Epidemiological and clinical characteristics of adenovirus-associated respiratory tract infection in children in Hangzhou, China, 2019-2024.

This study aimed to assess the impact of COVID-19 on the prevalence of adenovirus (AdV) infection in children. This study retrospectively analyzed the changes in the epidemiological and clinical features of AdV-associated respiratory infections in children in Hangzhou, China, between January 2019 and July 2024. A total of 771 316 samples were included in the study, and the positive rate was 6.10% (47 050/771 316). Among them, the positive rate of AdV infection was highest in 2019, reaching 11.29% (26 929/238 333), while the positive rates in the remaining years were between 2% and 9%. In terms of seasonal epidemic characteristics, the summer of 2019 was the peak of AdV incidence, with the positive rate peaking at around 16.95% (7275/45 268), followed by a gradual decline and a low-level epidemic in winter, with a positive rate of 8.79% (8094/92 060). However, during the period 2020-2024, the AdV epidemic season did not show any significant regularity. Gender analysis revealed that the positive rate of male patients was generally greater than that of female patients. In different age groups, the population susceptible to AdV changed before and after the epidemic. In the early and middle stages of the COVID-19 epidemic, the susceptible population was mainly 2-5 years old, whereas in the later stages of the epidemic, the susceptible population was 5-18 years old. In addition, the main clinical symptoms of AdV-positive children from 2019-2024 were respiratory tract symptoms and fever. In summary, the COVID-19 epidemic has had a certain impact on the prevalence of AdV. These findings provide an important basis and reference for the prevention and diagnosis of AdV, especially in the context of increasing age- and gender-specific public health strategies.

Defect Passivation of Mn2+-Doped CsPbX3(X=Cl,Br) Perovskite Nanocrystals as Electriccatalyst for Overall Water Splitting.

Mn:CsPbX3 (X= Cl, Br) nanosheets with excellent electrocatalytic properties are reported in this paper. Compared to conventional catalyst arrays, the band gap of Mn:CsPbBr3 nanocrystalline is easily tuned, the carrier diffusion distance is remote, the band edge position of the band structure is favorable for a wide range of electrocatalytic redox reactions, and the catalytic active site is maximally exposed. The Mn:CsPbBr3 exhibited preferable electrocatalytic hydrogen evolution (HER) performance in 1 mol/L KOH. The excess potential of the oxygen evolution reaction(OER) required to drive current densities of 10 and 100 mA cm-2 is only 114.4 and 505.4 mV, with a Tafel slope of 43 mV dec-1. At a current density of 10 mA cm-2, the excess potential required for the HER is 158.6 mV and it exhibited excellent electrochemical stability. The Mn:CsPbBr3 nanocrystalline consists of two electrodes for the overall water splitting, requiring a voltage of only 1.45 V. Which in turn provides implications for the optimization of electrocatalysts in alkaline electrolytes with the aim of developing the next generation of 2D electrocatalysts for overall water splitting.

Polyzwitterion-grafted decellularized bovine intercostal arteries as new substitutes of small-diameter arteries for vascular regeneration.

Coronary artery bypass grafting is acknowledged as a major clinical approach for treatment of severe coronary artery atherosclerotic heart disease. This procedure typically requires autologous small-diameter vascular grafts. However, the limited availability of the donor vessels and associated trauma during tissue harvest underscore the necessity for artificial arterial alternatives. Herein, decellularized bovine intercostal arteries were successfully fabricated with lengths ranging from 15 to 30 cm, which also closely match the inner diameters of human coronary arteries. These decellularized arterial grafts exhibited great promise following poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) grafting from the inner surface. Such surface modification endowed the decellularized arteries with superior mechanical strength, enhanced anticoagulant properties and improved biocompatibility, compared to the decellularized bovine intercostal arteries alone, or even those decellularized grafts modified with both heparin and vascular endothelial growth factor. After replacement of the carotid arteries in rabbits, all surface-modified vascular grafts have shown good patency within 30 days post-implantation. Notably, strong signal was observed after α-SMA immunofluorescence staining on the PMPC-grafted vessels, indicating significant potential for regenerating the vascular smooth muscle layer and thereby restoring full structures of the artery. Consequently, the decellularized bovine intercostal arteries surface modified by PMPC can emerge as a potent candidate for small-diameter artificial blood vessels, and have shown great promise to serve as viable substitutes of arterial autografts.

Structural elucidation of a capsular polysaccharide from Bacteroides uniformis and its ameliorative impact on DSS-induced colitis in mice.

