In a visual effect perspective, it doesn't matter.
In semantic meaning, it matters since you're using emphasis and strong emphasis in the same element (Some text). It's the same as using h1
in some places just because you want big texts and not because they're titles.
EM: Indicates emphasis.
STRONG: Indicates stronger emphasis.
Source
The presentation of phrase elements
depends on the user agent. Generally,
visual user agents present EM text in
italics and STRONG text in bold font.
**Speech synthesizer user agents may
change the synthesis parameters, such
as volume, pitch and rate accordingly.
So beware. Use CSS to acomplish visual effects, not markup.