, [url="http://mmak.bretas.cc.im/"]Parenting second judicial district court montana[/url], http://mmak.bretas.cc.im/ Parenting second judicial district court montana, nzlezg, <a href="http://pesj.exorl.cc.im/">Real estate and hardy arkansas</a>, [url="http://pesj.exorl.cc.im/"]Real estate and hardy arkansas[/url], http://pesj.exorl.cc.im/ Real estate and hardy arkansas, galz, <a href="http://utii.exorl.cc.im/#post_#.html">Mold black florida real estate law</a>, [url="http://utii.exorl.cc.im/#post_#.html"]Mold black florida real estate law[/url], http://utii.exorl.cc.im/#post_#.html Mold black florida real estate law, rqrlnc, <a href="http://hinf.luosupph.cc.im/">Cabin rental wisconsin sleeps 10</a>, [url="http://hinf.luosupph.cc.im/"]Cabin rental wisconsin sleeps 10[/url], http://hinf.luosupph.cc.im/ Cabin rental wisconsin sleeps 10, >:]], <a href="http://nfko.poiyt.cc.im/">Wounded warrior from nevada</a>, [url="http://nfko.poiyt.cc.im/"]Wounded warrior from nevada[/url], http://nfko.poiyt.cc.im/ Wounded warrior from nevada, ujd, <a href="http://jljb.nyret.cc.im/yb.html">Michigan garage sales thumb area</a>, [url="http://jljb.nyret.cc.im/yb.html"]Michigan garage sales thumb area[/url], http://jljb.nyret.cc.im/yb.html Michigan garage sales thumb area, 973, <a href="http://reublogn.vugg.net/wiki_fv.html">Westchester pennsylvania golf communities</a>, [url="http://reublogn.vugg.net/wiki_fv.html"]Westchester pennsylvania golf communities[/url], http://reublogn.vugg.net/wiki_fv.html Westchester pennsylvania golf communities, =-]], <a href="http://fxrb.repchooz.cc.im/#post_#.html">New homes in syracuse utah</a>, [url="http://fxrb.repchooz.cc.im/#post_#.html"]New homes in syracuse utah[/url], http://fxrb.repchooz.cc.im/#post_#.html New homes in syracuse utah, 76955, <a href="http://afjv.poiyt.cc.im/aj.html">Goodyear tire center in crofton maryland</a>, [url="http://afjv.poiyt.cc.im/aj.html"]Goodyear tire center in crofton maryland[/url], http://afjv.poiyt.cc.im/aj.html Goodyear tire center in crofton maryland, uzxqq, <a href="http://taidersm.vugg.net/wiki_ff.html">Mark heuer of illinois</a>, [url="http://taidersm.vugg.net/wiki_ff.html"]Mark heuer of illinois[/url], http://taidersm.vugg.net/wiki_ff.html Mark heuer of illinois, 0476, <a href="http://cqhx.poiyt.cc.im/">Charleston west virginia software company owner</a>, [url="http://cqhx.poiyt.cc.im/"]Charleston west virginia software company owner[/url], http://cqhx.poiyt.cc.im/ Charleston west virginia software company owner, %-[[[, <a href="http://rlut.peubiow.cc.im/">California home jumbo loan mortgage southern</a>, [url="http://rlut.peubiow.cc.im/"]California home jumbo loan mortgage southern[/url], http://rlut.peubiow.cc.im/ California home jumbo loan mortgage southern, :PP,
2011-03-24 22:11:22 by: 匿名用户
comment1, <a href="http://whfl.horodm.cc.im/#post_#.html">Foam insulation in tampa florida</a>, [url="http://whfl.horodm.cc.im/#post_#.html"]Foam insulation in tampa florida[/url], http://whfl.horodm.cc.im/#post_#.html Foam insulation in tampa florida, 711148, <a href="http://lnjd.flatocq.cc.im/#post_#.html">Englewood new jersey dress shops</a>, [url="http://lnjd.flatocq.cc.im/#post_#.html"]Englewood new jersey dress shops[/url], http://lnjd.flatocq.cc.im/#post_#.html Englewood new jersey dress shops, pprai, <a href="http://zlys.sererfe.cc.im/">Funeral gate texas george bush scandal</a>, [url="http://zlys.sererfe.cc.im/"]Funeral gate texas george bush scandal[/url], http://zlys.sererfe.cc.im/ Funeral gate texas george bush scandal, 579783, <a href="http://majux.vugg.net/wiki_fd.html">Central florida auto show orlando</a>, [url="http://majux.vugg.net/wiki_fd.html"]Central florida auto show orlando[/url], http://majux.vugg.net/wiki_fd.html Central florida auto show orlando, fan, <a href="http://zxoe.exorl.cc.im/#post_#.html">Villa madonna high school kentucky</a>, [url="http://zxoe.exorl.cc.im/#post_#.html"]Villa madonna high school kentucky[/url], http://zxoe.exorl.cc.im/#post_#.html Villa madonna high school kentucky, 273, <a href="http://rxcw.peubiow.cc.im/#post_#.html">Curtins california land use</a>, [url="http://rxcw.peubiow.cc.im/#post_#.html"]Curtins california land use[/url], http://rxcw.peubiow.cc.im/#post_#.html Curtins california land use, 8-OO, <a href="http://bmoc.nujiu.cc.im/">Joan c robertson north carolina</a>, [url="http://bmoc.nujiu.cc.im/"]Joan c robertson north carolina[/url], http://bmoc.nujiu.cc.im/ Joan c robertson north carolina, feno, <a href="http://vingderw.vugg.net/wiki_gi.html">New jersey senator school visit day</a>, [url="http://vingderw.vugg.net/wiki_gi.html"]New jersey senator school visit day[/url], http://vingderw.vugg.net/wiki_gi.html New jersey senator school visit day, =-), <a href="http://ancoj.vugg.net/wiki_rc.html">Thurmond mall columbia south carolina</a>, [url="http://ancoj.vugg.net/wiki_rc.html"]Thurmond mall columbia south carolina[/url], http://ancoj.vugg.net/wiki_rc.html Thurmond mall columbia south carolina, stt, <a href="http://reublogn.vugg.net/wiki_df.html">Tennessee ernie ford song list</a>, [url="http://reublogn.vugg.net/wiki_df.html"]Tennessee ernie ford song list[/url], http://reublogn.vugg.net/wiki_df.html Tennessee ernie ford song list, hkn, <a href="http://dcib.peubiow.cc.im/">Grand theft california section 487</a>, [url="http://dcib.peubiow.cc.im/"]Grand theft california section 487[/url], http://dcib.peubiow.cc.im/ Grand theft california section 487, fkmt, <a href="http://jubd.therquel.cc.im/">House for sale in north georgia</a>, [url="http://jubd.therquel.cc.im/"]House for sale in north georgia[/url], http://jubd.therquel.cc.im/ House for sale in north georgia, =[, <a href="http://tydg.leifonc.cc.im/#post_#.html">Baptist worship conference in indiana</a>, [url="http://tydg.leifonc.cc.im/#post_#.html"]Baptist worship conference in indiana[/url], http://tydg.leifonc.cc.im/#post_#.html Baptist worship conference in indiana, :-]], <a href="http://eoyy.sererfe.cc.im/km.html">Us passport office boise idaho</a>, [url="http://eoyy.sererfe.cc.im/km.html"]Us passport office boise idaho[/url], http://eoyy.sererfe.cc.im/km.html Us passport office boise idaho, yhjyx, <a href="http://sraa.byrew.cc.im/">Assisted living in butte county california</a>, [url="http://sraa.byrew.cc.im/"]Assisted living in butte county california[/url], http://sraa.byrew.cc.im/ Assisted living in butte county california, jnnnf, <a href="http://jlac.byrew.cc.im/yg.html">Farmers home furniture douglass county georgia</a>, [url="http://jlac.byrew.cc.im/yg.html"]Farmers home furniture douglass county georgia[/url], http://jlac.byrew.cc.im/yg.html Farmers home furniture douglass county georgia, 8-OO, <a href="http://mierep.vugg.net/wiki_hr.html">Prevailing wage ohio accountant</a>, [url="http://mierep.vugg.net/wiki_hr.html"]Prevailing wage ohio accountant[/url], http://mierep.vugg.net/wiki_hr.html Prevailing wage ohio accountant, 8-], <a href="http://mrvf.heuthrilv.cc.im/#post_#.html">Homes for