Capsular polysaccharides derived from Bacteroides species have emerged as potential mitigators of intestinal inflammation in murine models. However, research on capsular polysaccharides from B. uniformis, a Bacteroides species with reduced abundance in colons of patients with ulcerative colitis, remains scarce. In this study, we extracted a neutral polysaccharide component from B. uniformis ATCC8492, termed BUCPS1B, using ultrasonic disruption, ethanol precipitation, and anion exchange chromatography. Structural characterization revealed BUCPS1B as a water-soluble polysaccharide with an α-1,4-glucan main chain adorned with minor substituent sugar residues. BUCPS1B alleviated intestinal inflammation in a mouse model of colitis and induced polarization of macrophages into M2-type. Furthermore, BUCPS1B modulated the gut microbiota composition, increased the abundance of the probiotic Akkermansia muciniphila and altered the gut metabolic profile to promote phenylalanine and short chain fatty acids metabolism. BUCPS1B is therefore a promising candidate to prevent inflammation and augment intestinal health.

The Potential of a New Natural Vessel Source: Decellularized Intercostal Arteries as Sufficiently Long Small-Diameter Vascular Grafts.

Small-diameter vascular grafts (SDVGs) are severely lacking in clinical settings. Therefore, our study investigates a new source of biological vessels-bovine and porcine decellularized intercostal arteries (DIAs)-as potential SDVGs. We utilized a combination of SDS and Triton X-100 to perfuse the DIAs, establishing two different time protocols. The results show that perfusing with 1% concentrations of each decellularizing agent for 48 h yields DIAs with excellent biocompatibility and mechanical properties. The porcine decellularized intercostal arteries (PDIAs) we obtained had a length of approximately 14 cm and a diameter of about 1.5 mm, while the bovine decellularized intercostal arteries (BDIAs) were about 29 cm long with a diameter of approximately 2.2 mm. Although the lengths and diameters of both the PDIAs and BDIAs are suited for coronary artery bypass grafting (CABG), as the typical diameter of autologous arteries used in CABG is about 2 mm and the grafts required are at least 10 cm long, our research indicates that BDIAs possess more ideal mechanical characteristics for CABG than PDIAs, showing significant potential. Further enhancements may be necessary to address their limited hemocompatibility.

A study of the stabilization and solidification of heavy metals in co-vitrification of medical waste incineration ash and coal fly ash.

Medical waste incineration ash (MWIA) has significant concentrations of heavy metals, dioxins, and chlorine that, if handled incorrectly, might cause permanent damage to the environment and humans. The low content of calcium (Ca), silicon (Si), and aluminum (Al) is a brand-new challenge for the melting technique of MWIA. This work added coal fly ash (CFA) to explore the effect of melting on the detoxication treatment of MWIA. It was found that the produced vitrification product has a high vitreous content (98.61%) and a low potential ecological risk, with an initial ash solidification rate of 67.38%. By quantitatively assessing the morphological distribution features of heavy metals in ashes before melting and molten products, the stabilization and solidification rules of heavy metals during the melting process were investigated. This work ascertained the feasibility of co-vitrification of MWIA and CFA. In addition, the high-temperature melting and vitrification accelerated the detoxification of MWIA and the solidification of heavy metals.

Template Synthesis of Cyclometalated Macrocycle Iridium(III) Complexes Based on Photoinduced C-N Cross-Coupling Reactions In Situ.

The synthesis of metal macrocycle complexes holds paramount importance in coordination and supramolecular chemistry. Toward this end, we report a new, mild, and efficient protocol for the synthesis of cyclometalated macrocycle Ir(III) complexes: [Ir(L1)](PF6) (1), [Ir(L2)](PF6) (2), and [Ir(L3)](PF6) (3), where L1 presents 10,17-dioxa-3,6-diaza-2(2,8),7(8,2)-diquinolina-1,8(1,4)-dibenzenacyclooctadecaphane, L2 is 10,13,16,19,22,25-hexaoxa-3,6-diaza-2(2,8),7(8,2)-diquinolina-1,8(1,4)-dibenzenacyclohexacosaphane, and L3 is 4-methyl-10,13,16,19,22,25-hexaoxa-3,6-diaza-2(2,8),7(8,2)-diquinolina-1,8(1,4)-dibenzenacyclohexacosaphane. This synthesis involves the preassembly of two symmetric 2-phenylquinoline arms into C-shape complexes, followed by cyclization with diamine via in situ interligand C-N cross-coupling, employing a metal ion as a template. Moreover, the synthetic yield of these cyclometalated Ir(III) complexes, tethered by an 18-crown-6 ether-like chain, is significantly enhanced in the presence of K+ ion as a template. The resultant cyclometalated macrocycle Ir(III) complexes exhibit high stability, efficient singlet oxygen generation, and superior catalytic activity for the aerobic selective oxidation of sulfides into sulfoxides under visible light irradiation in aqueous media at room temperature. The photocatalyst 2 demonstrates recyclability and can be reused at least 10 times without a significant loss of catalytic activity. These results unveil a new and complementary approach to the design and in situ synthesis of cyclometalated macrocycle Ir(III) complexes via a mild interligand-coupling strategy.

