In late March, the Ministry of science and technology announced the latest batch of investigation and handling results of medical research integrity cases in some education and medical institutions, involving 55 research papers from 21 units and institutions, and notified more than 100 people. The proportion of falsification of papers in the medical field remains high, and many well-known universities are involved. As for the methods of falsification, they are still mainly the sale or writing of papers, the fabrication of research process, the falsification of research data, the falsification of correspondence author's mailbox, improper signature, etc. In fact, this is not the first official "roll call notification" of medical paper fraud. According to the media, only since June 2021, the National Health Commission and the Ministry of science and technology have published the investigation results of 20 batches of about 520 fake papers. Such a large-scale paper fraud can not be analyzed and attributed only from the perspective of micro cases. Why is medical paper fraud banned repeatedly? The author believes that falsifying papers has become a "rigid demand", which is affected by the guidance and reality of "paper only" in professional title evaluation. In the clinical medical industry, this "rigid demand" has also led to more tense contradictions. In addition, the punishment for counterfeiting is insufficient, and the verification of counterfeiting is relatively backward, which also makes many counterfeiters take chances. Many fake papers have not been effectively "intercepted" in the review link before publication, but mostly found in the link of post publication evaluation of professional titles, which also makes some people have the idea of muddling through. However, the more fundamental reason is that the diversified evaluation mechanism suitable for the characteristics of various majors has not been effectively established, and the "paper only" has not been effectively eliminated. Especially in the evaluation of senior professional titles, both the rigid requirements for papers and scientific research topics and the game rules of "only the most wins" in reality have raised the price of papers in disguised form. Some people believe that "publication is above everything", so they choose to take risks. It is necessary to investigate and expose the falsification of papers and release a clear signal of "zero tolerance" for academic falsification, which is also a part of cultivating academic ecology and social atmosphere. However, what is more important is to start from the source to prevent the emergence of false papers. The first gateway to prevention is, of course, the author. Almost all the authors of fake papers are well aware of the authenticity of their papers. Researchers should have a sense of awe, overcome their short-term utilitarian desire, cherish their professional reputation and academic life, and firmly hold the bottom line. The second pass is in all evaluation links of education and employment institutions. These relevant departments and institutions are responsible for supervision and should not interfere with professional judgment and evaluation. Those who participate in the evaluation of professional titles shall be objectively evaluated in strict accordance with the professional evaluation procedures. In terms of medicine, the completion of surgery with high professional level has the same value as the paper, but the clinical ability and the value of surgical technology of specific parties need to go through the identification procedure, which should be open and transparent. Relevant materials should be provided, and senior experts in the industry should write the identification opinions. The expert opinions written by experts shall be publicly subject to peer supervision. For those who issue impersonal and unprofessional expert opinions, not only their personal reputation is damaged, but also those with serious circumstances shall be held accountable. In August 2021, the National Health Commission issued the guiding opinions on deepening the reform of the professional title system of health professionals and technicians, which made it clear that in all links of professional title evaluation and post appointment, the number of papers and SCI (scientific Citation Index) and other relevant indicators were not used as preconditions and direct basis for evaluation, and the achievement representative work system was implemented. In addition to papers, clinical medical records, surgical videos, epidemiological investigation reports, emergency response reports, health standards, technical specifications, popular science works, technical patents, transformation of scientific research achievements, etc. can be reviewed as representative works of performance achievements. The key is to further refine these new systems into operable procedures for implementation. Or we can speed up the introduction of third-party evaluation in academic evaluation, professional title evaluation and performance appraisal, and accelerate the formation of a credible diversified comprehensive evaluation mechanism, so as to ensure the objectivity and fairness of talent evaluation to a greater extent. To curb paper counterfeiting, it is also necessary to strictly investigate and punish the companies involved in it, with writing and investment as the main business, and the journals suspected of "selling pages". Domestic universities and research institutions should also start self-examination, clean up untimely short-term utilitarian performance indicators, and curb the orientation of "paper only". (outlook new era)