rent dahlonega georgia</a>, [url="http://mrvf.heuthrilv.cc.im/#post_#.html"]Homes for rent dahlonega georgia[/url], http://mrvf.heuthrilv.cc.im/#post_#.html Homes for rent dahlonega georgia, 8-]], <a href="http://jflx.heuthrilv.cc.im/">Dermatologist is dublin georgia</a>, [url="http://jflx.heuthrilv.cc.im/"]Dermatologist is dublin georgia[/url], http://jflx.heuthrilv.cc.im/ Dermatologist is dublin georgia, cxx, <a href="http://fhwd.repchooz.cc.im/#post_#.html">Tommy williams homes florida gainesville</a>, [url="http://fhwd.repchooz.cc.im/#post_#.html"]Tommy williams homes florida gainesville[/url], http://fhwd.repchooz.cc.im/#post_#.html Tommy williams homes florida gainesville, 947533, <a href="http://ysgi.nuyher.cc.im/pb.html">Tennessee titans water bottle stainless steel</a>, [url="http://ysgi.nuyher.cc.im/pb.html"]Tennessee titans water bottle stainless steel[/url], http://ysgi.nuyher.cc.im/pb.html Tennessee titans water bottle stainless steel, jlor, <a href="http://grfd.treew.cc.im/">Professional image clothing in louisiana</a>, [url="http://grfd.treew.cc.im/"]Professional image clothing in louisiana[/url], http://grfd.treew.cc.im/ Professional image clothing in louisiana, tsrczm, <a href="http://ayuf.leifonc.cc.im/#post_#.html">John yukon westfield new jersey</a>, [url="http://ayuf.leifonc.cc.im/#post_#.html"]John yukon westfield new jersey[/url], http://ayuf.leifonc.cc.im/#post_#.html John yukon westfield new jersey, lxvg, <a href="http://pronleaq.vugg.net/wiki_xc.html">Mercruiser parts in portland oregon</a>, [url="http://pronleaq.vugg.net/wiki_xc.html"]Mercruiser parts in portland oregon[/url], http://pronleaq.vugg.net/wiki_xc.html Mercruiser parts in portland oregon, =-OOO,
2011-03-24 23:04:23 by: 匿名用户
comment3, <a href="http://xvey.cofasp.cc.im/">Tree solutions arborist washington</a>, [url="http://xvey.cofasp.cc.im/"]Tree solutions arborist washington[/url], http://xvey.cofasp.cc.im/ Tree solutions arborist washington, >:DDD, <a href="http://ancoj.vugg.net/wiki_di.html">Acreage california northern sale</a>, [url="http://ancoj.vugg.net/wiki_di.html"]Acreage california northern sale[/url], http://ancoj.vugg.net/wiki_di.html Acreage california northern sale, :-((, <a href="http://ggbr.ctersa.cc.im/">Motel south haven mississippi</a>, [url="http://ggbr.ctersa.cc.im/"]Motel south haven mississippi[/url], http://ggbr.ctersa.cc.im/ Motel south haven mississippi, tyiit, <a href="http://lxfr.peubiow.cc.im/#post_#.html">Trailer sales nashville tennessee</a>, [url="http://lxfr.peubiow.cc.im/#post_#.html"]Trailer sales nashville tennessee[/url], http://lxfr.peubiow.cc.im/#post_#.html Trailer sales nashville tennessee, 8-O, <a href="http://xddu.sererfe.cc.im/">Taxidermy connecticut antler mount</a>, [url="http://xddu.sererfe.cc.im/"]Taxidermy connecticut antler mount[/url], http://xddu.sererfe.cc.im/ Taxidermy connecticut antler mount, yjbat, <a href="http://gnxu.exorl.cc.im/#post_#.html">Onalaska school in washington</a>, [url="http://gnxu.exorl.cc.im/#post_#.html"]Onalaska school in washington[/url], http://gnxu.exorl.cc.im/#post_#.html Onalaska school in washington, =-), <a href="http://pjqd.leifonc.cc.im/">Dps wanted list orange county texas</a>, [url="http://pjqd.leifonc.cc.im/"]Dps wanted list orange county texas[/url], http://pjqd.leifonc.cc.im/ Dps wanted list orange county texas, >:-DDD, <a href="http://ancoj.vugg.net/wiki_wg.html">Poems that michigan poets wrote</a>, [url="http://ancoj.vugg.net/wiki_wg.html"]Poems that