Investigation of unexpected silane ions caused by gas-phase reactions in Orbitrap gas chromatography-mass spectrometry.

RATIONALE: The mass spectra of compounds containing dimethyl (phenyl)silyl group (-SiMe2Ph) sometimes exhibit unusual ion peaks when measured using Orbitrap gas chromatography-mass spectrometry (GC-MS). This would complicate the mass spectra and may limit the matching of spectral data with preexisting resources for compound annotation. These peaks were identified as products from reactions with residual water. METHODS: A series of dimethyl (phenyl)silyl compounds were dissolved in methanol and investigated using Orbitrap GC-MS. Certain ions reacted with residual water in the C-trap. The reaction was confirmed using accurate mass and elemental composition analysis via MS studies, and the active center of the reaction was determined using density functional theory (DFT) calculations. RESULTS: Two types of gas-phase reactions between gaseous water and cations from a series of silanes were identified. DFT calculations indicate that silicon (Si) acts as the active center for these gas-phase water reactions. Compounds with multiple Si atoms generate a larger number of additional ions, which would complicate the mass spectra. The mass spectra of vinylsilanes and alkylsilanes with -SiMe2Ph indicate that the conjugated group linked to -SiMe2Ph can affect the water adduction process. CONCLUSIONS: Silane ions could react with residual water in the C-trap of an Orbitrap mass spectrometer. The mass spectra of these compounds may exhibit unexplained peaks arising from gas-phase reactions. Although these reactions may decrease spectral matching scores for compound annotation, they offer opportunities for systematic investigations into the mechanistic and kinetic aspects of high-energy ion reactivity.

Attempts to obtain clean biochar from hyperaccumulator through pyrolysis: Removal of heavy metals and transformation of phosphorus.

The sound disposal of the ensuing heavy metal-rich plants can address the aftermath of phytoremediation. In this study, the first attempt was made to obtain heavy metals-free and phosphorus-rich biochar from phytoremediation residue (PR) by pyrolysis, and the effects of chlorinating agent type, chlorine dosage, and pyrolysis residence time on heavy metal removal, phosphorus (P) transformation, and biochar properties were investigated. The results showed that as chlorine dosage and pyrolysis residence time increased, added polyvinyl chloride (PVC) reduced the concentration of Zn in biochar to one-tenth of that in PR by intensified chlorination, where both Zn concentration (2727.50 mg/kg) and its leaching concentration (29.13 mg/L) met the utilization requirements, in which the acid-base property of biochar plays a key role in heavy metal leaching. Meanwhile, more than 90% of P in PR remained in biochar and the bioavailability of P in biochar enhanced with the decomposition of organic P to inorganic P, where the concentration of plant-availability P (Pnac) expanded from 1878.40 mg/kg in PR to 8454.00 mg/kg in biochar. This study demonstrated that heavy metal hyperaccumulator can be converted into heavy metal-free and phosphorus-rich biochar with promising applications, which provides new perspectives for the treatment of such hazardous wastes.

The Lateral Parabrachial Nucleus Inputs to the Lateral Hypothalamus Trigger Nocifensive Behaviors.

The lateral parabrachial nucleus (LPBN) is known to play a key role in relaying noxious information from the spinal cord to the brain. Different LPBN efferent mediate different aspects of the nocifensive response. However, the function of the LPBN â†’ lateral hypothalamus (LH) circuit in response to noxious stimuli has remained unknown. Here, we show that LPBN â†’ LH circuit is activated by noxious stimuli. Interestingly, either activation or inhibition of this circuit induced analgesia. Optogenetic activation of LPBN afferents in the LH elicited spontaneous jumping and induced place aversion. Optogenetic inhibition inhibited jumping behavior to noxious heat. Ablation of LH glutamatergic neurons could abolish light-evoked analgesia and jumping behavior. Our study revealed a role for the LPBN â†’ LH pathway in nocifensive behaviors.

