Abstract: In recent years, the number of retractions of academic papers has continued to increase, especially medical papers, which has caused adverse social impacts. Taking the academic integrity issue of medical journals as the research object, the article believes that current medical journals mainly face issues such as AI tools generating academic papers, violating biomedical ethics norms, peer review fraud, and implicit academic integrity. This paper analyzes the reasons why academic misconduct continues despite repeated prohibition, and points out that medical journals should actively face up to the academic integrity issues that arise in their work, improve the standards for the use of AI tools, improve editors' ability to identify academic misconduct, increase punishment for academic misconduct, establish journal academic integrity alliances, etc., in order to curb bad habits that undermine healthy academic development and create a clean and upright academic environment for the development of medical journals.