michigan poets wrote[/url], http://ancoj.vugg.net/wiki_wg.html Poems that michigan poets wrote, >:P, <a href="http://beothoj.vugg.net/wiki_mz.html">Merrimack new hampshire lawyer locator</a>, [url="http://beothoj.vugg.net/wiki_mz.html"]Merrimack new hampshire lawyer locator[/url], http://beothoj.vugg.net/wiki_mz.html Merrimack new hampshire lawyer locator, :-O, <a href="http://ymwz.luosupph.cc.im/">Property sales excise tax washington</a>, [url="http://ymwz.luosupph.cc.im/"]Property sales excise tax washington[/url], http://ymwz.luosupph.cc.im/ Property sales excise tax washington, 8-((,
2011-03-24 23:04:25 by: 匿名用户
comment5, <a href="http://rgax.repchooz.cc.im/#post_#.html">Gold star realty jacksonville alabama</a>, [url="http://rgax.repchooz.cc.im/#post_#.html"]Gold star realty jacksonville alabama[/url], http://rgax.repchooz.cc.im/#post_#.html Gold star realty jacksonville alabama, =-))), <a href="http://mierep.vugg.net/wiki_pj.html">Logging clearing bonners ferry idaho</a>, [url="http://mierep.vugg.net/wiki_pj.html"]Logging clearing bonners ferry idaho[/url], http://mierep.vugg.net/wiki_pj.html Logging clearing bonners ferry idaho, npuunj, <a href="http://nakf.poiyt.cc.im/li.html">White clover court ohio</a>, [url="http://nakf.poiyt.cc.im/li.html"]White clover court ohio[/url], http://nakf.poiyt.cc.im/li.html White clover court ohio, 47863, <a href="http://epgx.heuthrilv.cc.im/#post_#.html">Missouri auto insurance statute of limitation</a>, [url="http://epgx.heuthrilv.cc.im/#post_#.html"]Missouri auto insurance statute of limitation[/url], http://epgx.heuthrilv.cc.im/#post_#.html Missouri auto insurance statute of limitation, 8-PPP, <a href="http://vingderw.vugg.net/wiki_om.html">Oklahoma joe longhorn smokers</a>, [url="http://vingderw.vugg.net/wiki_om.html"]Oklahoma joe longhorn smokers[/url], http://vingderw.vugg.net/wiki_om.html Oklahoma joe longhorn smokers, =-OOO, <a href="http://wijk.cofasp.cc.im/">Rose of sharon fence in ohio</a>, [url="http://wijk.cofasp.cc.im/"]Rose of sharon fence in ohio[/url], http://wijk.cofasp.cc.im/ Rose of sharon fence in ohio, 583584, <a href="http://snca.therquel.cc.im/">Sex personals rebecca georgia</a>, [url="http://snca.therquel.cc.im/"]Sex personals rebecca georgia[/url], http://snca.therquel.cc.im/ Sex personals rebecca georgia, =-PPP, <a href="http://ymxi.bretfe.cc.im/cw.html">Texas roadhouse in longview</a>, [url="http://ymxi.bretfe.cc.im/cw.html"]Texas roadhouse in longview[/url], http://ymxi.bretfe.cc.im/cw.html Texas roadhouse in longview, 8[[, <a href="http://vingderw.vugg.net/wiki_jq.html">State farm in redwood falls minnesota</a>, [url="http://vingderw.vugg.net/wiki_jq.html"]State farm in redwood falls minnesota[/url], http://vingderw.vugg.net/wiki_jq.html State farm in redwood falls minnesota, soxghp, <a href="http://rtdl.therquel.cc.im/#post_#.html">Confined space blower in maine</a>, [url="http://rtdl.therquel.cc.im/#post_#.html"]Confined space blower in maine[/url], http://rtdl.therquel.cc.im/#post_#.html Confined space blower in maine, grbz, <a href="http://cswy.bretas.cc.im/kd.html">Shoe stores in christiansburg virginia</a>, [url="http://cswy.bretas.cc.im/kd.html"]Shoe stores in christiansburg virginia[/url], http://cswy.bretas.cc.im/kd.html Shoe stores in christiansburg virginia, 7893, <a href="http://lttb.ticgur.cc.im/">Dvd sales georgia ave dc</a>, [url="http://lttb.ticgur.cc.im/"]Dvd sales georgia ave dc[/url], http://lttb.ticgur.cc.im/ Dvd sales georgia ave dc, 893, <a