Research on structural strengthening technology for regenerative denitration catalysts.

The cost of replacing failed selective catalytic reduction (SCR) catalysts and their disposal as hazardous solid waste is high. If failed catalysts are recovered and regenerated into new SCR denitration catalysts, the cost of flue gas denitration can be effectively reduced. However, regenerated SCR catalysts have relatively low structural strength and activity and cannot yet form an effective replacement. In this study, aluminum dihydrogen phosphate, aluminum nitrate, and aluminum sulfate were used as structural strengthening agents in the regeneration of SCR catalysts, and over-impregnation, drumming-assisted impregnation, and ultrasonic-assisted preparation techniques were compared. The corresponding regenerated SCR catalysts were then prepared and analyzed for compressive strength, wear strength, H2-TPR, NH3-TPD, and in situ IR. Factors influencing the structural strength, physical properties, and catalytic activity of the regenerated catalysts were investigated. The best results were obtained as follows: compressive strength of 4.57 MPa, wear rate of 0.088% kg-1, and denitration of 58% after 10 min of drumming-assisted impregnation in an aluminum sulfate solution with a concentration of 16%. Based on this, a synergistic method for catalyst activity and structural strengthening was explored to support the design of better SCR catalysts for regeneration.

Zn-In Alloying Powder Solvent Free Electrode Toward High-Load Ampere-Hour Aqueous Zn-Mn Secondary Batteries.

Aqueous Zn-ion batteries (ZIBs) are promising candidates for large-scale energy storage due to high safety, abundant reserves, low-cost, and high energy density. However, the reversibility of the metallic Zn anode in the mild electrolyte is still unsatisfactory, due to the Zn dendrite growth, hydrogen evolution, and corrosion passivation. Herein, a Zn-In alloying powder solvent free electrode is proposed to replace the Zn foil in ZIBs. The novel Zn anodes are constructed by a solvent-free manufacturing process with carbons, forming a 3D Zn deposition network and providing uniformly electric field distribution. The In on the Zn powder surface can increase the overpotential for hydrogen evolution and further improve the morphology of Zn deposition against dendrite growth. The Zn solvent-free electrodes enable the Zn-MnO2 batteries with high cathode loading mass of 10-20 mg cm-2 to achieve >380 stable cycles. Furthermore, the assembled soft package batteries of 2.4 Ah (52 Wh kg-2 ) is evaluated and the capacity retention is maintained at 80% after 200 cycles at a high areal capacity of 5 mAh cm-2 without gas evolution. This work offers a workable strategy to develop a durable Zn anode for the eventually commercial applications of aqueous Zn-Mn secondary batteries.

Dysfunction of Glutamatergic Synaptic Transmission in Depression: Focus on AMPA Receptor Trafficking.

Pharmacological and anatomical evidence suggests that abnormal glutamatergic neurotransmission may be associated with the pathophysiology of depression. Compounds that act as NMDA receptor antagonists may be a potential treatment for depression, notably the rapid-acting agent ketamine. The rapid-acting and sustained antidepressant effects of ketamine rely on the activation of AMPA receptors (AMPARs). As the key elements of fast excitatory neurotransmission in the brain, AMPARs are crucially involved in synaptic plasticity and memory. Recent efforts have been directed toward investigating the bidirectional dysregulation of AMPAR-mediated synaptic transmission in depression. Here, we summarize the published evidence relevant to the dysfunction of AMPAR in stress conditions and review the recent progress toward the understanding of the involvement of AMPAR trafficking in the pathophysiology of depression, focusing on the roles of AMPAR auxiliary subunits, key AMPAR-interacting proteins, and posttranslational regulation of AMPARs. We also discuss new prospects for the development of improved therapeutics for depression.

Thrombospondin1 mimics rapidly relieve depression via Shank3 dependent uncoupling between dopamine D1 and D2 receptors.

Deficits in astrocyte function contribute to major depressive disorder (MDD) and suicide, but the therapeutic effect of directly reactivating astrocytes for depression remains unclear. Here, specific gains and losses of astrocytic cell functions in the medial prefrontal cortex (mPFC) bidirectionally regulate depression-like symptoms. Remarkably, recombinant human Thrombospondin-1 (rhTSP1), an astrocyte-secreted protein, exerted rapidly antidepressant-like actions through tyrosine hydroxylase (Th)/dopamine (DA)/dopamine D2 receptors (D2Rs) pathways, but not dopamine D1 receptors (D1Rs), which was dependent on SH3 and multiple ankyrin repeat domains 3 (Shank3) in the mPFC. TSP1 in the mPFC might have potential as a target for treating clinical depression.

