High-altitude exposure, characterized by hypobaric hypoxia, cold, and intense radiation, profoundly remodels the gut microbiota, triggering a cascade of physiological and pathological changes that extend far beyond the gastrointestinal tract. As millions travel to or reside in regions above 2500 meters, understanding this gut-centric axis has become critical for managing health risks. Hypoxia disrupts the delicate balance of the gut ecosystem, leading to dysbiosis, impaired barrier function, and increased intestinal permeability. This allows bacterial translocation and systemic inflammation, which underpin conditions like acute and chronic mountain sickness. Crucially, the gut microbiome acts as a dynamic environmental sensor; its altered production of metabolites—particularly short-chain fatty acids (SCFAs) and bile acids—directly influences host energy metabolism, immune responses, and acclimatization capacity. These changes are increasingly implicated in a spectrum of diseases, from metabolic disorders to colorectal cancer, positioning the gut as a central mediator of high-altitude health. This review synthesizes evidence from human and animal studies to elucidate how high-altitude stress reshapes the microbial landscape, explores the mechanisms linking microbiota to disease, and evaluates emerging microbiome-based interventions for promoting resilience.

Sequential anthracycline and trastuzumab therapy, while highly effective for HER2-positive breast cancer, carries a significant risk of cardiotoxicity, necessitating protective strategies. Qizaobaoxin Decoction (QZBXD), a modified Chinese herbal formula, has demonstrated potential in mitigating such cardiac damage. This investigation systematically delineates the chemical composition of QZBXD and elucidates its cardioprotective efficacy and underlying mechanisms against doxorubicin/trastuzumab (DOX/TRZ)-induced injury. Utilizing UPLC-Q-TOF-MS/MS analysis, 83 compounds were identified, predominantly flavonoids, organic acids, and phthalides. In a rat model of DOX/TRZ-induced cardiotoxicity, QZBXD administration significantly improved cardiac functional parameters, including left ventricular ejection fraction and fractional shortening. It also reduced serum biomarkers of myocardial injury and ameliorated histopathological damage. Mechanistically, multi-omics approaches revealed that QZBXD restored gut microbiota diversity, enriching beneficial bacteria like Bacteroides while suppressing detrimental genera such as Ruminococcus and Oscillibacter. Concurrently, untargeted metabolomics indicated modulation of tryptophan and arachidonic acid metabolic pathways. An integrated analysis established a gut microbiota-metabolite-cardiac axis, demonstrating that QZBXD's cardioprotection is mediated through microbial remodeling and subsequent metabolic reprogramming, providing a pharmacological foundation for its clinical application.

Fanconi anemia (FA), a rare genetic disorder marked by bone marrow failure, congenital anomalies, and cancer predisposition, often presents diagnostic challenges due to phenotypic overlap with other conditions. While FANCAgene mutations account for the majority of FA cases, the complexity of its clinical presentation necessitates comprehensive molecular analysis. This study elucidates the intricate diagnostic pathway for FANCA-related FA within a Chinese family, while simultaneously establishing a critical hereditary differential diagnosis for ectrodactyly (split-hand/foot malformation). Through integrated genomic approaches—including whole-genome sequencing, copy number variation (CNV) analysis, and functional assays—the research uncovers a co-occurrence of pathogenic FANCAmutations and a novel EHMT1splice-site variant. The findings demonstrate that the proband's hematological manifestations stem from biallelic FANCAdefects, whereas the limb anomaly segregates independently with an EHMT1variant, highlighting the necessity of disentangling complex phenotypes for accurate genetic counseling and management.

Diffuse large B-cell lymphoma (DLBCL) presenting with hyperlactatemia or lactic acidosis (LA) represents a rare, often fatal paraneoplastic phenomenon driven by tumor metabolism rather than hypoperfusion. This condition, classified as Type B LA, is frequently misdiagnosed as septic shock due to overlapping clinical features, leading to delayed oncologic intervention. A detailed analysis of two clinical cases combined with a systematic review of 19 published studies reveals critical prognostic thresholds: initial lactate levels between 5–14.9 mmol/L confer a significant survival advantage over levels of 15–24.9 mmol/L, and peak lactate concentration inversely correlates with survival time. Crucially, early initiation of chemotherapy-based regimens, rather than supportive care alone, significantly improves outcomes (P=0.026), establishing LA as an oncologic emergency requiring immediate hematologic workup. Adjunctive therapies, including sodium bicarbonate for severe acidemia and thiamine/Vitamin B supplementation to support mitochondrial function, may provide additional benefit, while medications exacerbating lactate production must be avoided.

