| 1 | Gallstone ileus:One-stage surgery in a patient with intermittent obstruction显示文摘Gallstone ileus, an uncommon complication of cholelithiasis, is described as a mechanical intestinal obstruction due to impaction of one or more large gallstones within the gastrointestinal tract. The clinical presentation is variable, depending on the site of obstruction, manifested as acute, intermittent or chronic episodes. A 51-year-old female patient was referred to our hospital with 3 events of intestinal obstruction during the previous 7 d. At admission, there were clinical signs of intestinal obstruction; abdominal film demonstrated dilated bowel loops, air-fluid levels and a vague image of a stone in the inferior left quadrant. Once stabilized, a laparotomy was performed. Surgical findings were distention of the jejunum and ileum proximal to a palpable stone in the ileum as well as gallstones and a cholecystoduodenal fistula in the gallbladder. An enterolithotomy, repair of the cholecystoduodenal fistula and cholecystectomy were performed. The postoperative course was uneventful. There is no uniform surgical procedure for this disease. When the patient is too ill or when biliary surgery is not advisable, an enterolithotomy is the best option. The one-stage procedure should be the offered to adequately stabilized patients when local and general conditions, such as good cardiorespiratory and metabolic reserve permit a more prolonged surgical procedure. | Carlos M Nuo-Guzmán José Arróniz-Jáuregui Pável A Moreno-Pérez édgar A Chávez-Solís Nereida Esparza-Arias Cuauhtémoc I Hernández-González | 2010 | World Journal of Gastrointestinal Surgery2010，2，5： | 5 |
| 3 | Early performance of two tropical dry forest species after assisted migration to pine-oak forests at different altitudes:strategic response to climate change显示文摘Assisted migration has been proposed as a strategy for adaptive management of forest species in response to expected effects of climate change,but it is controversial for several reasons.Tropical dry forests are among the most threatened ecosystems in the world.In Mexico,historically,land-use change and deforestation have been decreasing forest cover,and climate change is shifting the potential distribution of different forest types,exacerbating the risk of local extinctions.Assisted altitudinal migration could be a feasible strategy for reducing local extinctions in response to climate change and lack of landscape connectivity.Our objective was to evaluate survival and growth of Albizia plurijuga and Ceiba aesculifolia,two tropical deciduous forests species in Mexico.We transplanted 4-month-old seedlings to experimental raised beds at three altitudes(2100,2400 and 2700 m a.s.l.),exceeding their upper regional limit of distribution(2000 m a.s.l.).We also tested seed germination at each altitude.We monitored the experiment for 10 months.For both species,as altitude increased and cold weather was more prevalent,plant performance declined.Within species,differences in individual growth were significant among altitudes.Overall survival was 18.5%for A.plurijuga and 24.5%for C.aesculifolia.Both species had higher survival and better growth at lower altitude,and no seedling emergence at any altitude.We conclude that assisted migration can be implemented for each species by an upward attitudinal shift within,and not exceeding,400 m beyond their present upper altitudinal limit of distribution.Our results indicate that for many species that show altitudinal gradients at regional scales,unless current climate conditions change,the potential to establish outside their range is minimal. | Pilar Angélica Gómez-Ruiz Cuauhtémoc Sáenz-Romero Roberto Lindig-Cisneros | 2020 | Journal of Forestry Research2020，31，4： | 0 |
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