href="http://oaqz.nuyher.cc.im/">Cna wages in florida</a>, [url="http://oaqz.nuyher.cc.im/"]Cna wages in florida[/url], http://oaqz.nuyher.cc.im/ Cna wages in florida, %OO, <a href="http://vingderw.vugg.net/wiki_zg.html">S lyons ohio telephone directory</a>, [url="http://vingderw.vugg.net/wiki_zg.html"]S lyons ohio telephone directory[/url], http://vingderw.vugg.net/wiki_zg.html S lyons ohio telephone directory, 203, <a href="http://zftz.repchooz.cc.im/">Applying for hud in iowa</a>, [url="http://zftz.repchooz.cc.im/"]Applying for hud in iowa[/url], http://zftz.repchooz.cc.im/ Applying for hud in iowa, yzcsw, <a href="http://wmec.poiyt.cc.im/kx.html">Ratings for dentists in springfield illinois</a>, [url="http://wmec.poiyt.cc.im/kx.html"]Ratings for dentists in springfield illinois[/url], http://wmec.poiyt.cc.im/kx.html Ratings for dentists in springfield illinois, 9078, <a href="http://uwzd.heuthrilv.cc.im/">Dripping springs texas isd</a>, [url="http://uwzd.heuthrilv.cc.im/"]Dripping springs texas isd[/url], http://uwzd.heuthrilv.cc.im/ Dripping springs texas isd, 889, <a href="http://owtq.ctersa.cc.im/">Big eazy restaurant in flint michigan</a>, [url="http://owtq.ctersa.cc.im/"]Big eazy restaurant in flint michigan[/url], http://owtq.ctersa.cc.im/ Big eazy restaurant in flint michigan, qgntt, <a href="http://fmer.leifonc.cc.im/#post_#.html">Airlines flying into laramie wyoming airport</a>, [url="http://fmer.leifonc.cc.im/#post_#.html"]Airlines flying into laramie wyoming airport[/url], http://fmer.leifonc.cc.im/#post_#.html Airlines flying into laramie wyoming airport, yhh, <a href="http://xzns.flatocq.cc.im/">Madison county indiana chamber of commerce</a>, [url="http://xzns.flatocq.cc.im/"]Madison county indiana chamber of commerce[/url], http://xzns.flatocq.cc.im/ Madison county indiana chamber of commerce, 370653, <a href="http://misscladr.vugg.net/wiki_si.html">Texas board examiners psychologist</a>, [url="http://misscladr.vugg.net/wiki_si.html"]Texas board examiners psychologist[/url], http://misscladr.vugg.net/wiki_si.html Texas board examiners psychologist, %PP,
2011-03-24 23:04:28 by: 匿名用户
comment3, <a href="http://rybl.ticgur.cc.im/#post_#.html">Jacksonville florida naval hospital</a>, [url="http://rybl.ticgur.cc.im/#post_#.html"]Jacksonville florida naval hospital[/url], http://rybl.ticgur.cc.im/#post_#.html Jacksonville florida naval hospital, >:-), <a href="http://xqyj.nuyher.cc.im/">Safet net llc salem oregon</a>, [url="http://xqyj.nuyher.cc.im/"]Safet net llc salem oregon[/url], http://xqyj.nuyher.cc.im/ Safet net llc salem oregon, >:-DD, <a href="http://bwsm.cofasp.cc.im/#post_#.html">Maryland bathtub resurface removl</a>, [url="http://bwsm.cofasp.cc.im/#post_#.html"]Maryland bathtub resurface removl[/url], http://bwsm.cofasp.cc.im/#post_#.html Maryland bathtub resurface removl, :[[[, <a href="http://puvv.bretfe.cc.im/">Video dreams in chandler arizona</a>, [url="http://puvv.bretfe.cc.im/"]Video dreams in chandler arizona[/url], http://puvv.bretfe.cc.im/ Video dreams in chandler arizona, puiq, <a href="http://iftu.repchooz.cc.im/">Crystal grand wisconsin dells</a>, [url="http://iftu.repchooz.cc.im/"]Crystal grand wisconsin dells[/url], http://iftu.repchooz.cc.im/ Crystal grand wisconsin dells, >:-], <a href="http://reublogn.vugg.net/wiki_fc.html">Moving service kokomo indiana</a>, [url="http://reublogn.vugg.net/wiki_fc.html"]Moving service kokomo indiana[/url], http://reublogn.vugg.net/wiki_fc.html Moving service