Anaphylaxis Following Contrast-Enhanced CT with Iodixanol: A Case Report and Literature Review.

Background: Iodixanol-induced anaphylactic reaction is a well-known adverse event of contrast agents, which are generally well-tolerated and reversible. Serious and fatal reactions such as anaphylactic shock after computed tomography (CT) enhancement have been described. However, there is no data on these events in the literature. Objective: This report describes a case of a serious anaphylactic reaction, possibly related to iodixanol and provides an overview of case reports. Case Summary: A 47-year-old women who experienced persistent abdominal pain for more than one month, was proposed of hiatal hernia with CT images taken two weeks previously and was admitted to the gastrointestinal surgery department. The patient underwent contrast-enhanced abdominal CT for the evaluation of multiple intraperitoneal hemodynamic features. A few minutes after abdominal enhanced CT scan, the patient was pale, sweating, had muscle tension and trembling, even coma and profound hypotension with 90/43 mm Hg. Immediately she was supported with oxygen inhalation, was treated with adrenaline subcutaneously, dexamethasone intravenously, and rapid intravenous drip of compound sodium chloride. Ten minutes later, the patient was in respiratory and cardiac arrest and the pupils were dilated. CPR and intermittant static push of 1 mg adrenaline were immediately carried. After endotracheal intubation, the patient's spontaneous heart rate and pupils recovered, and her blood pressure recovered to 105/53 mm Hg. It was suggested that the patient was suffering from iodixanol-induced anaphylactic shock and nephropathy, and she was transferred to the intensive care unit. Despite immediate treatment, the patient died. Conclusion: A 47-year-old female patient with no history of allergies developed severe fatal anaphylactic shock after receiving iodixanol. Although contrast agents induced anaphylactoid/anaphylactic reactions do not often occur, clinicians should be conscious of the potentially serious anaphylactic reaction, which could lead to a life-threatening or fatal event.

Switching the Photoreactions of Ir(III) Diamine Complexes between C-N Coupling and Dehydrogenation under Visible Light Irradiation.

The selective photoreactions under mild conditions play an important role in synthetic chemistry. Herein, efficient and mild protocols for switching the photoreactions of Ir(III)-diamine complexes between the interligand C-N coupling and dehydrogenation are developed in the presence of O2 in EtOH solution. The photoreactions of achiral diamine complexes rac-[Ir(L)2(dm)](PF6) (L is 2-phenylquinoline or 2-(2,4-difluorophenyl)quinoline, dm is 1,2-ethylenediamine, 1,2-diaminopropane, 2-methyl-1,2-diamino-propane, or N,N'-dimethyl-1,2-ethylenediamine) are competitive in the oxidative C-N coupling and dehydrogenation at room temperature, which can be switched into the interligand C-N coupling reaction at 60 °C, affording hexadentate complexes in good to excellent yields, or the dehydrogenative reaction in the presence of a catalytic amount of TEMPO as an additive, affording imine complexes. Mechanism studies reveal that 1O2 is the major reactive oxygen species, and metal aminyl is the key intermediate in the formation of the oxidative C-N coupling and imine products in the photoreaction processes. These will provide a new and practical protocol for the synthesis of multidentate and imine ligands in situ via the postcoordinated strategy under mild conditions.

Hydrothermal oxidation degradation of dioxins in fly ash with water-washing and added Ce-Mn catalyst.

