ABSTRACT
@#目前，针对肿瘤治疗药物在体内应用中的局限性，出现了许多高效的药物递送系统的研究，其中纳米药物载体技术和 细胞药物载体技术较为热门，并取得了许多成果。纳米药物载体具有的优点，如防止药物发生降解及灭活，增加药物的靶向性， 降低药物的毒副作用，可量产等。细胞载体更是利用细胞本身固有的特性，具有主动靶向肿瘤部位、低免疫原性和穿过体内生理 屏障等优点，在药物递送研究中有广阔的应用前景，但是仍然存在很多问题及不足。研究人员创造性地将两者结合，使他们的优 势互补，极大地强化了递送药的效率，增加了体内靶向性，降低了周围组织的细胞毒性等。本文从近几年来细胞-纳米药物载体 系统研究的文献中，总结了红细胞、干细胞、单核/巨噬细胞、 T细胞、树突状细胞（dendritic cell，DC）等作为纳米药物细胞载体的优 缺点及目前的应用现状。
ABSTRACT
Objective To evaluate the safety and effectiveness of balloon-assisted clipping of paraclinoid aneurysms with hybrid operatioa Methods From July 2011 to July 2018,119 consecutive patients treated with the balloon-assisted clipping of paraclinoid aneurysms at the Hybrid Operation Room, Department of Neurosurgery, West China Hospital,Sichuan University were enrolled retrospectively. Patients' age, gender, Hunt-Hess grade, ocular symptoms at admission, and location and size of aneurysms were collected. Balloon-assisted craniotomy for clipping aneurysms was used ,95 of them were treated with detachable balloon at the proximal end of the aneurysms, and 24 were blocked by balloons in the aneurysm neck straddles. During the operation,the state of discharge after surgery,and the follow-up results at 6 months after discharge of the patients were observed. The operation effect and complications were evaluated.Results Of the 119 patients,94 were female and 25 were male;aged 27 -82 years (mean 57 ± 15 years). Twenty-nine patients (24. 4%) showed decreased vision,62 (52. 1%) had dizziness and headache symptoms. The remaining 28 had no obvious symptoms. Hunt-Hess grade III in 3 cases (2. 5%) ,grade I-II in 42 cases (35. 3%) ,the remaining 74 (62. 2%) were unruptured aneurysms. Twenty-one patients (17.6%) had clinoid segment aneurysms, 82 (68.9%) had ophthalmic segment aneurysms, and 16 (13. 4%) had posterior communication aneurysms. The maximum diameter of the aneurysms was 5 to 35 mm (mean 19 ±7 mm) ,and the aneurysm diameter of 112 patients (94.1%) were > 10 mm. The aneurysms were successfully clipped in 111 cases (93. 3%) during the operation. Five patients had aneurysm neck and internal carotid artery lacerations during the clipping,and one was obviously unable to be clipped due to the neck calcification. After Hyperglide balloon saddle block, 1 patient occurred balloon rupture during the puncture and aspiration of the aneurysmal cavity. When the balloon was blocked in 1 case, balloon displacement occurred during repeated filling adjustment of aneurysm clips and the distal end detached into an aneurysm cavity and was clipped by an aneurysm clip. Three patients died at discharge, they were all aneurysm neck and internal carotid artery lacerations, and they were patients with massive cerebral infarction after aneurysm tapping. Five patients were in a coma; another 6 had hemiplegia symptoms. The remaining 105 patients (88. 2%) had no obvious neurological deficits at discharge. Six months after discharge, 11 patients with neurological deficits were followed up by telephone. Among the 5 comatose patients,3 died within one week after discharge. The consciousness of 2 cases changed from coma to indifference, their left limb muscle strength was grade III,and blurred vision was the same as before operation. Of the 6 hemiplegic patients, 1 died 3 months after discharge, and the other 5 had clear consciousness and their blurred vision was the same as before operation, all had limb hemiplegia, and their muscle strength was grade I - U - Conclusion Hybrid surgery with balloon-assisted clipping technique may effectively treat complex paraclinoid aneurysms.