This review presents recent progress in understanding the molecular control of rice grain size and nutritional quality, and spotlights emerging routes for their genetic improvement.

Myocardial infarction (MI) and subsequent ischemia-reperfusion injury trigger a devastating cascade of oxidative stress and cardiomyocyte death, largely driven by mitochondrial dysfunction and excessive reactive oxygen species (ROS) production. While the nuclear factor erythroid 2-related factor 2 (Nrf2) antioxidant pathway has been extensively studied in cardioprotection, the role of its homolog, Nrf3, remains less clear. Emerging evidence now positions Nrf3 not as a protective factor but as a novel pathogenic driver in post-MI cardiac injury. A pivotal study published in Circulation(Chen et al., 2025) revealed that Nrf3 is significantly upregulated in infarcted human and mouse hearts, where it promotes mitochondrial superoxide generation, exacerbates apoptosis, and impairs cardiac function by epigenetically suppressing the transcription factor Pitx2. This finding challenges the traditional view of the Nrf family as uniformly protective and identifies the Nrf3-Pitx2 axis as a promising therapeutic target for mitigating infarct size and adverse remodeling.

High-altitude environments, characterized by hypobaric hypoxia, intense ultraviolet radiation, and cold, are increasingly recognized as significant drivers of accelerated biological aging, posing complex public health challenges as human activity in these regions grows. While traditional views often focus on acute mountain sickness, emerging evidence from epidemiological, epigenetic, and microbiological studies reveals that prolonged exposure can decouple chronological age from biological age, leading to premature declines in cognitive, physical, and metabolic health. This commentary synthesizes recent research to argue that high-altitude living acts as a potent environmental stressor that accelerates the aging process through multiple interconnected pathways, albeit with notable paradoxes and dose-dependent effects that complicate a straightforward narrative.

Recent decades have witnessed unprecedented scientific growth driven by the convergence of clinical medicine, life sciences, information technology, materials science, and quantum computing. Landmark achievements such as the Human Genome Project, CRISPR-Cas9 gene editing, and multi-omics technologies have provided deep insights into human biology. Meanwhile, artificial intelligence, wearable devices, big data analytics, and the Internet of Medical Things have revolutionized medical data processing, clinical decision-making, and remote patient monitoring. These advances are accelerating drug development, digitalizing public health systems, and transforming medical diagnosis from experience-based practice to AI-augmented precision detection. Personalized medicine now benefits millions of cancer patients, while regenerative medicine offers new solutions for tissue and organ repair. Against this backdrop, the inaugural issue of MedScience is launched as the new identity of the Chinese Academy of Engineering medical journal. Originally established as Frontiers of Medicine in China in 2007 and renamed Frontiers of Medicine in 2011, the journal has achieved indexing in Scopus, PubMed/Medline, and SCI-E. The name MedScience embodies a commitment to both medical service and scientific rigor. The journal will focus on emerging fields including cell and gene therapy, AI-driven drug discovery, organoids, precision medicine, and environmental health, aiming to serve as a dynamic international platform that transcends disciplinary boundaries and contributes to global human health advancement.

Reliable water supply in large canal systems is often compromised by unpredictable lateral offtake discharges.

Researchers have developed a bioinspired cellulose-based cooling aerogel capable of reflecting nearly all incoming sunlight while efficiently releasing heat through the atmospheric infrared window. Inspired by the optical structure of white beetles, the material integrates nanocellulose and hygroscopic metal-organic frameworks to construct a hierarchical photonic scattering network spanning nanoparticles, microfibers, and macropores. The resulting aerogel achieved a solar reflectance of 95.8% and an infrared emissivity of 95%, enabling subambient daytime cooling of up to 7.1 °C under outdoor sunlight. The biodegradable material also demonstrated strong UV durability and the potential to reduce annual cooling energy consumption in buildings by more than 40% in hot regions of China.