A comprehensive analysis of the effects of the temperature, reaction time, liquid-solid ratio (L/S), and initial pH on the hydrothermal degradation of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) (which are both PCDD/Fs) in municipal solid waste incineration (MSWI) fly ash is presented. Consequently, the hydrothermal degradation reaction is catalyzed using Ce-Mn catalyst under low-temperature conditions to study the effect of the catalyst on the degradation efficiency of PCDD/Fs. The experimental results show that temperature is the most critical factor for the reaction. When the hydrothermal oxidation temperature reaches 280 °C (reaction time = 120 min, original pH = 8.5, L/S = 4 mL/g), the toxicity equivalent (I-TEQ) of PCDD/Fs is only 5.4 ng TEQ/kg, and the degradation efficiency reaches 99.71%. Under these conditions, 2,3,4,7,8-P5CDF makes the highest contribution to I-TEQ degradation, reaching 37.4%. There are four main pathways for the reaction of 2,3,4,7,8-P5CDF with hydroxyl radicals. A comparison of the PCDD/F concentrations of different products shows that the addition of 0.5%, 1.0%, and 1.5% of the Ce-Mn catalyst reduces the degradation efficiency by 8.79%, 1.40%, and 0.07%, respectively, which indicates that the addition of a small quantity of Ce-Mn catalyst does not facilitate the degradation of PCDD/Fs. The addition of the catalyst significantly decreases the degradation efficiency of low-chlorinated homologs but has a relatively small effect on that of high-chlorinated homologs. Therefore, it is concluded that Ce-Mn catalysts are more likely to promote resynthesis than degradation of PCDD/Fs.

The Imprinted PARAFILM as a New Carrier Material for Dried Plasma Spots (DPSs) Utilizing Desorption Electrospray Ionization Mass Spectrometry (DESI-MS) in Phospholipidomics.

The application of desorption electrospray ionization mass spectrometry (DESI-MS) and dried blood spot (DBS) sampling has been successfully implemented several times. However, the difficulty of combining DBS sampling with DESI-MS is still the carrier material used for the blood samples. In this study, a new, easily obtained, and cost-effective carrier substrate for dried plasma spot (DPS) sampling and DESI-MS analysis and its application in phospholipidomics studies was described. First, the effects of several carrier materials, including cellulose-based materials (31 ET paper and filter paper) and non-cellulose-based materials (PARAFILM and its shape-modified material, PTFE-printed glass slide and polyvinylidene fluoride film), were tested. Second, a method combining DPS sampling with DESI-MS for phospholipidomics analysis was established, and parameters affecting compound signal intensities, such as sample volume and sprayer solvent system, were optimized. In conclusion, the total signal intensity obtained from shape-modified PARAFILM was the strongest. The suitable plasma sample volume deposited on PARAFILM carriers was 5 µl, and acetonitrile (ACN) was recommended as the optimal spray solvent for phospholipid (PL) profiling. Repeatability (87.5% of compounds with CV < 30%) and stability for data acquisition (48 h) were confirmed. Finally, the developed method was applied in phospholipidomics analysis of schistosomiasis, and a distinguished classification between control mice and infected mice was observed by using multivariate pattern recognition analysis, confirming the practical application of this new carrier material for DPS sampling and DESI-MS analysis. Compared with a previously reported method, the rapid metabolomics screening approach based on the implementation of DPS sampling coupled with the DESI-MS instrument developed in this study has increased analyte sensitivity, which may promote its further application in clinical studies.

Thionamide-induced Agranulocytosis: A Retrospective Analysis of 36 Patients With Hyperthyroidism.

OBJECTIVE: Agranulocytosis is a rare but serious adverse drug reaction (ADR) of thionamide antithyroid drugs (ATDs). We explored the characteristics of ADRs in patients with hyperthyroidism. METHODS: This retrospective study included 3558 inpatients with Graves disease treated in a Class A Grade 3 hospital between 2015 and 2019. The clinical presentation and laboratory workup of patients with antithyroid drug (ATD)-induced agranulocytosis was analyzed. RESULTS: Agranulocytosis was thought to be caused by ATDs in 36 patients. The hospital length of stay was 12 (10-16) days, and hospitalization costs were approximately $2810.89 ($2156.50-$4164.67). The median duration of ATD therapy prior to agranulocytosis development was 30 (20-40) days. Fever (83.33%) and sore throat (75%) were the most common symptoms as early signs of agranulocytosis. The lowest neutrophil counts were 0.01 (0.00-0.03) × 109/L and 0.14 (0.02-0.29) × 109/L in the methimazole and propylthiouracil groups, respectively (P = .037). The recovery times of agranulocytosis were 9.32 ± 2.89 days and 5.60 ± 4.10 days in the methimazole and propylthiouracil groups, respectively (P = .016). Patients with severe agranulocytosis required a longer time to recover (P < .001) and had closer to normal serum thyroxine and triiodothyronine levels. The interval between the first symptom of agranulocytosis and ATD withdrawal was 1 (0-3) day. CONCLUSIONS: Patients with agranulocytosis needed a long hospital length of stay and incurred high costs. Methimazole was prone to causing a more serious agranulocytosis than propylthiouracil. High thyroid hormone was unlikely to play a role in adverse drug reactions. Patient education is important.