This study focused on the current development status of global academic publishing in life sciences and medicine, against the backdrop of rapidly expanding research outputs from China in these fields. Despite continuous growth in China's academic achievements, challenges in boosting its academic standing and discourse power within the international scholarly community persist. This study systematically explores the geographical distribution of published papers in leading international life science and medical journals, track the dynamic changes in publication volume and manuscript rejection rates over a decade, identify key restrictive factors, and offer targeted policy recommendations to strengthen China's influence in the global academic system. In this study, seven globally recognized top-tier journals covering life sciences and clinical medicine were chosen as research subjects. Relevant publication data spanning from 2016 to 2025 were comprehensively retrieved and cross-verified via multiple reliable sources, mainly the Scopus database, official journal websites, Web of Science and PubMed. Manuscript rejection rate data were obtained from professional open access platforms specializing in academic publication statistics. Combined with typical case analysis, this paper conducts an in-depth, multidimensional investigation into factors affecting the publication of manuscripts submitted by Chinese researchers. The results indicated that China had witnessed a steady year-on-year increase in the number of published articles in these prestigious journals over the past ten years, with its global share of publications rising remarkably. Nevertheless, the rejection rate for manuscripts from Chinese authors had stayed at a relatively high level for a long time. Further analysis revealed three primary obstacles. First, the prevailing research evaluation system overly prioritized journal metrics and publication quantities, leading to mismatched submissions and weakened original research innovation. Second, Chinese scholars were underrepresented in the editorial boards and reviewer pools of international top journals, resulting in inadequate participation in journal governance and potential geographical bias during peer review. Third, heightened scrutiny triggered by publishing ethics concerns had also created additional barriers for Chinese submissions. Overall, a prominent structural contradiction exists in China's publication performance in top life science and medical journals: rapid growth in publication quantity coexists with persistently high rejection rates. To address this dilemma, we recommend reforming the research evaluation mechanism to prioritize the substantial academic value and practical contributions of research outcomes. It is also essential to encourage outstanding domestic scholars to take more active roles in international journal management and peer review. Additionally, China should accelerate the cultivation of world-class domestic academic journals, so as to establish an independent, open, and trustworthy platform for global academic communication and ultimately elevate China's international academic discourse power.