kokomo indiana, %-[[, <a href="http://mejb.luosupph.cc.im/">Washington county mh mr</a>, [url="http://mejb.luosupph.cc.im/"]Washington county mh mr[/url], http://mejb.luosupph.cc.im/ Washington county mh mr, 8-[[, <a href="http://cttp.snowtix.cc.im/#post_#.html">Biogrphy of george washington carver</a>, [url="http://cttp.snowtix.cc.im/#post_#.html"]Biogrphy of george washington carver[/url], http://cttp.snowtix.cc.im/#post_#.html Biogrphy of george washington carver, 8-D, <a href="http://fdwm.poiyt.cc.im/em.html">Michael e thompson wetlands maine</a>, [url="http://fdwm.poiyt.cc.im/em.html"]Michael e thompson wetlands maine[/url], http://fdwm.poiyt.cc.im/em.html Michael e thompson wetlands maine, 776, <a href="http://vwaa.treew.cc.im/br.html">Clinical trials clara maas new jersey</a>, [url="http://vwaa.treew.cc.im/br.html"]Clinical trials clara maas new jersey[/url], http://vwaa.treew.cc.im/br.html Clinical trials clara maas new jersey, alx, <a href="http://gugf.alers.cc.im/#post_#.html">Arizona harkins movie theater</a>, [url="http://gugf.alers.cc.im/#post_#.html"]Arizona harkins movie theater[/url], http://gugf.alers.cc.im/#post_#.html Arizona harkins movie theater, zgma, <a href="http://plib.leifonc.cc.im/#post_#.html">Bear hunts maine idaho guide</a>, [url="http://plib.leifonc.cc.im/#post_#.html"]Bear hunts maine idaho guide[/url], http://plib.leifonc.cc.im/#post_#.html Bear hunts maine idaho guide, dvhygr, <a href="http://fcxg.bretfe.cc.im/">Washington indiana mark kelsey</a>, [url="http://fcxg.bretfe.cc.im/"]Washington indiana mark kelsey[/url], http://fcxg.bretfe.cc.im/ Washington indiana mark kelsey, =DDD, <a href="http://iflv.suringd.cc.im/">Michigan youth baseball tournements</a>, [url="http://iflv.suringd.cc.im/"]Michigan youth baseball tournements[/url], http://iflv.suringd.cc.im/ Michigan youth baseball tournements, 8-]], <a href="http://yrag.flatocq.cc.im/#post_#.html">Overland park kansas fbi china</a>, [url="http://yrag.flatocq.cc.im/#post_#.html"]Overland park kansas fbi china[/url], http://yrag.flatocq.cc.im/#post_#.html Overland park kansas fbi china, >:DDD, <a href="http://ivmj.bretas.cc.im/wg.html">Pinnacle at creek apartment colorado</a>, [url="http://ivmj.bretas.cc.im/wg.html"]Pinnacle at creek apartment colorado[/url], http://ivmj.bretas.cc.im/wg.html Pinnacle at creek apartment colorado, 7370, <a href="http://yxwv.nujiu.cc.im/ud.html">Bonneville high 1985 idaho falls</a>, [url="http://yxwv.nujiu.cc.im/ud.html"]Bonneville high 1985 idaho falls[/url], http://yxwv.nujiu.cc.im/ud.html Bonneville high 1985 idaho falls, 403, <a href="http://fwuw.nujiu.cc.im/oa.html">Identify a north carolina lizard</a>, [url="http://fwuw.nujiu.cc.im/oa.html"]Identify a north carolina lizard[/url], http://fwuw.nujiu.cc.im/oa.html Identify a north carolina lizard, 222451, <a href="http://ehjj.bretfe.cc.im/">Fort myers florida school calendar</a>, [url="http://ehjj.bretfe.cc.im/"]Fort myers florida school calendar[/url], http://ehjj.bretfe.cc.im/ Fort myers florida school calendar, :(((, <a href="http://lfwv.ticgur.cc.im/#post_#.html">Cdl cycle in new jersey</a>, [url="http://lfwv.ticgur.cc.im/#post_#.html"]Cdl cycle in new jersey[/url], http://lfwv.ticgur.cc.im/#post_#.html Cdl cycle in new jersey, xtjzp, <a href="http://xqmr.repchooz.cc.im/">Texas dept of assessments</a>, [url="http://xqmr.repchooz.cc.im/"]Texas dept of assessments[/url], http://xqmr.repchooz.cc.im/ Texas dept of assessments, 351477,
最短5个字
医心微信 >
京公网安备 11010102002968号